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Heroin Addiction and Related Clinical Problems: 2020, 22, N3 (pages: 13 - 19)

Extent and Trend of Prescription Opioids in Assisted Treatment Programmes for Opioid Addiction and Pain Medications in Slovenia from 2007 until 2018

Kostnapfel T., Korosec A., and Kastelic A.

Summary: Background. There is a wide accessibility of prescription pain medications and medications for treating opioid-dependent individuals in medication-assisted treatment programmes for opioid addiction in the Republic of Slovenia. Aim: The aim of the present study was to analyse the overall trends in prescriptions for opioid analgesics (N02A) and for the medications used in medication-assisted treatment (N07B) of opioid addictions in Slovenia in the period from 2007 until 2018. Methods. Anonymised data from the Slovenian "Outpatient Prescription Database" were used based on the WHO Anatomical-Therapeutic-Chemical methodology. Compiled data were processed by means of descriptive statistics and tested for the presence of linear trends. Results. In Slovenia, DDD/TID of opioid analgesics rose between 2009 (9.07 DDD/TID) and 2017 (12.57 DDD/TID), with a decrease observed in 2018 (11.76). The percentage of the population treated with prescription opioids rose from 6.7% in 2009 to 7.6% in 2013, and fell between 2013 and 2018. In the Centres for the Prevention and Treatment of Drug Addiction in Slovenia, an upward trend was seen in buprenorphine use between 2013 and 2018, and a downward trend in methadone use after 2015. Conclusions. Clinical guidelines for pain management and medication-assisted treatment programmes have been developed in the Republic of Slovenia, but treatment should only be initiated and performed by competent and well-trained clinicians to reduce the abuse, misuse and diversion of opioid medications, which often lead to fatal overdoses and higher public costs.