Prescribed opioid analgesic use developments in three Nordic countries, 2006-2017

Area of Science:

• Pharmacology and Public Health
• Pain Management and Drug Utilization Studies

Background:

• Nordic countries have strict opioid controls for chronic non-cancer pain.
• Despite controls, strong opioid prescriptions have shown an increasing trend.
• Monitoring opioid dispensing is crucial for public health.

Purpose of the Study:

• To examine the consumption and trends of dispensed prescribed opioids in ambulatory care in Norway, Denmark, and Sweden from 2006 to 2017.
• To analyze changes in the prevalence of weak (tramadol, codeine) and strong (oxycodone) opioids.
• To compare opioid dispensing patterns across the three Nordic countries.

Main Methods:

• Utilized a repeated, cross-sectional design using national prescription registry data.
• Reported one-year prevalence of all dispensed opioids (ATC N02A) by gender for 2006-2017.
• Analyzed prevalence of tramadol, codeine, and oxycodone, and mean defined daily doses (DDD) per user in 2016.

Main Results:

• Significant differences in opioid dispensing patterns observed between 2006 and 2017 across the countries.
• Tramadol increased in Norway; codeine declined universally; oxycodone increased in all three nations.
• Norway showed the highest prevalence of dispensed opioids, while Sweden had the largest proportion of its population on oxycodone with the lowest mean doses.

Conclusions:

• Substantial shifts in prescribed opioid dispensing occurred in Norway, Sweden, and Denmark over 12 years.
• The rising prevalence of oxycodone necessitates continued monitoring.
• Publicly available prescription data are valuable for evidence-based prescribing policies.