• Cristina Bosetti, Claudia Santucci, Silvia Radrezza, Juliana Erthal, Stefano Berterame, and Oscar Corli.
• Laboratory of Methodology for Clinical Research, Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.
• Eur J Pain. 2019 Apr 1; 23 (4): 697-707.

BackgroundOver the last decades, consumption of opioids for the treatment of pain increased steadily in the United States, Australia, and a few European countries. To date, no study has analysed time trends in opioid consumption across Europe.MethodsWe analysed data provided by International Narcotics Control Boards on the consumption of fentanyl, oxycodone, morphine, hydromorphone and pethidine in 40 European countries over the last decade. Trends in total opioid consumption from 1990 to 2016 in 22 selected European countries, the European Union (EU) as a whole, and, for comparison purpose, the United States, were analysed using the joinpoint regression analysis.ResultsIn 2014-2016, opioid use was >10,000 defined daily doses for statistical purposes (s-DDD) per 1,000,000 inhabitants die in Western/Northern countries, whereas it was <1000 s-DDD in Southern/Eastern ones. In most European countries, opioid consumption increased to a great extent between 2004-2006 and 2014-2016; it rose from 6,477 to 8,967 s-DDD (+38.4%) in the EU, and from 14,598 to 16,491 s-DDD (+13%) in the United States. The increase in opioid use was steady since the early to mid-1990s in most European countries and it slowed down after the mid- to late 2000s. In Denmark, Finland, France, Ireland, Switzerland, Poland and the EU, opioid use levelled off or declined over most recent years.ConclusionsConsumption of opioid analgesics sharply increased in most of European countries since the early to mid-1990s. This notwithstanding, in the mid-2010s there was still a more than 10-fold difference between the highest consumption in Western/Northern countries and the lowest one in Southern/Eastern countries.SignificanceThis study provides an updated and comprehensive analysis of time trends and geographic variations in opioid consumption use across European countries over the last three decades.© 2018 European Pain Federation - EFIC®.

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