Opioid use disorders national registries and opioids sales registries: A 10-year prevalence study from a middle-income country

Daniela Yucumá, MD; Ana Beatriz Pizarro, RN; Diego Alberto Moreno, MD; Juan David Mosos, MD; Marian Rincón-Montaña, MD; Diego Rosselli, MD

doi:10.5055/jom.2021.0671

Authors

Daniela Yucumá, MD https://orcid.org/0000-0002-3815-7244
Ana Beatriz Pizarro, RN https://orcid.org/0000-0003-4089-454X
Diego Alberto Moreno, MD
Juan David Mosos, MD
Marian Rincón-Montaña, MD
Diego Rosselli, MD

DOI:

https://doi.org/10.5055/jom.2021.0671

Keywords:

opioids, opioid use disorder, mental disorder, behavioral disorder

Abstract

Objectives: (1) To estimate the prevalence, geographic distribution, and demographic characteristics of patients diagnosed with mental and behavioral disorders due to the use of opioids in Colombia, between 2009 and 2018. (2) To describe the opioid sales trends in Colombia over the last few years.

Methods: We conducted an observational study analyzing information from Individual National Registry of Health Services and the Colombian official database for pharmaceuticals prices and quantities sold. The included ICD-10 codes were mental and behavioral disorders due to the use of opioids (F11) codes subdivisions.

Results: 12,557 cases of mental and behavioral disorders due to opioid use were reported, with a rate of 3.0 per 100,000 inhabitants for the studied period. Men represented 74.2 percent, with a male:female ratio of 2.9:1. The highest prevalence was found between 20 and 24 years, in the northwest Colombian area. A progressive increase in the total number of opioid units sold during the study period was found, and the most frequently sold opioids were tramadol (55 percent) and codeine (20 percent).

Conclusions: Recognition of opioid use disorders has increased in the last 10 years; it affects more males than females, mostly young adults, and is higher in certain affluent regions of Colombia. We found a progressive annual increase in the sales of opioids in the country, which could be related to the increase in the rate of registries. Studies that have analyzed opioid abuse in Latin America are limited, and further studies are needed to evaluate this situation in middle-income countries from the region.

Author Biographies

Daniela Yucumá, MD

Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia

Ana Beatriz Pizarro, RN

Clinical Research Center, Fundación Valle del Lili, Cali, Colombia

Diego Alberto Moreno, MD

Assistant Professor, Department of Anesthesia, Faculty of Medicine, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia

Juan David Mosos, MD

Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia

Marian Rincón-Montaña, MD

Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia

Diego Rosselli, MD

Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia

References

Strang J, Volkow ND, Degenhardt L, et al.: Opioid use disorder. Nat Rev Dis Prim. 2020; 6(1): 3.

Vadivelu N, Kai AM, Kodumudi V, et al.: The opioid crisis: A comprehensive overview. Curr Pain Headache Rep. 2018; 22(3): 16.

Kolodny A, Courtwright DT, Hwang CS, et al.: The prescription opioid and heroin crisis: A public health approach to an epidemic of addiction. Annu Rev Public Health. 2015; 36(1): 559-574.

Salmond S, Allread V, Marsh R: Management of opioid use disorder treatment: An overview. Orthop Nurs. 2019; 38(2): 118-126.

Manchikanti L, Helm S, Fellows B, et al.: Opioid epidemic in the United States. Pain Phys. 2012; 15(3 Suppl.): ES9-ES38.

Kunnumpurath S, Julien N, Kodumudi G, et al.: Global supply and demand of opioids for pain management. Curr Pain Headache Rep. 2018; 22(5): 34.

Birnbaum HG, White AG, Schiller M, et al.: Societal costs of prescription opioid abuse, dependence, and misuse in the United States. Pain Med. 2011; 12(4): 657-667.

Rudd RA, Seth P, David F, et al.: Increases in drug and opioid-involved overdose deaths—United States, 2010-2015. MMWR Morb Mortal Wkly Rep. 2016; 65(5051): 1445-1452.

Rico MA, Kraychete DC, Iskandar AJ, et al.: Use of opioids in Latin America: The need of an evidence-based change. Pain Med. 2016; 17(4): 704-716.

Meucci RD, Fassa AG, Faria NM: Prevalence of chronic low back pain: Systematic review. Rev Saude Publica. 2015; 49(1): 1.

de Moraes Vieira EB, Santos Garcia JB, Moura da Silva AA, et al.: Prevalence, characteristics, and factors associated with chronic pain with and without neuropathic characteristics in Sao Luis, Brazil. J Pain Symptom Manage. 2012; 44(2): 239-251.

Santos Garcia JB: Change pain Latin America: New initiative established to enhance management of patients with chronic pain in Latin America. Brazi J Anesthesiol. 2014; 64(2): 140-142.

Díaz Cabezas R, Marulanda Mejía F, Sáenz X: Estudio epidemiológico del dolor crónico en Caldas, Colombia (estudio dolca). Acta Med Colomb. 2009; 34(3): 96-102.

Bilbeny N, Miranda JP, Eberhard ME, et al.: Survey of chronic pain in Chile—Prevalence and treatment, impact on mood, daily activities and quality of life. Scand J Pain. 2018; 18(3): 449-456.

Díaz R, Marulanda F: Dolor crónico nociceptivo y neuropático en población adulta de manizales (Colombia). Acta Med Col. 2019; 36(1): 10-17.

Gomes Dellaroza MS, de Mattos Pimenta CA, Lebrao ML, et al.: Association of chronic pain with the use of health care services by older adults in Sao Paulo. Rev Saude Publica. 2013; 47(5): 914-922.

Knaul FM, Farmer PE, Krakauer EL, et al.: Alleviating the access abyss in palliative care and pain relief—An imperative of universal health coverage: The lancet commission report. Lancet. 2018; 391(10128): 1391-1454.

Observatorio de Drogas de Colombia, Ministerio de Salud y Protección Social, Ministerio de Justicia y del Derecho: Estudio nacional de consumo de sustancias psicoactivas en Colombia. 2013. Available at https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/GCFI/Estudio%20de%20Consumo%20SPA%20EN%20HOGARES%202013.pdf. Accessed June 4, 2020.

Furlan AD, Harvey AM, Chadha R: Warning from Canada: Latin America, South Africa and India may face an opioid epidemic in the coming years. J Glob Health. 2020; 10(1): 010324.

Pacurucu-Castillo SF, Ordóñez-Mancheno JM, Hernández-Cruz A, et al.: World opioid and substance use epidemic: A Latin American perspective. Psych Res Clin Pract. 2019; 1(1): 38-42.

Vowles KE, McEntee ML, Julnes PS, et al.: Rates of opioid misuse, abuse, and addiction in chronic pain: A systematic review and data synthesis. Pain. 2015; 156(4): 569-576.

Muhuri PK, Gfroerer JC, Davies MC: Associations of nonmedical pain reliever use and initiation of heroin use in the United States. CBHSQ Data Rev. 2013. Available at https://www.samhsa.gov/data/sites/default/files/DR006/DR006/nonmedicalpain-reliever-use-2013.htm. Accessed June 4, 2020.

Cicero TJ, Ellis MS, Surratt HL, et al.: The changing face of heroin use in the United States: A retrospective analysis of the past 50 years. JAMA Psychiatry. 2014; 71(7): 821-826. DOI: 10.1001/jamapsychiatry.2014.366.

Lzak L, Halverson J: The opioid crisis in Canada: A national perspective. Health Promot Chronic Dis Prev Can. 2018; 38(6): 224-233.

Machado-Duque M, Ramírez-Valencia D, Murillo-Muñoz M, et al.: Trends in opioid use in a cohort of patients with rheumatoid arthritis. Pain Res Manag. 2020; 2020(2): 1-6.

Sanchez MA, Leon MX, Rodriguez LF, et al.: Anuario Observatorio Colombiano de Cuidados Paliativos 2017. Bogotá: Editorial Universidad El Bosque, 2018. Available at https://occp.com.co/wp-content/uploads/2018/11/anuario2018.pdf. Accessed June 4, 2020.