Use of prescription opioids in Israel and socio-economic correlations between 2010 and 2020
Abstract Background The use of opioids has increased dramatically over the past several years in Israel. The aim of this study was to explore the trends of opioid consumption in Israel over a decade (2010–2020) stratified by socioeconomic status (SES), residence in the periphery, and ethnic backgrou...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-03-01
|
| Series: | Israel Journal of Health Policy Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13584-024-00598-9 |
| _version_ | 1827321465009078272 |
|---|---|
| author | Limor Adler Bar Cohen Shirley Shapiro Ben Daviv Ori Liran Daniella Rahamim-Cohen Afif Nakhleh Arnon Shahar Joseph Azuri |
| author_facet | Limor Adler Bar Cohen Shirley Shapiro Ben Daviv Ori Liran Daniella Rahamim-Cohen Afif Nakhleh Arnon Shahar Joseph Azuri |
| author_sort | Limor Adler |
| collection | DOAJ |
| description | Abstract Background The use of opioids has increased dramatically over the past several years in Israel. The aim of this study was to explore the trends of opioid consumption in Israel over a decade (2010–2020) stratified by socioeconomic status (SES), residence in the periphery, and ethnic background. Methods This cross-sectional study included all adult Maccabi Healthcare Services (MHS) patients who filled at least one prescription for opioids during the past decade. In order to standardize dosages and compare different opioid medications, we used the Morphine Milligram Equivalent (MME) conversion factor. We performed The Mann–Kendall test with autocorrelation correction to assess each trend. We then checked the differences between the trends with the Mann–Whitney test (for periphery) and the Kruskal Wallis (for SES and ethnic background). Results Between the years 2010–2020, 261,270 MHS members met the study's inclusion criteria. The proportions of opioids consumption were 23.9/1000 patients in 2010 and 27.6/1000 patients in 2020, representing a 15% increase. The average daily consumption of opioids was 4.6 and 10.5 MME in 2010 and 2020, respectively, an increase of 227%. The daily MME during 2020 was higher for residents of the periphery compared to non-periphery residents (daily MME of 14.0 compared to 10.1, respectively). Average daily MME increased gradually during the study period for all levels of SES; the values were highest for the low SES group and the lowest for the high SES group (daily MME in 2020 for the lowest, middle, and high SES groups were 15.2 vs. 11.8 vs. 6.7 respectively). Conclusions This study highlights that the primary concern in the increase of opioid use is the increasing dosages. The increase in the number of patients using opioids is also significant but to a minor extent. These phenomena disproportionately impact vulnerable populations. Education programs should be offered to physicians regarding the possible harms of long-term use of opioids. These programs should emphasize the risk factors associated with the development of opioid use disorder (OUD) and the caution needed when increasing dosages or switching to higher-potency drugs. Pain clinics and centers for rehabilitation for patients with chronic pain or OUD should be available, not only in central areas but also in the periphery of the country. These clinics and centers should use a holistic approach and a multidisciplinary team that includes specialists in pain and addiction. They should be financially accessible for patients from low SES group and provide solutions in multiple languages. |
| first_indexed | 2024-04-25T01:06:38Z |
| format | Article |
| id | doaj.art-fc2ec35cf7d148849326459b4008aeb5 |
| institution | Directory Open Access Journal |
| issn | 2045-4015 |
| language | English |
| last_indexed | 2024-04-25T01:06:38Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Israel Journal of Health Policy Research |
| spelling | doaj.art-fc2ec35cf7d148849326459b4008aeb52024-03-10T12:14:36ZengBMCIsrael Journal of Health Policy Research2045-40152024-03-011311910.1186/s13584-024-00598-9Use of prescription opioids in Israel and socio-economic correlations between 2010 and 2020Limor Adler0Bar Cohen1Shirley Shapiro Ben Daviv2Ori Liran3Daniella Rahamim-Cohen4Afif Nakhleh5Arnon Shahar6Joseph Azuri7Health Division, Maccabi Healthcare ServicesDepartment of Family Medicine, Faculty of Medicine, Tel Aviv UniversityHealth Division, Maccabi Healthcare ServicesHealth Division, Maccabi Healthcare ServicesHealth Division, Maccabi Healthcare ServicesDiabetes and Endocrinology Clinic, Maccabi Healthcare ServicesHealth Division, Maccabi Healthcare ServicesHealth Division, Maccabi Healthcare ServicesAbstract Background The use of opioids has increased dramatically over the past several years in Israel. The aim of this study was to explore the trends of opioid consumption in Israel over a decade (2010–2020) stratified by socioeconomic status (SES), residence in the periphery, and ethnic background. Methods This cross-sectional study included all adult Maccabi Healthcare Services (MHS) patients who filled at least one prescription for opioids during the past decade. In order to standardize dosages and compare different opioid medications, we used the Morphine Milligram Equivalent (MME) conversion factor. We performed The Mann–Kendall test with autocorrelation correction to assess each trend. We then checked the differences between the trends with the Mann–Whitney test (for periphery) and the Kruskal Wallis (for SES and ethnic background). Results Between the years 2010–2020, 261,270 MHS members met the study's inclusion criteria. The proportions of opioids consumption were 23.9/1000 patients in 2010 and 27.6/1000 patients in 2020, representing a 15% increase. The average daily consumption of opioids was 4.6 and 10.5 MME in 2010 and 2020, respectively, an increase of 227%. The daily MME during 2020 was higher for residents of the periphery compared to non-periphery residents (daily MME of 14.0 compared to 10.1, respectively). Average daily MME increased gradually during the study period for all levels of SES; the values were highest for the low SES group and the lowest for the high SES group (daily MME in 2020 for the lowest, middle, and high SES groups were 15.2 vs. 11.8 vs. 6.7 respectively). Conclusions This study highlights that the primary concern in the increase of opioid use is the increasing dosages. The increase in the number of patients using opioids is also significant but to a minor extent. These phenomena disproportionately impact vulnerable populations. Education programs should be offered to physicians regarding the possible harms of long-term use of opioids. These programs should emphasize the risk factors associated with the development of opioid use disorder (OUD) and the caution needed when increasing dosages or switching to higher-potency drugs. Pain clinics and centers for rehabilitation for patients with chronic pain or OUD should be available, not only in central areas but also in the periphery of the country. These clinics and centers should use a holistic approach and a multidisciplinary team that includes specialists in pain and addiction. They should be financially accessible for patients from low SES group and provide solutions in multiple languages.https://doi.org/10.1186/s13584-024-00598-9Opioid usageSocioeconomic statusPeripherial residencyArab populationOrthodox-JewsMinorities |
| spellingShingle | Limor Adler Bar Cohen Shirley Shapiro Ben Daviv Ori Liran Daniella Rahamim-Cohen Afif Nakhleh Arnon Shahar Joseph Azuri Use of prescription opioids in Israel and socio-economic correlations between 2010 and 2020 Israel Journal of Health Policy Research Opioid usage Socioeconomic status Peripherial residency Arab population Orthodox-Jews Minorities |
| title | Use of prescription opioids in Israel and socio-economic correlations between 2010 and 2020 |
| title_full | Use of prescription opioids in Israel and socio-economic correlations between 2010 and 2020 |
| title_fullStr | Use of prescription opioids in Israel and socio-economic correlations between 2010 and 2020 |
| title_full_unstemmed | Use of prescription opioids in Israel and socio-economic correlations between 2010 and 2020 |
| title_short | Use of prescription opioids in Israel and socio-economic correlations between 2010 and 2020 |
| title_sort | use of prescription opioids in israel and socio economic correlations between 2010 and 2020 |
| topic | Opioid usage Socioeconomic status Peripherial residency Arab population Orthodox-Jews Minorities |
| url | https://doi.org/10.1186/s13584-024-00598-9 |
| work_keys_str_mv | AT limoradler useofprescriptionopioidsinisraelandsocioeconomiccorrelationsbetween2010and2020 AT barcohen useofprescriptionopioidsinisraelandsocioeconomiccorrelationsbetween2010and2020 AT shirleyshapirobendaviv useofprescriptionopioidsinisraelandsocioeconomiccorrelationsbetween2010and2020 AT oriliran useofprescriptionopioidsinisraelandsocioeconomiccorrelationsbetween2010and2020 AT daniellarahamimcohen useofprescriptionopioidsinisraelandsocioeconomiccorrelationsbetween2010and2020 AT afifnakhleh useofprescriptionopioidsinisraelandsocioeconomiccorrelationsbetween2010and2020 AT arnonshahar useofprescriptionopioidsinisraelandsocioeconomiccorrelationsbetween2010and2020 AT josephazuri useofprescriptionopioidsinisraelandsocioeconomiccorrelationsbetween2010and2020 |