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Published on: April 14, 2016
Concomitant medication among persistent opioid users with chronic non-malignant pain.
A Mellbye1, K Svendsen, P C Borchgrevink
1Department of Circulation and Medical Imaging, Pain and Palliation Research Group, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. andrm@stud.ntnu.no
Acta Anaesthesiologica Scandinavica
|September 6, 2012
Summary
Sixty percent of patients on long-term opioid therapy for chronic pain were prescribed benzodiazepines, contradicting treatment guidelines. This co-prescription may increase risks of problematic opioid use.
Area of Science:
- Pharmacology
- Pain Management
- Public Health
Background:
- Recent guidelines advise against co-prescribing opioids with benzodiazepines for chronic non-malignant pain.
- Non-opioid analgesics and co-analgesics are recommended for potential opioid-sparing effects.
Purpose of the Study:
- To determine the 1-year prevalence of co-medication in persistent opioid users with chronic non-malignant pain.
- To examine co-prescription patterns of benzodiazepines, hypnotics, non-opioid analgesics, co-analgesics, and antidepressants.
Main Methods:
- Utilized data from the Norwegian Prescription Database for all outpatient drug dispensations in 2008.
- Compared concomitant medication use in persistent opioid users against the general Norwegian population.
Main Results:
- 1.2% of Norwegian adults met criteria for persistent opioid use.
- 60% of persistent opioid users received benzodiazepines or related hypnotics regularly; 15% received high amounts of both.
- 62% received non-opioid analgesics, 47% antidepressants, and 33% antiepileptic drugs.
Conclusions:
- A significant proportion (60%) of persistent opioid users are co-prescribed benzodiazepines or related hypnotics regularly.
- This co-medication pattern conflicts with current pain management guidelines.
- Such practices may elevate the risk of problematic opioid use among these patients.
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