Abstract

In the past decade, health authorities in various jurisdictions have reported an upsurge in prescription opioid utilisation and an unprecedented rise in opioid-related mortality. In this scoping review, we weigh current epidemiological evidence associated with a prescription opioid use problem in Israel. We summarise available indicators on prescription opioid use, availability, mortality, morbidity, and service utilisation. Although most available indicators show an increase in opioid prescribing and availability, others show that opioid-related mortality has declined in the past two decades. We further discuss potential reasons for the declining mortality despite an increase in opioid use. Based on current evidence, we conclude that Israel is not experiencing an opioid crisis in the magnitude of that encountered in the United States, Canada, and Australia. Trends pointing to increased opioid prescribing could be an alerting signal to an ongoing public health problem. However, such conclusions are limited by the lack of robust data on an increase in opioid-related morbidity and mortality. In the context of differences in health systems, regulatory frameworks, and treatment capacity across countries, providing decision-makers with information on the cause and extent of their domestic opioid crisis is essential for devising appropriate policies.

摘要

在过去十年中，各个司法管辖区的卫生当局报告了处方阿片类药物的使用激增和阿片类药物相关死亡率的空前上升。在本次范围审查中，我们权衡了与以色列处方阿片类药物使用问题相关的当前流行病学证据。我们总结了关于处方阿片类药物使用、可用性、死亡率、发病率和服务利用的可用指标。尽管大多数可用指标显示阿片类药物的处方和可用性有所增加，但其他指标表明，与阿片类药物相关的死亡率在过去二十年中有所下降。我们进一步讨论了尽管阿片类药物使用增加但死亡率下降的潜在原因。根据目前的证据，我们得出结论，以色列没有经历美国、加拿大、和澳大利亚。指向阿片类药物处方增加的趋势可能是一个持续存在的公共卫生问题的警报信号。然而，由于缺乏关于阿片类药物相关发病率和死亡率增加的可靠数据，此类结论受到限制。在各国卫生系统、监管框架和治疗能力存在差异的背景下，为决策者提供有关其国内阿片类药物危机的原因和程度的信息对于制定适当的政策至关重要。