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Opioid Use Disorder in Brazil: Emerging Patterns, Critical Gaps, and Implications for Public Health Policy - A
Mariana Campello de Oliveira1, Henrique Alves Bezerra2, Cláudia Carneiro de Araújo Palmeira1
1Instituto Perdizes, Departamento de Álcool e Drogas, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil. Faculdade de Medicina da Universidade de São Paulo, Departamento de Psiquiatria, São Paulo, SP, Brazil.
Background:
Opioid Use Disorder (OUD) has become a major global public health concern, yet its epidemiological and clinical profile in Brazil remains insufficiently characterized. This systematic review aimed to synthesize the available evidence on OUD in the Brazilian context.
Methods:
Following a protocol registered in PROSPERO (CRD420250656485), we searched PubMed, BVS/LILACS, Scopus, and Web of Science from inception to April 30, 2025. Studies conducted in Brazil and involving individuals with OUD were eligible. Methodological quality was assessed using standardized critical appraisal tools.
Results:
Twelve studies met inclusion criteria, with 58% rated as high methodological quality. Most studies reported low absolute numbers of opioid users. Illicit opioid use was rare (<0.5%), whereas non-medical use of prescription opioids was considerably more prevalent. Health care professionals showed a higher risk. No randomized controlled trials (RCTs) were identified.
Conclusions:
Brazil faces a distinct opioid landscape characterized by low prevalence of illicit opioid use but notable misuse of prescription opioids. The absence of RCTs evaluating treatment effectiveness represents a significant evidence gap. Urgent research is needed to assess the feasibility and effectiveness of Medication for Opioid Use Disorder (MOUD) within the Brazilian health care system (SUS).
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