Willem K. Scholten is with Mech-Sense, Aalborg University Hospital, Aalborg, Denmark, and Willem Scholten Consultancy, Lopik, the Netherlands. Ann-Eva Christensen is with the Unit of Epidemiology and Biostatistics, Aalborg University Hospital. Anne Estrup Olesen and Asbjørn Mohr Drewes are with Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, and Department of Clinical Medicine, Aalborg University, Aalborg. Anne Estrup Olesen is also with Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Am J Public Health. 2019 Jan;109(1):52-57. doi: 10.2105/AJPH.2018.304753. Epub 2018 Nov 29.
Opioid analgesics are the mainstay for treatment of moderate and severe pain but, in many countries, the consumption of these medicines is inadequate. Over time, various groups have published opioid analgesic metrics, including authors from the World Health Organization. They linked consumption to a level considered adequate based on the actual consumption in developed countries. In this study, we present our current results on the adequacy of opioid analgesic consumption. We included statistics for 18 controlled opioid medicines that are primarily used as analgesics, and we developed the Adequacy of Opioid Consumption (AOC) Index. The average of the 20 most developed countries for 2015 is set as equal to an AOC Index of 100. An AOC Index of 100 or higher is considered adequate consumption. The average opioid analgesic consumption of the top-20 countries of the Human Development Index increased from 84 morphine milligram equivalents per capita (2000) to 256 morphine milligram equivalents per capita (2015). The extremes we found for 2015 were Germany (AOC Index: 304) and Nigeria (AOC Index: 0.0069). These extremes differ by 44 000 times. Adequacy of opioid analgesic consumption continues to be problematic around the world.
阿片类镇痛药是治疗中重度疼痛的主要药物，但在许多国家，这些药物的用量不足。随着时间的推移，不同的组织已经发布了阿片类镇痛药的指标，其中包括世界卫生组织的作者。他们将消耗量与基于发达国家实际消耗量的被认为足够的水平联系起来。在这项研究中，我们报告了我们目前关于阿片类镇痛药消耗充足性的结果。我们纳入了主要用作镇痛药的 18 种受控阿片类药物的统计数据，并开发了阿片类药物消耗充足性指数（AOC 指数）。2015 年 20 个最发达国家的平均值设定为 AOC 指数为 100。AOC 指数等于或高于 100 被认为是充足的消耗量。人类发展指数前 20 名国家的平均阿片类镇痛药消耗量从 2000 年的每人 84 吗啡毫克当量增加到 2015 年的每人 256 吗啡毫克当量。我们在 2015 年发现的极端情况是德国（AOC 指数：304）和尼日利亚（AOC 指数：0.0069）。这两个极端情况相差 44000 倍。阿片类镇痛药消耗的充足性仍然是全球范围内的一个问题。
