引言：在过去几十年间，欧洲国家，特别是在非癌症疼痛治疗方面，镇痛药的使用数量显著增加，包括治疗疼痛性慢性肌肉骨骼疾病。然而，在不同地理区域之间使用水平存在显著差异，并存在明显的上下文特定的弱效和强效镇痛药使用模式。本研究的目的是描述处方镇痛药在西班牙加那利群岛的大加纳利亚岛、兰萨罗特岛和富埃特文图拉岛使用情况的现实趋势。为此，分析了若干因素，如生活在城市或农村地区、65岁及以上的人口、人口密度或社会经济地位。方法：从供应社区药店的批发商那里获取了人口层面的数据。处方镇痛药使用量以每千名居民每天定义日剂量（DDD）计量。使用基于协方差分析的模型，包括两个嵌套固定因素和一个协变量，进行不同层面的对比分析。结果：西班牙的总DDD每千名居民每天和年变化率与大加纳利亚岛和富埃特文图拉岛非常相似（分别为0.967和1.006），尽管发药水平不同（分别为14.75和18.24以及12.7）。在所有问题上，兰萨罗特岛完全不同，镇痛药消费率在研究期内保持稳定，但呈下降趋势。强效镇痛药的发药水平在岛屿之间有所变化，富埃特文图拉岛为56.41%，而大加纳利亚岛为17.61%，尽管这些值保持稳定。与其他类型的弱效镇痛药相比，盐酸曲马多和扑热息痛的混合制剂以及单独使用的盐酸曲马多最为常用，而布洛芬酚丁胺是最常用的强效镇痛药，其次是芬太尼，尽管在岛屿之间需求有所变化，但透皮制剂是最常见的制剂形式。结论：处方镇痛药使用的差异很可能是由每个岛屿的镇痛药处方实践所解释，而城市化水平、人口年龄、人口密度和社会经济地位等因素并不能解释农村和城市地区处方镇痛药使用的差异。版权所有 © 2023 Oliva，González de Chavez，Dévora和Abdala。

Introduction: The use of opioids has increased markedly in the past decades in European countries, especially for treatment of non-cancer pain including painful chronic musculoskeletal conditions. However, there are some notable differences in the relative levels of use between geographical areas and some distinct, context-specific patterns of weak and strong opioid use. The aim of this work is to describe real world trends in dosage forms and population exposure in the prescription opioid use on isolated geographically area: The Canary Islands of Gran Canaria, Lanzarote and Fuerteventura, Spain. For this, several factors such as living in a rural or urban area, population over 65 years of age, population density or socioeconomic status were analyzed. Methods: Data were extracted from the wholesalers who supply the community pharmacies at the population level. Prescription opioid use was measured as defined daily doses (DDD) per 1,000 inhabitants per day. A model based on covariance analysis with two nested fixed factors and one co-variable was used for contrast analysis at different level. Results: The overall DDD per 1000 inhabitants per day and year variation rate in Spain was very similar to that obtained for Gran Canaria and Fuerteventura (0.967 vs. 1.006), although the levels of dispensation were different (14.75 versus 18.24 for Gran Canaria and 12.7 for Fuerteventura, respectively). Lanzarote is completely different in all issues, where the opioid consumption rate remained stable during the study period, but with a decreasing tendency. The dispensation level of strong opioids varied between islands, from 56.41% for Fuerteventura vs. 17.61% for Gran Canaria, although these values remained stable. Tramadol with acetaminophen and Tramadol in monotherapy were the most consumed forms of the weak opioids, whereas Buprenorphine was the most used strong opioid followed by Fentanyl, although demand for it varied between islands, the transdermal formulations were the most frequent pharmaceutical preparation. Conclusion: The differences in prescription opioid use are most likely explained by the opioid prescribing practices in each island, whereas factors such urbanicity level, population age, population density and status socioeconomic does not help to explain the differences in prescription opioid use across rural and urban areas.Copyright © 2023 Oliva, González de Chavez, Dévora and Abdala.