Patterns of opioid consumption in cancer patients

Tamar Freud, Michael Sherf, Erez Battat, Daniel Vardy, Pesach Shvartzman

Research output: Contribution to journalArticlepeer-review


Background: Opioids are considered a cornerstone in the treatment of cancer pain. Objectives: To assess opioid use during a 6 year period (2001- 2006) among cancer patients served by Clalit Health Services, the largest health management organization in Israel. Methods: Purchasing data of opioids authorized for use in Israel were obtained from the computerized databases of Clalit for the period 2001-2006. Patients' demographic and cancer morbidity data were extracted. The data were analyzed by translating the purchased opioids (fentanyl patch, oxycodone, buprenorphine, methadone, hydromorphone) to oral morphine equivalents (OME). Results: During the study period 182,066 Clalit members were diagnosed with cancer; 58,443 (32.1%) of them died and 31,628 (17.3%) purchased opioids at least once. In 2001, 7.5% of Clalit cancer patients purchased opioids at least once within 5 years of the initial diagnosis. Between 2002 and 2006 this percentage increased consistently, reaching 9.9% in 2006. The average daily dose of opioids increased from 104.1 mg OME in the year 2001 to 115.2 mg OME in 2006 (11% increase). The average duration of opioid purchasing was 5.0 ± 8.3 months (range 1-84 months, median 2). During the study period 19,426 cancer patients who purchased opioids at least once died; only 14.3% (3274) were still alive 2 years after their first opioid prescription. Conclusions: Opioid purchasing increased during the study period, especially during the final months of life. Children (0-18 years old) and elderly male patients (≥ 65 years) began opioid treatment later compared to other age groups. Only a few patients had an opioid early enough to relieve their pain.

Original languageEnglish
Pages (from-to)89-93
Number of pages5
JournalIsrael Medical Association Journal
Issue number2
StatePublished - Feb 2013
Externally publishedYes


  • Cancer patients
  • Consumption trends
  • Health management organization (HMO)
  • Opioids
  • Pain

ASJC Scopus subject areas

  • General Medicine


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