Author(s): Dinesh Sangarran Ramachandram, V. Chitra, Rini. R


DOI: 10.5958/0974-360X.2020.00358.3   

Address: Dinesh Sangarran Ramachandram, V. Chitra, Rini. R
Department of Pharmacology, SRM College of Pharmacy, SRM Institute of Science and Technology, Kattankulathur, Chengalpet- 603203.
*Corresponding Author

Published In:   Volume - 13,      Issue - 4,     Year - 2020

Background: Opioids are being used more frequently in the management of non-malignant chronic pain. This practice has now led to a new and growing problem with addiction and misuse of opioids. Because of various negative effects, the use of opioids for long term management of chronic pain is not indicated unless other pain relievers of low risk have been found ineffective. Opioids are commonly prescribed and widely used to treat pain outcomes in Asia. Method: A stretched analysis was used in this review, by a comprehensive study using MEDLINE/Pubmed, Google Scholar, Sciencedirect and library searches. Peer reviewed articles were also included in this review of opioid findings in Southeast Asia. Results: Results from the cross-sectional study with 465 adult cancer patients from 22 sites in Southeast Asia who received analgesic prescription shows 90.7% (419) of them were prescribed with opioids. Recent studies have shown that heroin misuse has advanced further in Asia, both geographically and economically, including countries as India and Sri Lanka, which had no history with this issue. Studies have also shown that the misuse of narcotic drugs has been growing and that heroin addicts devote to these when heroin is challenging to get. Administering drug among opiate misusers has been found as the major reason of the wide spread of HIV/AIDS in Southeast and Southwest Asia. Conclusion: Thus these data shows that both opioid use disorder and withdrawal symptoms are due to increased opioid abuse and accessibility in Asia. Better prevention strategies have to be implemented for effective decrease in the rate of opioid misuse and opioid overdose epidemic.

Cite this article:
Dinesh Sangarran Ramachandram, V. Chitra, Rini. R. Current Opioid Access, Use and Problems in Asian Jurisdictions. Research J. Pharm. and Tech. 2020; 13(4):1989-1994. doi: 10.5958/0974-360X.2020.00358.3

Dinesh Sangarran Ramachandram, V. Chitra, Rini. R. Current Opioid Access, Use and Problems in Asian Jurisdictions. Research J. Pharm. and Tech. 2020; 13(4):1989-1994. doi: 10.5958/0974-360X.2020.00358.3   Available on:

1.    Ogura, Takahiro; Egan, Talmage D. (2013). "Chapter 15 – Opioid Agonists and Antagonists". Pharmacology and physiology for anesthesia : foundations and clinical application. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1-4377-1679-5.
2.    Hemmings, Hugh C.; Egan, Talmage D. (2013). Pharmacology and Physiology for Anesthesia: Foundations and Clinical Application: Expert Consult - Online and Print. Elsevier Health Sciences. p. 253.
3.    Stromgaard, Kristian; Krogsgaard-Larsen, Povl; Madsen, Ulf (2009). Textbook of Drug Design and Discovery, Fourth Edition. CRC Press. ISBN 9781439882405.
4.    Sterken, Joeri; Troubleyn, Joris; Gasthuys, Frank; Maes, Viviane; Diltoer, Mark; Verborgh, Christian (2004-10-01). "Intentional overdose of Large Animal Immobilon". European Journal of Emergency Medicine. 11 (5): 298–301. doi:10.1097/00063110-200410000-00013. ISSN 0969-9546. PMID 15359207.
5.    Lembke, Anna (2016). Drug Dealer, MD: How Doctors Were Duped, Patients Got Hooked, and Why It’s So Hard to Stop. Johns Hopkins University Press. ISBN 978-1421421407.
6.    "FDA requires strong warnings for opioid analgesics, prescription opioid cough products, and benzodiazepine labelling related to serious risks and death from combined use". FDA. August 31, 2016. Retrieved 1 September 2016.
7.    World Drug Report 2018 (United Nations publication, Sales No. E.18.XI.9)
8.    "Status and Trend Analysis of Illicit [sic] Drug Markets". World Drug Report 2016 (PDF).
9.    "Report III: FDA Approved Medications for the Treatment of Opiate Dependence: Literature Reviews on Effectiveness & Cost- Effectiveness, Treatment Research Institute". Advancing Access to Addiction Medications: Implications for Opioid Addiction Treatment. p. 41.
10.    Tetrault, Jeanette M.; Butner, Jenna L. (2015-09-03). "Non-Medical Prescription Opioid Use and Prescription Opioid Use Disorder: A Review". The Yale Journal of Biology and Medicine. 88 (3): 227–233. ISSN 0044-0086. PMC 4553642. PMID 26339205.
11.    Tarabar, Asim F.; Nelson, Lewis S. (2003-04-01). "The resurgence and abuse of heroin by children in the United States". Current Opinion in Pediatrics. 15 (2): 210–215. doi:10.1097/00008480-200304000-00013. ISSN 1040-8703. PMID 12640281.
12.    Gray, Eliza (2014-02-04). "Heroin Gains Popularity as Cheap Doses Flood the U.S." Retrieved 2016-02-12.
13.    Maltoni, M. (2008-01-01). "Opioids, pain, and fear". Annals of Oncology. 19 (1): 5–7. doi:10.1093/annonc/mdm555. ISSN 0923-7534. PMID 18073220.  
14.    McCarberg, Bill H. (2011-03-01). "Pain management in primary care: strategies to mitigate opioid misuse, abuse, and diversion". Postgraduate Medicine. 123 (2): 119–130. doi:10.3810/pgm.2011.03.2270.  
15.    “Narcotic Drugs Stupéfiants Estupefacientes" (PDF). International Narcotics Control Board. 2012. Retrieved March 6, 2017.
16.    “Opioid Consumption Data | Pain & Policy Studies Group". Retrieved 2016-01-07.
17.    Dell CA, Roberts G, Kilty J, Taylor K, Daschuk M, Hopkins C, Dell D (2012). "Researching Prescription Drug Misuse among First Nations in Canada: Starting from a Health Promotion Framework". Subst Abuse. 6: 23–31. doi:10.4137/SART.S9247.
18.    Socially disadvantaged Ontarians being prescribed opioids on an ongoing basis and at doses that far exceed Canadian guidelines". 2011-01-25. Retrieved 2016-01-07.
19.    Avoiding Abuse, Achieving a Balance: Tackling the Opioid Public Health Crisis" (PDF). College of Physicians and Surgeons of Ontario. 8 September 2010. Archived from the original (PDF)on 7 June 2016. Retrieved 6 March 2017
20.    Thinh et al., Patient and Physician Satisfaction with Analgesic Treatment: Findings from the Analgesic Treatment for Cancer Pain in Southeast Asia (ACE) Study Hindawi, Pain Research and Management Volume 2018, Article ID 2193710, 8 pages
21.    Vikcnasingam, B., Mazlan M., Schottenfeld R. S., Chawarski, M. C. (2010). Injection of buprenorphine and buprenorphine/ naloxone tablets in Malaysia. Drug and Alcohol Dependence, 111, 44-49.
22.    Schottenfeld, R.S., Chawarski, M. C., Mazlan, M., (2008). Maintenance treatment with demised, double-blind, placebo-controlled trial. Lancet 371, 2192-2200
23.    Vicknasingam, B., Dazali, M. N. M., Singh, D., Schottenfeld, Chawarski, M. C. (2015). Buprenorphine/naloxone treatment practices in Malaysia: Result of national surveys of physicians and patients. Drug and Alcohol Dependence,152, 164 – 169.
24.    W. Scholten, Improving access to adequate pain management in Taiwan, Acta Anaesthesiologica Taiwanica 53 (2015) 62-65.
25.    Kang et al., Trends in major opioid analgesic consumption in Taiwan 2002- 2014, Journal of the Formosan Medical Association (2017) 116, 529-535
26.    S.Y Fang., H Nicole., J.H Tsay., S H Chang., C Y Chen., Excess mortality in children born to opioid addicted parents: A national register study in Taiwan: Drug and Alcohol dependence 183 (2018), 118-126
27.    L. Gilbert et al., Reducing opioid overdose in Kazakhstan: A randomized controlled trial of a couple-based integrated HIV/HCV and overdose prevention intervention "Renaissance”: International Journal of Drug Policy 54 (2018), 105-113.
28.    Chen, W., Nong, Z., Li, Y., Huang, J., Chen, C., Huang, L. (2017). Role of dopamine signalling in drug addiction. Current Eopics in Medicinal Chemistry, 17 1-16. doi:10.2174/1568026617666170504100642
29.    Ali N, Aziz SA, Nordin S, Mi NC, Abdullah N, Paranthaman V, Mahmud M, Yee A, Danaee M.Evaluation of Methadone Treatment in Malaysia: Findings from the Malaysian Methadone Treatment Outcome Study (MyTOS).Subst Use Misuse. 2018 Jan 28;53(2):239-248
30.    Mukherjee et al., Factors associated with interest in receiving prison-based methadone maintenance therapy in Malaysia: Drug Alcohol Depend. 2016 July 01; 164: 120–127.
31.    UN Office on Drugs and Crime, Economic and Social Commission for Asia and the Pacific, Joint United Nations Programme on HIV/AIDS. Report of the second regional consultation on compulsory centres for drug users in Asia and the Pacific. Kuala Lumpur: UNODC, 2012.
32.    Kamarulzaman A. Impact of HIV prevention programs on drug users in Malaysia. J Acquir Immune Defi C Syndr 2009; 52 (suppl 1): S17–19.
33.    Wegman, M. P., Altice, F. L., Kaur, S., Rajandaran, V., Osornprasop, S., Wilson, D., Wilson, D. P., Kamarulzaman, A. (2017). Relapse to opioid use in opioid-dependent individuals released from compulsory drug detention centres compared with those from voluntary methadone treatment centres in Malaysia: a two-arm, prospective observational study. Lancet Glob Health, 5, e198-207.
34.    George, P., Vicknasingam, B., Thurairajasingam, S., Ramasamy, P., Yusof, H. M., Yasin, M. A. B. M., Shah, Z. U. B. S., (2018). Drug and Alcohol Review, 37, 147-151.
35.    Zhang, B., Cai, T., Zhihua, Y., Mburu, G., Wang, B., Yang L. (2016). Impact of blended treatment literacy and psychoeducation on methadone maintenance treatment outcomes in Yunnan, China. Harm Reduction Journal, 13:8.
36.    Tran
37.    World Health Organization. Global status report on noncommunicable diseases 2010: Description of the global burden of NCDs, their risk factors and determinants. Geneva, Switzerland: WHO Press, 2011.
38.    World Health Organization. World cancer report 2008. Lyon, France: IARC Press, 2008.
39.    Paudel et al., Opioid Availability and Palliative Care in Nepal: Influence of an International Pain Policy Fellowship J Pain Symptom Manage 2015;49: 110- 116.
40.    Krakauer et al., Toward Safe Accessibility of Opioid Pain Medicines in Vietnam and Other Developing Countries: A Balanced Policy Method, J Pain Symptom Manage 2015;49:916- 922.
41.    R. Raoet. al, Factors affecting drug use during incarceration: a cross sectional study of opioid dependent persons from India. Journal of Substance Abuse Treatment (2015),
42.    G. Poojitha, S. Jayakumari. A Prospective Study on Due of Hormonal Supplements using in Gynecology Department. Research J. Pharm. and Tech 2018; 11(2):690-694.
43.    Shariff Halim, Nasir Mohamad, Nor Hidayah Abu Bakar, Syed Hadzrullathfi Syed Omar, Mohd Shahril Othman, Abdulsoma Thoarlim, Nur Atikah Muhammad, P.M. Ridzuan, Nur Husna Zakaria. Effect of Zamzam Water Alone or In Combination with Methadone on Animal Withdrawal Symptoms in Morphine Dependent Rats. Research J. Pharm. and Tech 2017; 10(11): 3783-3788.
44.    Nurulhuda Mat Hassan, Norwati Daud, Aniza Abd Aziz, Khairi Che Mat. Associated Factors for Relapse in Opioid Addicts undergoing Therapy. Research J. Pharm. and Tech 2018; 11(7): 2724-2728.
45.    Mamata Prasad. An Overview of Changing Pattern of Women Work Participation and Related Problems. Int. J. Ad. Social Sciences 4(3): July- Sept., 2016; Page 149-154.
46.    N. Sujatha. A Study on Psycho Social Problems of Senior Citizens Residing at Home for Aged, Karaikal. Asian J. Nur. Edu. and Research 1(4): Oct-Dec. 2011; Page 105-106.
47.    Chittaranjan Bhanja, Satyaban Jena. Synthesis Planning of a Potent Opioid Analgesic “Fentanyl”: A Retrosynthetic Approach. Asian J. Research Chem. 5(7): July, 2012; Page 925-931.
48.    Praveen D, Ranadheer Chowdary P, Gandikota Thanmayi, Gangabathina Poojitha, Vijey Aanandhi M. Antioxidant and Analgesic Activity of Leaf Extracts of Artocarpus heterophyllus. Research J. Pharm. and Tech. 9(3): Mar., 2016; Page 257-261.
49.    Anilkumar B. Jarali, G. Radhakrishnan. Stress, Obesity and Selected Health Problems among Professionals. Asian J. Nur. Edu. and Research 3(3): July-Sept., 2013; Page 154-163.
50.    Proshob Mathew, Chandrashekar M. A Study to Assess the Emotional and Behavioral problems among Overweight Children in Selected Schools at Mysuru. Asian J. Nur. Edu. and Research 5(4): Oct.- Dec.2015; Page 451-456
51.    J. Ravi Kumar Reddy, Y. Indira Muzib, K. P. R. Chowdary. Development and Characterization of Novel Trans Buccoadhesive Bilayer Tablets of Tapentadol Hydrochloride. Asian J. Res. Pharm. Sci. 2013; Vol. 3: Issue 2, Pg 83-89.
52.    Shraddha. B. Patil, Bhavana. U. Jain, Manish Kondawar. A Review on Drug Therapy Problems. Asian J. Res. Pharm. Sci. 2019; 9(2): 137-140.

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