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Trends in pharmaceutical opioid consumption in the World Health Organization Eastern Mediterranean Region, 2010–2019

Background: Pharmaceutical opioid consumption has been increasing worldwide, yet disparities in access to these medications still exist. Few countries of the World Health Organization Eastern Mediterranean Region have well defined pain management policies. Aims: To present trends in the consumption of pharmaceutical opioids in the 22 countries in the Eastern Mediterranean Region from 2010 to 2019, with a comparative intra- and extra-regional analysis; to analyse the correlation between pharmaceutical opioid consumption and human development index rankings; and to identify the pharmaceutical opioids used in the region. Methods: We calculated defined daily doses for statistical purposes (S-DDD) per million inhabitants per day of pharmaceutical opioids from 2010 to 2019, and used mixed effects models to assess changes in consumption. We used regression analyses to establish the strength of associations between human development index level and consumption in the region and elsewhere. Results: Pharmaceutical opioid use has fluctuated in the region since 2010, with a mean sum of S-DDD of 2547 for 2010–2019. Consumption is relatively low in the region irrespective of human development index level. The highest-consuming country reported 369 S-DDD in 2019 and the lowest 1 S-DDD. The most consumed pharmaceutical opioids in the region were fentanyl, morphine, pethidine, oxycodone and codeine. Conclusion: Consumption could be considered inadequate or very inadequate in several countries of the region. Supporting these countries to improve collection and reporting of consumption data, and providing humanitarian assistance to enhance access to pain relief should be a priority for the international community.