[Prescription of strong opioids by physicians.]

Morphine and other strong opioids are very often needed for the treatment of severe pain. In the FRG the prescription of these analgesics is limited by law, especially for outpatients. Special prescriptions are needed for opioid medication. We analyzed the treatment of outpatients with strong opioids in the first 6 months of 1985 and of 1988. Only 184 members of the AOK Hannover, a large insurance branch with more then 320,000 members, received a prescription of strong opioids from January to July 1985 (=0.057% of all members). On the whole, only 994 prescriptions (=0.094% of the total amount of prescriptions) of strong opioids were issued by the family physicians. During the first 6 months of 1988 we found comparable data: 1,581 prescriptions (=0.145%) for 243 members of the AOK Hannover (=0.075%). In 1985 as well as in 1988 only 16% of the physicians registered in the area of Hannover prescribed strong opioids. Insufficient treatment of outpatients suffering from severe pain is obvious. The complex regulations in the FRG concerning the prescription of strong opioids are the main reason for insufficient treatment. It is necessary to liberalize these regulations in order to treat severe pain better.