Using a Morphine Equivalence Metric to Quantify Opioid Consumption: Examining the Capacity to Provide Effective Treatment of Debilitating Pain at the.

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Using a Morphine Equivalence Metric to Quantify Opioid Consumption: Examining the Capacity to Provide Effective Treatment of Debilitating Pain at the Global, Regional, and Country Levels Aaron M. Gilson, MS, MSSW, PhD, Martha A. Maurer, MSSW, MPH, PhD, Karen M. Ryan, MA, Paul J. Rathouz, PhD, James F. Cleary, MD, FRCAP, FAChPM Journal of Pain and Symptom Management Volume 45, Issue 4, Pages 681-700 (April 2013) DOI: 10.1016/j.jpainsymman.2012.03.011 Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions

Fig. 1 Log scale of global consumption trends for morphine and Total ME (mg/person). ME=morphine equivalence; Total ME=aggregate ME consumption of each study opioid. Journal of Pain and Symptom Management 2013 45, 681-700DOI: (10.1016/j.jpainsymman.2012.03.011) Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions

Fig. 2 Log scale of U.N. regional consumption trends for morphine and Total ME (mg/person). U.N.=United Nations; ME=morphine equivalence; Total ME=aggregate ME consumption of each study opioid. Journal of Pain and Symptom Management 2013 45, 681-700DOI: (10.1016/j.jpainsymman.2012.03.011) Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions

Fig. 3 (a–e) Log scale of consumption trends per U.N. region for morphine and Total ME (mg/person). a=Africa; b=Americas; c=Asia; d=Europe; e=Oceania; U.N.=United Nations; ME=morphine equivalence; Total ME=aggregate ME consumption of each study opioid. Journal of Pain and Symptom Management 2013 45, 681-700DOI: (10.1016/j.jpainsymman.2012.03.011) Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions

Fig. 4 (a–f) Log scale of consumption trends for morphine and Total ME (mg/person), in the Africa region. a=Ethiopia; b=Sao Tome & Principe; c=Tunisia; d=Botswana; e=South Africa; f=Mauritius; ME=morphine equivalence; Total ME=aggregate ME consumption of each study opioid. Journal of Pain and Symptom Management 2013 45, 681-700DOI: (10.1016/j.jpainsymman.2012.03.011) Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions

Fig. 5 (a–d) Log scale of consumption trends for morphine and Total ME (mg/person), in the Americas region. a=Cuba; b=Nicaragua; c=Ecuador; d=Canada; ME=morphine equivalence; Total ME=aggregate ME consumption of each study opioid. Journal of Pain and Symptom Management 2013 45, 681-700DOI: (10.1016/j.jpainsymman.2012.03.011) Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions

Fig. 6 (a–f) Log scale of consumption trends for morphine and Total ME (mg/person), in the Asia region. a=Uzbekistan; b=China; c=India; d=Nepal; e=Malaysia; f=Lebanon; ME=morphine equivalence; Total ME=aggregate ME consumption of each study opioid. Journal of Pain and Symptom Management 2013 45, 681-700DOI: (10.1016/j.jpainsymman.2012.03.011) Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions

Fig. 7 (a–d) Log scale of consumption trends for morphine and Total ME (mg/person), in the Europe region. a=Poland; b=Denmark; c=Albania; d=Germany; ME=morphine equivalence; Total ME=aggregate ME consumption of each study opioid. Journal of Pain and Symptom Management 2013 45, 681-700DOI: (10.1016/j.jpainsymman.2012.03.011) Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions

Fig. 8 (a–d) Log scale of consumption trends for morphine and Total ME (mg/person), in the Oceania region. a=Australia; b=New Caledonia; c=Kiribati; d=Cook Islands; ME=morphine equivalence; Total ME= aggregate ME consumption of each study opioid. Journal of Pain and Symptom Management 2013 45, 681-700DOI: (10.1016/j.jpainsymman.2012.03.011) Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions