[Re: https://www.hifa.org/dgroups-rss/opioid-drugs-33-q4-what-can-be-done-rai... ]
Dear Neil,
Thank you so much for continuing to motivate us with your questions and reflections to delve deeper into this topic.
Regarding your question:
"What can be done to increase public awareness about the harms of opioid misuse?"
I reviewed the existing information on how this issue is addressed in Latin America, which, as I've already mentioned, is not yet at an epidemic stage in terms of opioid abuse. I can tell you that interventions in this area are in their early stages and are fragmented compared to other regions. They tend to be integrated within broader drug prevention strategies, rather than as specific interventions.
These interventions focus more on:
professional education
rational use
health policy development
And little or nothing on:
communication campaigns
specific interventions for young people
Is this enough to prevent the emergence of the opioid abuse problem without affecting the already insufficient response to appropriate use in patients suffering from pain who are prescribed opioids?
Perhaps using campaigns based on real testimonials and digital strategies targeted at young people could help. Does anyone have experience with these tools?
What also caught my attention in your message was the information about the UK study on patients with chronic musculoskeletal pain, where 59% were prescribed opioids. According to the same study, "these drugs may have been overprescribed according to national guidelines."
Is this a problem of insufficient training, or, as you mention, pressure from patients demanding pain relief at any cost?
Do countries have clear protocols or guidelines on when and by whom to initiate opioids in pain management?
Establishing clear algorithms on: when to initiate opioids, dosage, duration, and follow-up, as well as discontinuation criteria could be helpful.
In Uruguay, while we have a National Palliative Care Plan from the Ministry of Public Health, there isn't a widely disseminated national guideline specifically for chronic non-cancer pain in primary care.
Is the same true in other countries?
Kind regards,
Eduardo
Eduardo Bianco, MD, MSc, BIR
ATHP Director
Addiction Training for Health Professionals
Email: ebianco@nextgenu.org
HIFA profile: Eduardo Bianco is a medical doctor and Cardiologist, Certified Tobacco Cessation Expert with a Master's in Prevention and Treatment of Addictive Disorders. Bianco also has a degree in International Relations. Currently, he is Director of International Policy Education in Addictions of the Frank Foundation for International Health and Member of the Interim Policy Committee of the Global Alliance for Tobacco Control (GATC). He had a prominent role in promoting smoking cessation, tobacco control, WHO-FCTC implementation and NCD control in his country (Uruguay) as well as in Latin America for over 25 years. Bianco participated directly in most of the development process of the WHO-Framework Convention on Tobacco control and in the Sessions of the Conference of the Parties to this treaty. He was Director or Tobacco Control Program of InterAmerican Heart Foundation, Regional Coordinator for the Americas of the Framework Convention Alliance (FCA), Chair of the Tobacco Expert Group of the World Heart Federation and Technical Director of the MOH Center for International Cooperation for Tobacco as well as Founder and Former President of the Tobacco Epidemic Research Center (CIET) in Uruguay. Eduardo helps coordinate the HIFA working group on substance use disorders. https://www.hifa.org/support/members/eduardo https://www.hifa.org/projects/mental-health-meeting-information-needs-su...