| Abstract [eng] |
ABSTRACT: Background: Opioids have become one of the most prevalent treatment of pain and a commonly used medicine across the globe. The recent opioid crisis in the US and other parts of the world has strained the controlling and regulating authorities worldwide to evaluate the related on the use of opioids among the population and the adverse effects for the individual users. This reflects the critical nature of the issue and the need for a better treatment and care for people with pain. Aim: This research is aimed at the following objectives analyse opioid utilization rates in Lithuania, Sweden, and Norway between 2014 and 2021. Objectives: 1. Assess if there are any differences in total use of opioids through comparing wholesale data in Lithuania, Sweden, and Norway between 2014 and 2021. 2. Examine the distribution of different substances (opioids) in Lithuania, Sweden, and Norway between 2014 and 2021. 3. Assess sex- and age differences prescribing of opiods in Lithuania through comparison using two months for reference (2017-04 and 2017-06) Methodology: The study uses wholesale data records to compare the trends in opioid use across the three countries from 2014 to 2021. The comparative analysis provides key insights regarding the use trends and growth of opioid use in healthcare and medication. Moreover, Lithuanian prescription data has been used to get deeper insight into opioid utilization patterns between different sex and age groups. Results and conclusions: The research reveals that Norway and Sweden have reduced opioid use. At the same time, Lithuania has increased it due to a lack of regulation, opioid availability, and awareness of the consequences. Even though, it is still far lower than Norway and Sweden. Codeine, paracetamol, and tramadol were the most often used opioids in Norway, Sweden, and Lithuania, respectively. The key findings of this study are as follows: In Lithuania, Opioid usage increased progressively from 2014 (1.71 DDD/TID) to 2021 (3.26 DDD/TID). The use of fixed combination of codeine and paracetamol use slightly increased from 2014 (0.16 DDD/TID) to 2021 (0.38 DDD/TID), while tramadol remained constant at around 0.93 DDD/TID. Fentanyl use slightly increased from 2014 to 2021 (0.36-0.44 DDD/TID), while morphine use slightly decreased (0.23-0.19 DDD/TID). In April and June 2017, prescription amounts for females were higher than for males, and prescription amounts increased significantly from April to June for both sexes. The prescription amount across all the relevant matrices almost doubled between April and June 2017. In Norway, Opioid usage was highest in 2014 (19.93 DDD/TID) and lowest in 2021 (18.22 DDD/TID). Tramadol usage slightly reduced from 2014-2021 (4.09-3.94 DDD/TID). The utilization of codeine and paracetamol in fixed combinations was highest in 2014 (9.90 DDD/TID) and slightly reduced in 2021 (7.72 DDD/TID). Oxycodone usage was lowest in 2014 (1.94 DDD/TID) and increased substantially in 2021 (2.45 DDD/TID). Fentanyl usage reduced slightly from 2014 to 2021 (1.36-1.29 DDD/TID). Morphine usage showed a similar reduction pattern from 2014 to 2021 (1.17-1.06 DDD/TID). In Sweden, Opioid usage was highest to 2021 (17.67 DDD/TID) and lowest in 2021 (10.65 DDD/TID). Fixed combination of codeine and paracetamol usage were highest in 2014 (6.37 DDD/TID) and lowest in 2021 (3.86 DDD/TID). Tramadol usage was highest in 2014 (4.66 DDD/TID) and lowest in 2021 (1.70 DDD/TID). Oxycodone usage was lowest in 2014 (1.82 DDD/TID) and increased substantially in 2021 (2.24 DDD/TID). The research study identified large differences in trends of opioid utilization between three neighbouring countries. It promotes the significance of addressing the root causes of opioid usage in each country and there may be opportunies for learning between countries to utilise opioids more efficiently. Finally, it advocates safe opioid use, according to international healthcare organisation guidelines. |
