Objective. The objective of this study was to assess opioid use during 7 years (2000–2006) among
Clalit Health Services (CHS) members.
Design. Purchasing data of opioids authorized for use in Israel were obtained from the computerized databases of CHS. Patient demographics and cancer morbidity were also extracted. The data
were analyzed by converting the purchased opioids to oral morphine equivalents (OMEs).
Setting. CHS is the largest health maintenance organization in Israel (3,774,600) and insures almost
54% of the Israeli population.
Patients. All CHS members who purchased an opioid at least once during the 7-year study period
(2000–2006).
Intervention. There were no interventions in this study.
Outcome Measures. The ourcome measures of this study were total OME purchased per year, OME
(mg) per capita/per year, and OME (mg) daily dose.
Results. There were 119,562 patients who purchased an opioid at least once (3.2% of CHS population). Of them, 57.4% were women, 69.0% aged 65 years and above (average age 56.05
years 26.7), 7.7% purchased opioids for more than 12 months, and 81.3% purchased opioids for
only 1–4 months. A 96% increase in total OME purchased was found between 2000 and 2006 (from
56.4 kg to 110.6 kg). The annual OME purchased per capita increased from 15.7 mg in the year
2000 to 29.3 mg in 2006. The total number of patients who received at least one opioid prescription
increased by 60%, while the growth in total number of CHS members was smaller (4.8%).
Conclusions. There is a growing use of opioids at CHS during the 7-year period, a potential indicator
of the progress made in improving accessibility and availability of opioids in our health care
organization in Israel.
Key Words. Opioids; Pain Relief; Chronic Pain; Consumption; Cancer Pain; Non-Cancer Pain