Trends in opioid analgesics consumption, Israel, 2000-2008.
OBJECTIVE
To describe trends in opioid consumption in Israel (morphine, methadone, oxycodone, pethidine, fentanyl, buprenorphine, codeine, and dextropropoxyphene) over the 9 years, 2000-2008, and to explore explanations for changes in consumption, in amounts and the pattern.


METHODS
Data for the 2000-2008 period (all treatment settings, private and public) were drawn from the database maintained by the Israel Ministry of Health's Pharmaceutical Administration. The data were converted into a defined daily dose (DDD)/1,000 inhabitants/day.


RESULTS
Consumption of the five strong opioids (requiring a special prescription form) increased by 47%, from 2.46 DDD/1,000 inhabitants per day in 2000 to 3.61 DDD/1,000 inhabitants per day in 2008. This rise was mainly the result of a 4-fold increase in fentanyl consumption from 0.32 DDD/1,000 inhabitants per day in 2000 to 1.28 DDD/1,000 inhabitants per day in 2008. Oxycodone and methadone consumption levels increased moderately, and buprenorphine and dextropropoxyphene consumption rose drastically, whereas morphine, pethidine, and codeine use significantly fell.


CONCLUSIONS
There has been a modest increase in opioid consumption in the years 2000-2008. This has been associated with substantial changes in the pattern of differential opioid prescribing characterized by increased prescription of oxycodone, fentanyl, buprenorphine, and dextropropoxyphene, and decreases in morphine, pethidine, and codeine.
Mental Health Services, Ministry of Health, 2 Ben Tabai Street, 93591 Jerusalem, Israel. alexander.ponizovsky@moh.health.gov.il
Alexander M
AM
Ponizovsky
Eli
E
Marom
Alexander
A
Zeldin
Nathan I
NI
Cherny
D000701:Analgesics, Opioid / Q000008:administration & dosage*; D011307:Drug Prescriptions; D004363:Drug Utilization / Q000639:trends*; D006801:Humans; D007557:Israel; D010818:Practice Patterns, Physicians' / Q000639:trends*
D000701:Analgesics, Opioid