OBJECTIVES

: Appropriate treatment of pain because of affecting both individuals and society, is a significant International issue.

In clinical practice the major role of opioid drugs is the management of acute and chronic pain. Being initiated for a wide range of indications and the advent of different opioids with different aspects are the major reasons of ascending trend of opioid analgesics consumption. In addition, Opioids can pass through the blood-brain barrier and thus can be overused. Some patients, because of the fear of addiction, refrain from using them reasonably well. As a result, achieving balance in the rational consumption of opioids requires some investigations.

Our study aim is determining the total amount of opioids used for pain management and their trend of consumption during 2000-2019. In addition, unlike developed countries, there is no such study in our country.

METHODS : Annual sales information is obtained from Iran’s Food and Drug Organization, in which data are classified based on ATC/DDD system. We reported the amount of consumption based on Defined Daily Dose/1000 inhabitants/Day and OMEQ (oral morphine equivalent) /1000 inhabitants/Day. Methods such as mann kendall and SPSS have been used for analysis of data and statistical analysis, respectively.

RESULTS

: In general, the increase in strong opioid consumption persisted throughout the years 2000-2019, characterized by significant increases in oxycodone, fentanyl, buprenorphine, pethidine and to a lesser extent in morphine. Contrariwise, weak opioids such as tramadol and pentazocine utilization have been decreased. The number of opioids used in health system have been changed from 2 to 7 and the total consumption of opioids have been increased significantly, about 450 folds higher. We also have examined the possible reasons for this trend.

CONCLUSIONS : Providing a comprehensive plan of opioid analgesics utilization in Iran, make it possible to improve rational prescription and use of analgesics by some appropriate interventions.