Opioid use in chronic pain management in the Philippines.

The aim of this investigation was to determine current opioid use in the Philippines and the reasons why its use is very low. We surveyed 314 doctors in Metro Manila to determine their specialty, possession of narcotics license, and knowledge of opioid use beyond the terminal stage. We found that the majority of respondents possess a narcotics licence. All of them see pain patients in their practice. They agree that opioids should not be reserved for the terminally ill; 235 have prescribed opioids for non-cancer pain. A small minority believes that use of opioids for non-cancer pain can lead to addiction. Opioids that were most easily recalled were morphine, meperidine and nalbuphine. The survey contradicts the national data for opioid use. With an INCB (International Narcotics Control Board) allocation of 87 kilograms annually, less than 15 kilograms are consumed every year. Fentanyl has a 7 gram usage versus a 100 gram INCB allocation. We conclude that actual opioid use in the Philippines is minimal. However, the correlation between survey results and actual usage indicates a strong awareness of the usefulness of opioids but hesitancy in opioid prescription.

Serum epidemiology of eastern, western and Venezuelan equine encephalitides in Mexico.

The presence of HI antibodies for the Eastern, Western and Venezuelan equine encephalitis was investigated in 16,405 human sera collected in 47 communities in the Mexican Republic. It was found that there is a high percentage of individuals who have antibodies against Venezuelan equine encephalitis. In turn, it was discovered that persons with Western equine encephalitis virus antibodies live in the northwestern states of the country. Very few cases with Eastern equine encephalitis antibodies were detected.