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In the past decade, health authorities in various jurisdictions have reported an upsurge in prescription opioid utilisation and an unprecedented rise in opioid-related mortality. In this scoping review, we weigh current epidemiological evidence associated with a prescription opioid use problem in Israel. We summarise available indicators on prescription opioid use, availability, mortality, morbidity, and service utilisation. Although most available indicators show an increase in opioid prescribing and availability, others show that opioid-related mortality has declined in the past two decades. We further discuss potential reasons for the declining mortality despite an increase in opioid use. Based on current evidence, we conclude that Israel is not experiencing an opioid crisis in the magnitude of that encountered in the United States, Canada, and Australia. Trends pointing to increased opioid prescribing could be an alerting signal to an ongoing public health problem. However, such conclusions are limited by the lack of robust data on an increase in opioid-related morbidity and mortality. In the context of differences in health systems, regulatory frameworks, and treatment capacity across countries, providing decision-makers with information on the cause and extent of their domestic opioid crisis is essential for devising appropriate policies.

Mountain or molehill? A scoping review of evidence on an opioid use problem in Israel