{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T18:55:15Z","timestamp":1772045715613,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,2,8]],"date-time":"2017-02-08T00:00:00Z","timestamp":1486512000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aims<\/jats:title><jats:p>Barriers linked to drug control systems are considered to contribute to inequitable access to controlled medicines, leaving millions of people in pain and suffering. Most studies focus on access to opioids for the treatment of severe (cancer) pain. This study aims to identify specific access barriers for patients with opioid dependence in legislation and regulations of 11 central and eastern European countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study builds on a previous analysis of legislation and regulations as part of the EU 7th Framework Access To Opioid Medication in Europe (ATOME) project. An in\u2010depth analysis was undertaken to determine specific barriers for patients with opioid dependence in need of opioid analgesics or opioid agonist therapy (OAT). For each country, the number and nature of specific potential barriers for these patients were assessed according to eight categories: prescribing; dispensing; manufacturing; usage; trade and distribution; affordability; penalties; and other. An additional keyword search was conducted to minimize the omission of barriers. Barriers in an additional category, language, were recorded qualitatively. Countries included Bulgaria, Cyprus, Estonia, Greece, Hungary, Latvia, Lithuania, Serbia, Slovakia, Slovenia and Turkey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten of the 11 countries (all except Estonia) showed specific potential barriers in their legislation and regulations. The total number of barriers varied from two (Slovenia) to 46 (Lithuania); the number of categories varied from one (Slovenia) to five (Lithuania). Most specific potential barriers were shown in the categories \u2018prescribing\u2019, \u2018usage\u2019 and \u2018other\u2019. The total number in a single category varied from one to 18 (Lithuania, prescribing). Individual differences between countries in the same specific potential barrier were shown; for example, variation in minimum age criteria for admission to OAT ranging from 15 (Lithuania, in special cases) to 20\u00a0years (Greece). All countries had stigmatizing language in their legislation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with opioid dependence are likely to experience specific barriers to accessing opioids in addition to those experienced by other non\u2010dependent patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.13755","type":"journal-article","created":{"date-parts":[[2017,1,14]],"date-time":"2017-01-14T12:53:04Z","timestamp":1484398384000},"page":"1069-1076","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Barriers to access to opioid medicines for patients with opioid dependence: a review of legislation and regulations in eleven central and eastern European countries"],"prefix":"10.1111","volume":"112","author":[{"given":"Marjolein J. M.","family":"Vranken","sequence":"first","affiliation":[{"name":"Utrecht Institute for Pharmaceutical Sciences Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University  Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aukje K.","family":"Mantel\u2010Teeuwisse","sequence":"additional","affiliation":[{"name":"Utrecht Institute for Pharmaceutical Sciences Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University  Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saskia","family":"J\u00fcnger","sequence":"additional","affiliation":[{"name":"Institute of General Practice Hannover Medical School  Hannover Germany"},{"name":"Research Unit Ethics University Hospital Cologne  Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas","family":"Radbruch","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine University Hospital, Bonn  Germany"},{"name":"Centre for Palliative Care Malteser Hospital, Bonn  Bonn Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Willem","family":"Scholten","sequence":"additional","affiliation":[{"name":"Willem Scholten Consultancy Medicines and Controlled Substances  Lopik The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John A.","family":"Lisman","sequence":"additional","affiliation":[{"name":"Lisman Legal Life sciences  Nieuwerbrug The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marija","family":"Subataite","sequence":"additional","affiliation":[{"name":"Eurasian Harm Reduction Network  Vilnius Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie\u2010H\u00e9l\u00e8ne D. B.","family":"Schutjens","sequence":"additional","affiliation":[{"name":"Utrecht Institute for Pharmaceutical Sciences Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University  Utrecht The Netherlands"},{"name":"Schutjens de Bruin  Tilburg The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,2,8]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h5540"},{"key":"e_1_2_7_3_1","unstructured":"Global Commission on Drug Policy.The negative impact of drug control on public health: the Global Crisis of Avoidable Pain. Geneva Switzerland;2015."},{"key":"e_1_2_7_4_1","volume-title":"Ensuring Balance in National Policies on Controlled Substances: Guidance for Availability and Accessibility of Controlled Medicines","author":"World Health Organization (WHO)","year":"2011"},{"key":"e_1_2_7_5_1","volume-title":"Availability of Internationally Controlled Drugs\u00a0: Ensuring Adequate Access for Medical and Scientific Purposes","author":"International Narcotics Control Board (INCB)","year":"2016"},{"key":"e_1_2_7_6_1","unstructured":"World Health Organization.Resolution WHA 67.19: Strengthening of palliative care as a component of comprehensive care throughout the life course. Geneva Switzerland: World Health Assembly 67;2014. 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Available at:https:\/\/www.incb.org\/documents\/Publications\/AnnualReports\/Thematic_chapters\/English\/AR_1999_E_Chapter_I.pdf(accessed 18 April 2016) (Archived athttp:\/\/www.webcitation.org\/6nuTrvXCjon 30 January 2017)."},{"key":"e_1_2_7_13_1","volume-title":"Access to Controlled Medications Programme, Framework","author":"World Health Organization (WHO)","year":"2007"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2015.0051"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2009.11.006"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2015.12.021"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/1747-597X-8-26"},{"key":"e_1_2_7_18_1","unstructured":"Joint United Nations Programme on HIV\/AIDS (UNAIDS).Do No Harm. Health Human Rights and Peolple Who Use Drugs. Geneva Switzerland: United Nations;2016. 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