Zin Che Suraya
Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia.
J Pharm Bioallied Sci. 2020 Nov;12(Suppl 2):S846-S851. doi: 10.4103/jpbs.JPBS_252_19. Epub 2020 Nov 5.
It was reported that opioid consumption in developing countries was stagnated or decreased, but precise data on the consumption are unclear. This study examined the trends and patterns of opioid consumption in Malaysia and other four Southeast Asian countries.
Data of five strong opioids consumption (morphine, oxycodone, fentanyl, pethidine, and methadone) between 2005 and 2014 from Malaysia, Singapore, Indonesia, Thailand, and Vietnam were extracted from the Pain and Policy Studies Group. Defined daily doses per 1000 inhabitants per day (DDD/1000 inhabitants/day) was used for calculating the annual amount of opioid use.
The total consumption of five strong opioids was increased in all five Southeast Asian countries during a 10-year study period. Malaysia was recorded with the largest increase of the opioid consumption (993.18%), followed by Indonesia (530.34%), Vietnam (170.17%), Singapore (116.16%), and Thailand (104.66%). Malaysia also had the highest total strong opioid consumption (11.2 DDD/1000 inhabitants/day), primarily for methadone. Among the opioids used for pain management, fentanyl was primarily used in Malaysia and Singapore but the greatest increase in these two countries was for oxycodone. Fentanyl was also primarily used in Indonesia while morphine was predominantly used in Thailand and Vietnam.
Growing trends of strong opioids consumption in all five Southeast Asian countries demonstrated in this study may indicate improved access to opioid analgesics in these countries. Given the increasing trends, it is important to ensure that the utilization of opioids is according to the guideline to prevent the negative consequences of opioids particularly when used in chronic non-cancer pain.
据报道，发展中国家的阿片类药物消费量停滞不前或有所下降，但关于消费量的精确数据尚不清楚。本研究调查了马来西亚及其他四个东南亚国家阿片类药物消费的趋势和模式。
从疼痛与政策研究小组提取了2005年至2014年期间马来西亚、新加坡、印度尼西亚、泰国和越南五种强效阿片类药物（吗啡、羟考酮、芬太尼、哌替啶和美沙酮）的消费数据。使用每1000居民每天的限定日剂量（DDD/1000居民/天）来计算阿片类药物的年使用量。
在为期10年的研究期间，所有五个东南亚国家的五种强效阿片类药物的总消费量均有所增加。马来西亚的阿片类药物消费量增幅最大（993.18%），其次是印度尼西亚（530.34%）、越南（170.17%）、新加坡（116.16%）和泰国（104.66%）。马来西亚的强效阿片类药物总消费量也最高（11.2 DDD/1000居民/天），主要是美沙酮。在用于疼痛管理的阿片类药物中，芬太尼主要在马来西亚和新加坡使用，但这两个国家增幅最大的是羟考酮。芬太尼在印度尼西亚也主要被使用，而吗啡在泰国和越南占主导地位。
本研究表明，所有五个东南亚国家的强效阿片类药物消费呈增长趋势，这可能表明这些国家阿片类镇痛药的可及性有所改善。鉴于这种增长趋势，重要的是要确保阿片类药物的使用符合指南，以防止阿片类药物的负面后果，尤其是在用于慢性非癌性疼痛时。
