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| Opioid Availability and Consumption in Lithuania |
| The following opioid analgesics are registered in Lithuania: alfentanyl; codeine; dihydrocodeine, ethylmorphine, fentanyl, methadone (for use with patients with addictions only), morphine, pethidine, piritramide, remifentanyl, tilidine. There are 82 different registered forms and dosages of registered opioid analgesics, including solutions for injection, oral tablets, oral capsules, oral solution, suppositories, and transdermal patches. Opioids are not manufactured in Lithuania, though one company is licensed for the preparation of morphine solutions for injection using the imported substance. Every physician (under a regulation of 1997) can prescribe narcotics using a special prescription form, which may be used for one substance only. It is prohibited to prescribe narcotic drugs for a period longer than 7 days for incurable patients, though from June 2002 transdermal patches will be allowed over a period of 30 days.4 |
| Since 1995 there has been a steady increase in morphine consumption in Lithuania: 1995 (3.6 kg); 1996 (4 kg); 1997 (5.3 kg); 1998 (6.9 kg).5 |
| Oral Morphine was not available in Lithuania before 1996 and legislation inhibited the easy prescription of opioids for medical use.6 |
| The average daily consumption of defined daily doses of opioids per million inhabitants between 1994-98 was: codeine (4); ethylmorphine (1); morphine (130); methadone (99).7 |
In February 2002, issues relating to the use of opioids in Lithuania were summarised by an expert group8 as follows, and an action plan was formulated to address them:
- Does national policy require the use of a special prescription form?
Yes, triplicate for reimbursed narcotics
- Does the physician or institution have to pay for the special prescription form?
No
- Does national policy establish a validity period for opioid prescriptions? If so, what amount?
Yes, 5 days
- Does national policy establish a maximum amount that can be prescribed at one time? If so, what amount?
Yes, 7 days per prescription (30 days for fentanyl patch)
- Does national policy limit the length of time that a patient may be treated with an opioid?
No
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| Average defined daily doses of morphine, Central and Eastern Europe (1994-1998) |
 Source: Clark D, Wright M (2002) Transitions in End of Life Care: Hospice and Related Developments in Eastern Europe and Central Asia. Buckingham: Open University Press |
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