Where Is the Opioid Use Epidemic in Mexico? A Cautionary Tale for Policymakers South of the US-Mexico Border.

In North America, opioid use and its harms have increased in the United States and Canada over the past 2 decades. However, Mexico has yet to document patterns suggesting a higher level of opioid use or attendant harms.Historically, Mexico has been a country with low-level use of opioids, although heroin use has been documented. Low-level opioid use is likely attributable to structural, cultural, and individual factors. However, a range of dynamic factors may be converging to increase the use of opioids: legislative changes to opioid prescribing, national health insurance coverage of opioids, pressure from the pharmaceutical industry, changing demographics and disease burden, forced migration and its trauma, and an increase in the production and trafficking of heroin. In addition, harm-reduction services are scarce.Mexico may transition from a country of low opioid use to high opioid use but has the opportunity to respond effectively through a combination of targeted public health surveillance of high-risk groups, preparation of appropriate infrastructure to support evidence-based treatment, and interventions and policies to avoid a widespread opioid use epidemic.

Regulación de la dispensación de medicamentos y su efecto en el consumo de antibióticos en Venezuela / Regulations governing the dispensing of medications and their effect on antibiotic consumption in Venezuela

Objetivo. Determinar las variaciones en la tendencia de consumo de los antibióticos regulados y no regulados en Venezuela, entre el período antes (2005) y después (2006–2008) de introducir la regulación de su venta por receta. Métodos. Se obtuvo información sobre consumo de antibióticos en Venezuela de los datos aportados por International Marketing Services. El consumo se expresó en dosis diarias definidas por 1 000 habitantes por día. Se realizaron análisis de varianzas (ANOVA) con un intervalo de confianza de 95% para conocer las diferencias entre los períodos estudiados. Resultados. Los antibióticos regulados de mayor consumo fueron ciprofloxacina y azitromicina. Las clases de antibióticos no regulados de mayor consumo fueron penicilinas y cefalosporinas de primera generación, aminoglucósidos, diaminopiridinas-sulfamidas y tetraciclinas. El consumo total de las categorías de antibióticos de libre dispensación fue el doble del de las categorías de venta regulada, tanto antes como después de haberse aplicado la regulación. Conclusiones. No se encontraron diferencias estadísticamente significativas en el consumo de antibióticos, ya fueran regulados o de libre dispensación, ni antes ni después de aplicarse la medida regulatoria de dispensación de antibióticos.

Objective. Determine the variations in consumption trends for regulated and unregulated antibiotics in Venezuela in the period before (2005) and after (2006–2008) the regulation of prescription sales was introduced. Methods. Information on antibiotic consumption in Venezuela was obtained from the data provided by International Marketing Services. Consumption was expressed in daily doses per 1 000 inhabitants. Analyses of variance (ANOVA) were performed, with a 95% confidence interval, to identify the differences between the periods studied. Results. The regulated antibiotics with the highest consumption were ciprofloxacin and azithromycin. The classes of unregulated antibiotics with the highest consumption were penicillins and first-generation cephalosporins, aminoglycosides, diaminopyridine- sulfonamides, and tetracyclines. Total consumption in the categories of antibiotics with unregulated dispensing was twice as high as in the categories with regulated sales, both before and after introduction of the regulation. Conclusions. There were no statistically significant differences in antibiotic consumption with regulated or unregulated dispensing, either before or after the introduction of measures regulating the dispensing of antibiotics.

[Regulations governing the dispensing of medications and their effect on antibiotic consumption in Venezuela]. / Regulación de la dispensación de medicamentos y su efecto en el consumo de antibióticos en Venezuela.

OBJECTIVE: Determine the variations in consumption trends for regulated and unregulated antibiotics in Venezuela in the period before (2005) and after (2006-2008) the regulation of prescription sales was introduced. METHODS: Information on antibiotic consumption in Venezuela was obtained from the data provided by International Marketing Services. Consumption was expressed in daily doses per 1,000 inhabitants. Analyses of variance (ANOVA) were performed, with a 95% confidence interval, to identify the differences between the periods studied. RESULTS: The regulated antibiotics with the highest consumption were ciprofloxacin and azithromycin. The classes of unregulated antibiotics with the highest consumption were penicillins and first-generation cephalosporins, aminoglycosides, diaminopyridine-sulfonamides, and tetracyclines. Total consumption in the categories of antibiotics with unregulated dispensing was twice as high as in the categories with regulated sales, both before and after introduction of the regulation. CONCLUSIONS: There were no statistically significant differences in antibiotic consumption with regulated or unregulated dispensing, either before or after the introduction of measures regulating the dispensing of antibiotics.