%0 Observational Study
%T Trends in Israeli community-based opioid prescribing, 2010-2020, an observational study of the country's largest HMO.
%A Dressler RL
%A Kaliner E
%A Cohen MJ
%J Isr J Health Policy Res
%V 12
%N 1
%D 2023 Nov 16
%M 37974249
%F 2.465
%R 10.1186/s13584-023-00581-w
%X <B>BACKGROUND: </B>Prescription opioids are widely used for pain control and palliative care but have been associated with a variety of untoward effects, including opioid use disorder, addiction, and increased mortality. Patterns of opioid use in Israel are to date poorly described.<BR><B>METHODS: </B>Using a community-based database, the authors performed a retrospective analysis of filled opioid prescriptions of Israeli HMO members 18 years of age or older during the years of 2010-2020 that filled at least one opioid prescription. Morphine milligram equivalent (MME) calculations were stratified by presence or absence of oncology diagnosis and by specific opioid medication.<BR><B>RESULTS: </B>The percentage of HMO members who filled at least one opioid prescription increased every year from 2.1% in 2010 to 4.2% in 2020. There was an increase in the MME per prescription (44.2%), daily MME per capita (142.1%) and MME per prescription-filling patient (39%) from 2010 to 2020. Increased prescription opioid use is driven by a small group of non-oncological patients, which is less than 1.5% of opioid-prescribed patients and 0.1% of the adult population, primarily owing to fentanyl use.<BR><B>CONCLUSIONS: </B>Supervision and control of opioid prescriptions in Israel should be a focused effort directed at patients prescribed uniquely high dosages rather than a population-wide strategy that focuses on all patients prescribed opioids. This should be complemented by improved physician training and access to non-opioid therapies, as well as improved data collection and analysis.