OUTPATIENT DISPENSATION OF OPIOIDS BY THE UNIFIED HEALTH SYSTEM IN BRAZIL AND MINAS GERAIS FROM 2018 TO 2023: AN ECOLOGICAL STUDY

Abstract

Background: Opioid use in Brazil remains low, despite international recommendations and growing demand for effective pain treatment. Objective: To analyze trends in the outpatient dispensation of selected opioids - codeine, morphine, and methadone - by the Unified Health System (SUS) in Brazil and in the state of Minas Gerais between 2018 and 2023. Methods: A descriptive and ecological study using secondary data from the health information systems of the SUS. Amounts in milligrams, equivalent in milligrams of morphine (MME) and defined daily doses (S-DDD per million inhabitants) were evaluated. Results: The most commonly dispensed presentations were codeine 30 mg and methadone 10 mg. Codeine was the most consumed opioid, followed by morphine and methadone. Between 2018 and 2023, a moderate upward trend was observed in Brazil (5.36% per year) and a sharper increase in Minas Gerais (56% per year). However, consumption levels remained very inadequate (<100 S-DDD), with significant fluctuations and a sharp decline in 2019. In 2023, Brazil reached 42.5 S-DDD/million inhabitants. Conclusions: The findings highlight the persistent underuse of opioids in Brazil and Minas Gerais, with structural, regulatory, and educational barriers hindering adequate access, especially among SUS users. There is an urgent need to strengthen public policies, improve the training of health workers, and ensure equitable access to essential medicines for pain relief.