Last March, Patricia González de Chávez Ledesma, a pharmacy graduate, successfully defended her doctoral thesis entitled “Opioid Drug Consumption in the Province of Las Palmas during the Period 2016-2021.” The thesis falls within the doctoral program in Medical and Pharmaceutical Sciences, Development and Quality of Life, under the supervision of [name of supervisor missing in original text]. Alexis Oliva Martín, from the Department of Chemical Engineering and Pharmaceutical Technology, and Sandra Dévora Gutiérrez, from the Department of Physical Medicine and Pharmacology.
In this work, an aggregated and standardized database was developed using the anatomical-chemical-therapeutic (ATC) drug classification system and the defined daily dose (DDD), which allowed an analysis of opioid consumption patterns, offering a comprehensive and comparative view at the provincial, island, and municipal levels, a novel aspect, and providing tools to assess the impact of local factors on the use of these medications.
In all geographical areas analyzed, the most consumed therapeutic subgroups were the combinations of tramadol with non-opioid analgesics (N02AJ) and synthetic major opioids such as buprenorphine and fentanyl (N02AE), in line with international clinical guidelines that prioritize safe and effective options for the management of chronic pain.
The most commonly used presentation was tramadol tablets for oral administration, both as monotherapy and in combination with paracetamol, which has become established as an effective therapeutic option for managing chronic pain. Its favorable safety profile makes it particularly suitable for vulnerable populations, such as the elderly or patients with comorbidities. Transdermal and transmucosal formulations of buprenorphine and fentanyl were the second most popular, especially indicated for the treatment of severe chronic pain and in cancer patients.
The islands of Gran Canaria, Lanzarote, and Fuerteventura exhibit differences in their opioid consumption patterns, possibly due to demographic, economic, and healthcare accessibility factors. Gran Canaria registers the highest rates of opioid consumption, influenced by its higher population density and concentration of healthcare services, while Lanzarote and Fuerteventura show more homogeneous consumption, conditioned by more equitable, but still limited, access to healthcare services.
In Gran Canaria, significant differences in opioid consumption were observed at both the district and municipal levels. Analysis of the districts revealed higher consumption in the metropolitan area, while the northern and southern districts registered lower levels, likely due to more limited access to specialized medical services. At the municipal level, Las Palmas de Gran Canaria and Telde, in the metropolitan area, showed the highest consumption levels, a trend associated with their high population density and the concentration of healthcare services. Meanwhile, the greatest differences were observed in the northern district, with the municipality of Moya showing the highest rates on the entire island, compared to the municipalities of Artenara and Tejeda, which showed the lowest consumption rates, attributable to their rural character, geographical isolation, and barriers to accessing medical care.
Finally, it should be noted that the unique consumption patterns observed in an island context reinforce the need to implement public health policies that take into account the specific characteristics of each area, promoting adequate training in rational prescribing as well as ensuring equitable access to effective and safe treatments, especially in rural and under-resourced areas, and thus minimizing the risk of dependence and adverse reactions associated with opioid use.
The results of this study cannot be directly extrapolated to other provinces or regions due to the unique cultural, economic, and demographic characteristics of the province of Las Palmas. However, they constitute a valuable reference point for designing adapted strategies in contexts with similar characteristics, according to the authors of the research.
This work is part of a research project funded by the Spanish Pharmaceutical Cooperative (COFARES), whose principal investigator is Alexis Oliva, Professor of Pharmacy and Pharmaceutical Technology at the University of La Laguna (ULL). The project's objective has been to establish a methodology for analyzing opioid consumption trends in geographically isolated areas such as the Canary Islands. The researcher emphasizes that the main advantage of this methodology is its applicability to other drug groups.
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