Universität zu Köln

Vranken, Marjolein J. M., Mantel-Teeuwisse, Aukje K., Juenger, Saskia, Radbruch, Lukas, Scholten, Willem, Lisman, John A., Subataite, Marija and Schutjens, Marie-Helene D. B. (2017). Barriers to access to opioid medicines for patients with opioid dependence: a review of legislation and regulations in eleven central and eastern European countries. Addiction, 112 (6). S. 1069 - 1077. HOBOKEN: WILEY. ISSN 1360-0443

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Abstract

Background and aimsBarriers linked to drug control systems are considered to contribute to inequitable access to controlled medicines, leaving millions of people in pain and suffering. Most studies focus on access to opioids for the treatment of severe (cancer) pain. This study aims to identify specific access barriers for patients with opioid dependence in legislation and regulations of 11 central and eastern European countries. MethodsThis study builds on a previous analysis of legislation and regulations as part of the EU 7th Framework Access To Opioid Medication in Europe (ATOME) project. An in-depth analysis was undertaken to determine specific barriers for patients with opioid dependence in need of opioid analgesics or opioid agonist therapy (OAT). For each country, the number and nature of specific potential barriers for these patients were assessed according to eight categories: prescribing; dispensing; manufacturing; usage; trade and distribution; affordability; penalties; and other. An additional keyword search was conducted to minimize the omission of barriers. Barriers in an additional category, language, were recorded qualitatively. Countries included Bulgaria, Cyprus, Estonia, Greece, Hungary, Latvia, Lithuania, Serbia, Slovakia, Slovenia and Turkey. ResultsTen of the 11 countries (all except Estonia) showed specific potential barriers in their legislation and regulations. The total number of barriers varied from two (Slovenia) to 46 (Lithuania); the number of categories varied from one (Slovenia) to five (Lithuania). Most specific potential barriers were shown in the categories prescribing', usage' and other'. The total number in a single category varied from one to 18 (Lithuania, prescribing). Individual differences between countries in the same specific potential barrier were shown; for example, variation in minimum age criteria for admission to OAT ranging from 15 (Lithuania, in special cases) to 20years (Greece). All countries had stigmatizing language in their legislation. ConclusionsPatients with opioid dependence are likely to experience specific barriers to accessing opioids in addition to those experienced by other non-dependent patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Vranken, Marjolein J. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mantel-Teeuwisse, Aukje K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Juenger, Saskia UNSPECIFIED UNSPECIFIED UNSPECIFIED Radbruch, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Scholten, Willem UNSPECIFIED UNSPECIFIED UNSPECIFIED Lisman, John A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Subataite, Marija UNSPECIFIED UNSPECIFIED UNSPECIFIED Schutjens, Marie-Helene D. B. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-230461
DOI:	10.1111/add.13755
Journal or Publication Title:	Addiction
Volume:	112
Number:	6
Page Range:	S. 1069 - 1077
Date:	2017
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1360-0443
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OPIATE SUBSTITUTION TREATMENT; INJECT DRUGS; AVAILABILITY; CARE; ACCESSIBILITY; PEOPLE Multiple languages Substance Abuse; Psychiatry Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/23046