Noa Krawczyk and M. Claire Greene are with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Rafaela Zorzanelli is with the Social Medicine Institute of the State University of Rio de Janeiro, Rio de Janeiro, Brazil. Francisco I. Bastos is with the FIOCRUZ-Oswaldo Cruz Foundation, Rio de Janeiro.
Am J Public Health. 2018 May;108(5):666-668. doi: 10.2105/AJPH.2018.304341. Epub 2018 Mar 22.
To present and discuss recent patterns of prescription opioid sales throughout Brazil.
We graphed linear trends of opioid prescriptions sold from registered pharmacies across Brazil from 2009 to 2015. We then calculated the change in rate of prescriptions sold per 1000 persons in 2015 compared with 2009.
Opioid sales increased across Brazil from 1 601 043 prescriptions in 2009 to 9 045 945 prescriptions in 2015, corresponding to a 465% increase in 6 years. The largest absolute increase was for codeine products (rate ratio (RR) = 5.30; 95% confidence interval [CI] = 5.29, 5.31), accounting for more than 98% of prescriptions in both years. Oxycodone had the largest relative increase (RR = 11.39; 95% CI = 11.19, 11.59), and fentanyl products had the smallest absolute and relative increase (RR = 2.91; 95% CI = 2.78, 3.03).
Given rapid increases in opioid sales across Brazil, it is critical to introduce effective prescribing and monitoring methods that allow patients to access necessary medications without escalating risk of opioid misuse and related consequences. Careful surveillance of supply and subsequent outcomes are needed to prevent the development of another devastating opioid epidemic in the Americas.
呈现并讨论巴西各地处方类阿片销售的最新模式。
我们对巴西各地注册药店 2009 年至 2015 年期间销售的类阿片处方进行线性趋势分析。然后计算 2015 年与 2009 年相比，每千人销售处方数量的变化率。
巴西各地的类阿片销售从 2009 年的 1601043 张处方增加到 2015 年的 9045945 张处方，6 年内增长了 465%。绝对增幅最大的是可待因产品（率比（RR）=5.30；95%置信区间[CI] = 5.29，5.31），占这两年处方的 98%以上。羟考酮的相对增幅最大（RR = 11.39；95% CI = 11.19，11.59），而芬太尼产品的绝对和相对增幅最小（RR = 2.91；95% CI = 2.78，3.03）。
鉴于巴西各地类阿片销售的快速增长，引入有效的处方和监测方法至关重要，这可以使患者在不增加阿片类药物滥用风险和相关后果的情况下获得必要的药物。需要仔细监测供应情况和随后的结果，以防止在美洲再次出现另一场毁灭性的阿片类药物流行。
