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      Reflexión ética sobre el crecimiento del uso de opioides en España: ¿está fundamentada la limitación de uso del fentanilo de liberación inmediata? Translated title: Ethical discussion about the growing use of opioids in Spain: is it fundamented the limination of inmediate release fentanyl use?

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          Abstract

          Resumen El entorno de adicción y mortalidad por opioides (ilegales y de prescripción) en Estados Unidos (lo que comúnmente se ha llamado la epidemia de opioides) ha puesto sobre la mesa la discusión ética sobre la idoneidad de usar o no opioides fuera de indicación, sobre todo en relación al uso del fentanilo de liberación inmediata en pacientes no-oncológicos. En el año 2018 la Agencia Española del Medicamento y Productos Sanitarios (AEMPS) emitió una advertencia en contra de este uso, justificando esta decisión con una serie de argumentos y datos que analizamos en este artículo. Estos medicamentos tienen un papel esencial en el tratamiento del dolor irruptivo, un tipo de dolor que está presente tanto en pacientes con cáncer como en pacientes sin cáncer. Atendiendo a la advertencia regulatoria de la AEMPS, los médicos se enfrentan actualmente al dilema ético de no utilizar estos fármacos en pacientes no-oncológicos, o prescribirlos de forma off-label.

          Translated abstract

          Abstract The current environment of addiction and mortality associated to both illegal and prescription opioids in United States of America (what is commonly called the opioids epidemic) has put on the table the ethical discussion about the use or not of opioids in off-label, especially in relation to the use of immediate release fentanyl in non-cancer patients. In 2018 the Spanish Agency of Medicines issued a warning note about the use of those medicaments supporting this decision in some arguments and data that will be analyzed in this publication. Those drugs have an essential role in the treatment of breakthrough pain, that is present in both cancer and noncancer patients. Considering the warning of the agency, doctors are facing the ethical dilemma of no use these drugs in no-cancer patients or prescribe them as off-label.

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          Most cited references15

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          Declaration of Montréal: declaration that access to pain management is a fundamental human right.

          (2011)
          At the conclusion of the 13th World Congress on Pain in Montreal, Quebec, Canada, the International Association for the Study of Pain (IASP) hosted an International Pain Summit on September 3, 2010, to address the tragedy of unrelieved pain in the world. At the conclusion of the Summit, the delegates adopted a Declaration that Access to Pain Management is a Fundamental Human Right. That Declaration is presented.
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            Utilización de medicamentos opioides en España durante el periodo 2008- 2015

            (2017)
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              European Pain Federation position paper on appropriate opioid use in chronic pain management

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                Author and article information

                Journal
                ofil
                Revista de la OFIL
                Rev. OFIL·ILAPHAR
                Organización de Farmacéuticos Ibero-Latinoamericanos (Madrid, Madrid, Spain )
                1131-9429
                1699-714X
                March 2023
                : 33
                : 1
                : 83-89
                Affiliations
                [1] Pamplona Navarra orgnameUniversidad de Navarra Spain eregueras@ 123456alumni.unav.es
                Article
                S1699-714X2023000100015 S1699-714X(23)03300100015
                10.4321/s1699-714x2023000100015
                965c4713-08e8-498d-95c3-e6bc2e8d3f4d

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 18 August 2021
                : 15 September 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 15, Pages: 7
                Product

                SciELO Spain

                Categories
                Artículo Especial

                breakthrough,Opioides,dolor,irruptivo,fentanilo,Opioids,pain,fentanyl
                breakthrough, Opioides, dolor, irruptivo, fentanilo, Opioids, pain, fentanyl

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