Trends in prescription of strong opioids

Trends in prescription of strong opioids for 41–80 year old Norwegians, 2005–2010 

C.I. Neutel¹, S. Skurtveit², C. Berg³, S. Sakshaug^3,*

Abstract

Background

The use of strong opioids is affected by various influences such as increasing emphasis on adequate pain control and increasing measures to counteract opioid abuse. This study will examine trends of analgesic strong opioid use in an older population.

Methods

The study population includes people aged 41–80 who filled at least one prescription for analgesic strong opioids in 2005–2010. Information was obtained from the Norwegian Prescription Database (NorPD), that is, all prescriptions filled in Norwegian pharmacies.

Results

Annual rates per 1000 population of opioid users increased from 8.6/1000 in 2005 to 13.3/1000 in 2010 with the greatest increases for the oldest. Oxycodone showed the highest use in Norway and the greatest increase. Buprenorphine showed little use in 2005 but ranked second highest in 2010 at 3.3/1000. Morphine use remained stable over the years. Mean annual amount in defined daily doses (DDDs)/person decreased in the youngest age groups over 2005–2010 and showed a pattern of decreasing amounts with increasing age. About 20% of the study population received opioids from more than two prescribers and annually 20% received more than one type of opioid. High end users were younger and used more prescribers.

Conclusions

Rate of analgesic strong opioid use, particularly oxycodone and buprenorphine, in this older age group increased annually. 
The pattern of increasing opioid use is consistent with an increased focus on pain control but may also be influenced by altered reimbursement policies and the new convenient pharmaceutical formulations.