[Opioid prescription changes in Sweden 2000–2015]

Area of Science:

• Pharmacology
• Public Health
• Health Services Research

Background:

• The US opioid epidemic is well-documented, yet Swedish opioid prescription trends remain largely unknown.
• Understanding national prescription patterns is crucial for public health and patient safety.
• The period 2000-2015 saw significant shifts in the pharmaceutical landscape, including drug withdrawals.

Purpose of the Study:

• To analyze trends in opioid prescription prevalence and patterns in Sweden between 2000 and 2015.
• To investigate changes in the utilization of specific opioid medications during this period.
• To identify shifts in opioid prescribing practices in the absence of an "opioid epidemic" context.

Main Methods:

• Descriptive analysis of aggregated data from the Swedish Board of Health and Welfare's open statistical database.
• Examination of yearly prevalence of opioid prescriptions from 2006 to 2015.
• Analysis of changes in the number of individuals using specific opioids and their prescribed dosages (Defined Daily Dose/patient/year).

Main Results:

• Overall yearly prevalence of opioid prescriptions showed no change between 2006 and 2015.
• Dextropropoxyphene was withdrawn from the market during the study period.
• Tramadol use decreased in patient numbers (-54%) but increased in average dosage (+41%).
• Oxycodone (+465%) and morphine (+137%) use increased significantly in patient numbers, but with decreased average dosages (-56% and -54%, respectively).

Conclusions:

• Swedish opioid prescription patterns underwent substantial changes between 2006 and 2015, despite stable overall prevalence.
• The market withdrawal of dextropropoxyphene and shifts towards increased use of oxycodone and morphine warrant further investigation.
• Further studies using non-aggregated data are needed to understand the implications of these prescription pattern shifts.