Che Suraya Zin1
1) Malaysia
It was reported that opioid consumption in developing countries was stagnated or decreased but precise data on the consumption are unclear. This study examined the trends and patterns of opioid consumption in Malaysia and other South-east Asian countries.
Data of five strong opioids consumption (morphine, oxycodone, fentanyl, pethidine and methadone) between 2005 and 2014 from Malaysia, Singapore, Indonesia, Thailand and Vietnam were extracted from the Pain & Policy Studies Group (PPSG). The PPSG is the WHO Collaborating Center for Pain Policy and Palliative Care that annually obtains opioid consumption data directly from the International Narcotics Control Board. The annual amount of opioid used was calculated as daily defined doses per 1000 inhabitants per day (DDD/1000 inhabitants/day) for each opioid in each country. Descriptive statistics and linear trend analysis were performed using Stata 13.
Over a 10-year study period, the total opioid consumption in Malaysia (11.2 DDD/1000 inhabitants/day) was higher than that of Vietnam (2.22), Singapore (1.79), Thailand (0.98) and Indonesia (0.38). Vietnam had the largest increase (8454.79%, p<0.0001) in the total opioid consumption followed by Malaysia (993.18%, p<0.0001), Indonesia (137.75%, P>0.05), Singapore (113.08%, P<0.005) and Thailand (102.86%, p<0.0001). Ninety percents of the total opioid consumption in Malaysia (10.16 DDD/1000 inhabitants/day) was contributed by methadone which was mainly used in the opioid dependence program. For pain management, fentanyl was predominantly used in Malaysia (0.431 DDD/1000 inhabitants/day) but the greatest increase was for oxycodone (79.5%, p<0.0001).
Malaysia has the highest opioid consumption compared to the other four South-east Asian countries, primarily for methadone. Although fentanyl was primarily used for pain management in Malaysia, the greatest increase was for oxycodone. Overall, all countries have demonstrated increasing trends of opioid consumption reflecting the improvement in the availability of opioid analgesics despite it being lower than global average.
C.S.Z was supported by a research grant from The Ministry of Education Malaysia (Fundamental Research Grant Scheme-FRGS 14-195-0436). The author would like to thank the Pain & Policy Studies Group for giving the permission to access the data.
