Esteban Zavaleta-Monestel, Sebastián Arguedas-Chacón, Jeaustin Mora-Jiménez, Carlos Wu-Chin, Roberto Rodríguez-Miranda
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引用次数: 0
Abstract
Introduction: The global opioid crisis has highlighted substantial differences in prescribing, monitoring, and regulatory practices across health systems. In Costa Rica, comprehensive national data on opioid use have been limited. This study aimed to describe temporal trends in legally prescribed opioid consumption between 2017 and 2024 using nationwide administrative data.
Methods: A nationwide, retrospective, population-based analysis was conducted using data from the Costa Rican Ministry of Health's narcotics registry. Dispensation records for morphine, methadone, fentanyl, oxycodone, and tapentadol were included. Opioid consumption was standardized to Morphine Milligram Equivalents (MME) using NIH HEAL conversion factors. Temporal trends were assessed using descriptive statistics and simple linear regression.
Results: A total of 31.9 million opioid dispensations were recorded during the study period. National opioid consumption peaked in 2018 (395.1 million MME), followed by an approximate 70% decline through 2023 and a modest increase in 2024. Consumption of morphine and methadone declined substantially (-72.2% and -82.4%, respectively), while oxycodone and tapentadol showed moderate increases over time. These findings indicate a marked reduction in overall opioid consumption alongside changes in the distribution of use across opioid agents.
Conclusions: Between 2017 and 2024, Costa Rica experienced a sustained decline in total opioid dispensing and a redistribution of opioid use across substances. These trends occurred in the context of strengthened regulatory oversight and expanded digital monitoring of controlled substances. While causal relationships cannot be established, the findings provide relevant population-level evidence to support opioid stewardship and inform regulatory and public health strategies in middle-income health systems.
期刊介绍：
The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report.
Particular areas of interest include:
design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology;
comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world;
methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology;
assessments of harm versus benefit in drug therapy;
patterns of drug utilization;
relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines;
evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.
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