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首页> 外文期刊>Substance Abuse Treatment, Prevention, and Policy >Opioid use, regulation, and harms in Brazil: a comprehensive narrative overview of available data and indicators
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Opioid use, regulation, and harms in Brazil: a comprehensive narrative overview of available data and indicators

机译：巴西的阿片类药用，监管和危害：全面的可用数据和指标叙述概述

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Global opioid consumption increased multifold post-2000, disproportionately in high-income countries, with severe mortality/morbidity consequences. Latin America features comparatively low opioid availability; Brazil, the region’s most populous country, makes an interesting case study concerning opioid use/harms. In this comprehensive overview, we aimed to identify and summarize medical and non-medical data and indicators of opioid availability and use, regulation/control, and harm outcomes in Brazil since 2000. We searched multiple scientific databases to identify relevant publications and conducted additional ‘grey’ literature searches to identify other pertinent information. Despite some essential indicators, opioid-related data are limited for Brazil. Data indicate that population-level availability of prescription opioids represents only a small fraction of use in comparison to high-income countries. However, within Latin America, Brazil ranks mid-level for opioid consumption, indicating relatively moderate consumption compared to neighboring jurisdictions. Brazil has implemented restrictive regulations to opioid prescribing and is considered ‘highly restricted’ for opioid access. Codeine remains the major opioid analgesic utilized, but stronger opioids such as oxycodone are becoming more common. Professional knowledge regarding medical opioid use and effects appears limited. National surveys indicate increases in non-medical use of prescription opioids, albeit lower than observed in North America, while illicit opioids (e.g., heroin) are highly uncommon. Overall population-level opioid availability and corresponding levels of opioid-related harms in Brazil remain substantially lower than rates reported for North America. However, the available surveillance and analytical data on opioid use, policy/practice, and harms in Brazil are limited and insufficient. Since existing and acute (e.g., pain-related) needs for improved opioid utilization and practice appear to be substantiated, improved indicators for and understanding of opioid use, practice, and harms in Brazil are required.
机译：全球阿片类药物消费量增加了2000年后的多重职位，在高收入国家，具有严重的死亡率/发病率后果。拉丁美洲的特征相对低，阿片类药物可用性低;该地区大多数人口众多的国家巴西，有关表述的使用/危害的有趣案例研究。在这一全面的概述中，我们旨在自2000年以来识别和总结巴西阿片式可用性和使用，监管/控制和危害的医疗和非医疗数据和指标。我们搜查了多个科学数据库以识别相关出版物并进行额外的“额外”灰色'文献搜索以识别其他相关信息。尽管有一些基本指标，但阿片类药物有限的数据限制为巴西。数据表明，与高收入国家相比，处方阿片类药物的人口级别可用性仅代表一小部分使用。然而，在拉丁美洲，巴西在与邻近司法管辖区相比，巴西排名中间水平的阿片类药物消费，表明消费相对中等。巴西已经实施了对阿片类药物的限制性规定，被认为是阿片类药物的“高度限制”。可待因仍然是使用的主要阿片类药物镇痛药，但羟考酮等较强的阿片类药物变得越来越普遍。有关医疗阿片类药物使用和效果的专业知识似乎有限。国家调查表明处方阿片类药物的非医学用途增加，尽管在北美的观察中低于观察，而非法阿片类药物（例如，海洛因）非常罕见。总人口水平阿片类药物可用性和巴西与阿片类有关的危害相应水平大幅低于北美报告的率。但是，巴西的阿片类药物使用，政策/练习和危害的可用监测和分析数据是有限的，不足。由于现有和急性（例如，疼痛相关的）改善的阿片类药物利用和实践的需求似乎得到了证实，因此需要改进的指标和理解阿片类药物使用，做法和危害巴西。

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