[Variable prescription of opioids to cancer patients in Norway].
BACKGROUND
We examined prescription of the opioids used most often in cancer pain relief in the Norwegian counties, doctors' use of the law section concerning reimbursement of medicine to incurable far advanced cancer patients, and the prescription of analgesics with codein to this patient group.


METHODS
Data were retrieved from The Norwegian prescription database for the period 01.01.04 to 31.08.05 (NorPD) on every prescription of slow and instant release morphine and oxycodone for oral administration and of transdermal fentanyl patches. SPSS was used for analyses.


RESULTS
5,675,038 Defined Daily Doses (DDD) of strong opioids were prescribed to 20,797 patients (46% of these to cancer patients) from 01.01.04 to 31.08.05. The county that prescribed most had prescribed 2.83 times more opioids than the county that had prescribed the least. Use of the law section concerning prescription of opioids indicates that these are prescribed as much for non-malignant diseases as for cancer. "Codein analgesics" are also commonly prescribed to cancer patients.


CONCLUSIONS
Prescription of strong opioids varies substantially in Norway's counties. Doctors' knowledge, attitude, geographical and cultural differences may be some reasons for this. Knowledge about and use of the law section concerning reimbursement is probably not good enough. Increased awareness of how to treat cancer pain is important go give a good treatment offer to all in Norway.
Det medisinske fakultet, Universitetet i Tromsø, 9037 Tromsø. astorol@mailbox.uit.no
Anders Storhaug
AS
Olsen
Stig
S
Ottesen
D000701:Analgesics, Opioid / Q000008:administration & dosage*; D001291:Attitude of Health Personnel; D003061:Codeine / Q000008:administration & dosage; D011307:Drug Prescriptions; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010818:Practice Patterns, Physicians'; D012042:Registries; D012051:Reimbursement Mechanisms
D000701:Analgesics, Opioid; D003061:Codeine