Trends in Postoperative Opioid Use in Norway 2011-2018: A Nationwide Registry-Based Study

Area of Science:

• Pharmacology
• Public Health
• Epidemiology

Background:

• Limited data exists on postoperative opioid use trends in Nordic countries.
• Understanding these trends is crucial for public health initiatives and pain management strategies.

Purpose of the Study:

• To investigate trends in postoperative opioid use in Norway from 2011 to 2018.
• To analyze changes in opioid substance distribution, initial dosage, and formulation types.

Main Methods:

• Utilized linked data from Norwegian health registries (Prescription, Patient, Cancer, Cause of Death).
• Defined postoperative opioid use as first dispensing within 14 days of a surgical procedure.
• Calculated period prevalence, substance distribution, initial amount (MME), and long-acting formulation proportions, excluding cancer patients and those on maintenance therapy.

Main Results:

• Period prevalence of postoperative opioid use increased from 27.0 to 30.0 per 1000 individuals (≥15 years).
• Long-term use prevalence rose from 2.0 to 3.3 per 1000.
• Shift observed from codeine dominance to more equal dispensing of codeine and tramadol, with oxycodone increasing from 3% to 12%; initial amounts decreased for oxycodone and tramadol, while long-acting formulations increased from 5% to 12%.

Conclusions:

• Postoperative opioid use in Norway showed an increasing trend between 2011 and 2018.
• A notable shift occurred towards tramadol and oxycodone, with reduced initial dosages but increased use of long-acting formulations, indicating evolving prescribing patterns.