Opioid Utilisation in Hungary: National and Regional Analysis in Ambulatory and Hospital Care Sector

Background/Objectives: Opioid consumption analysis in Hungary, particularly through ambulatory and hospital sales data, including regional information, is lacking. This study examines opioid use in both sectors, explores regional variations, and identifies influencing factors. Methods: A cross-sectional analysis was conducted using sales data from ambulatory and hospital care, quantifying opioid consumption in defined daily doses (DDD) per 1000 inhabitants (DID) and per day, or DDD per 100 patient days (DHPD) at national and regional levels. Correlations between opioid utilisation and regional variables were assessed using Spearman's rank test. Results: Total opioid use has risen from 4.73 DID in 2012 to 6.75 DID in 2021, with weak and oral opioids being the most used. Ambulatory care experienced significant increases in weak (61.48%) and oral opioid use (60.01%). Hospital care experienced a decline in DID and stagnation in DHPD. Tramadol combinations grew notably in ambulatory care, with tramadol-paracetamol rising from 0.37 DID to 2.17 DID (484.61% increase) and tramadol-dexketoprofen from 0.12 DID to 0.91 DID (650.27% increase). Interregional differences showed a maximum to minimum ratio of 1.79 in ambulatory and 3.03 in hospital care in 2021. Positive correlations were found between opioid use and geriatric population percentage (r = 0.475; p = 0.035) and, also, unemployment rate (r = 0.546; p = 0.014). A moderate negative correlation was observed between the number of general practitioners (r = -0.458; p = 0.043) and ambulatory care opioid use. Conclusions: Opioid use is increasing in Hungarian ambulatory care while remaining steady in the hospital sector. Regional variations are possibly linked to demographic and economic factors in ambulatory care.