title: [Evolution of opiate use in two Primary Health Care Areas in the community of Madrid (Spain) and their referral hospitals between 2002 and 2006].
abstract: OBJECTIVE
  Describe the evolution of prescription opioids from 2002 to 2006 in Primary Health Care Area 2 and 5 in the Madrid Community and its referral hospitals (University Hospitals of la Princesa and La Paz).
  
  
  METHODS
  A retrospective observational study of prescriptions made by calculating defined daily doses per million inhabitants.
  
  
  RESULTS
  In Primary Care, transdermal fentanyl (78.39% of the total in 2006 in area 2 and 76.69% in the area 5) is the opioid prescribed most on the third step on the WHO analgesic ladder. This is followed by buprenofin (12.30% and 13.23%) and morphine (6.94% and 8.45%). As for the second step, tramadol is the most prescribed opioid with 85.12% and 83.56% of total consumption. We see a growth in consumption in the third step that goes from a defined daily doses per one million inhabitants of 897.67 in 2003 in area 5 and 1056.42 in area 2 to 1490.15 and 1601.48, respectively in 2006 and the second step goes from 1545.25 and 1629.94 in 2003 to 1904.70 and 1730.66 in both areas in 2006. In the hospitals analyzed, there is a similar progression, with a gradual increase in the use of fentanyl and a trend towards reduction in the consumption of morphine.
  
  
  CONCLUSIONS
  Our data reflect the increase in consumption of opioids, despite declining morphine. It is noteworthy that transdermal fentanyl is the opioid prescribed most.
authors.affiliation: Unidad de Cuidados Paliativos, Fundación Instituto San José, Madrid, España. druizlopez@telefonica.net
authors.forename: D
authors.initials: D
authors.lastname: Ruiz López
authors.forename: A
authors.initials: A
authors.lastname: Alonso Babarro
authors.forename: P
authors.initials: P
authors.lastname: Gómez Salcedo
authors.forename: M
authors.initials: M
authors.lastname: Varela Cerdeira
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D002391:Catchment Area, Health; D003153:Community Health Services / Q000706:statistics & numerical data*; D018450:Disease Progression; D054796:Drug Dosage Calculations; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D009293:Opioid-Related Disorders / Q000453:epidemiology* / Q000534:rehabilitation*; D010146:Pain / Q000188:drug therapy* / Q000453:epidemiology*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid