Trends in opioid consumption in the Nordic countries 2002-2006.
OBJECTIVE
The purpose of the study was to examine the trends in opioid consumption in the five Nordic countries between 2002 and 2006 and to explore possible explanations for changes in the quality and quantity of opioids consumed.


METHODS
Data on opioid consumption were extracted from the databases of the respective national authorities. Six strong and four weak opioids were included in the analysis. Data were presented as DDDs/1000 inhabitants/day. In addition, information on the reimbursement system and opioid prescription regulations in respective countries was obtained. Also, the cost of analgesic medication in the Nordic countries was compared as equipotent doses of CR morphine, CR oxycodone and transdermal fentanyl.


RESULTS
During the five year period examined the total use of opioids showed some increase in all countries except Sweden. In Finland and Norway the increase in the total consumption was mainly due to an increase in the consumption of strong opioids while in Denmark the rise was due to increased consumption of weak opioids. The consumption of morphine was stabile or decreased slightly in all countries while the use of transdermal fentanyl increased in Denmark, Finland and Sweden and oxycodone in all countries except Iceland. The consumption of dextropropoxyphene decreased in all countries. Reimbursement policies or prescription regulations do not seem to explain the kind/type of opioids consumed or changes in their consumption.


CONCLUSIONS
Consumption of opioid analgesics in the Nordic countries showed changes over the five year period that cannot be explained by pharmacology, price, reimbursement or prescription regulations. Marketing has most likely significantly influenced the type and amount of opioids consumed.
Hamunen
Katri
K
Pain Clinic, Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Central Hospital, Meilahti Hospital, Helsinki, HUS, Finland. katri.hamunen@fimnet.fi
Paakkari
Pirkko
P
Kalso
Eija
E
D000701:Analgesics, Opioid / Q000191:economics / Q000627:therapeutic use*; D016208:Databases, Factual; D003718:Denmark / Q000453:epidemiology; D011431:Dextropropoxyphene / Q000627:therapeutic use; D004333:Drug Administration Routes; D016527:Drug Costs / Q000706:statistics & numerical data / Q000639:trends; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends; D004335:Drug and Narcotic Control; D005283:Fentanyl / Q000627:therapeutic use; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D020380:Needs Assessment; D009664:Norway / Q000453:epidemiology; D009293:Opioid-Related Disorders / Q000453:epidemiology*; D010098:Oxycodone / Q000627:therapeutic use; D010146:Pain / Q000188:drug therapy*; D011358:Product Surveillance, Postmarketing; D012042:Registries; D012051:Reimbursement Mechanisms / Q000706:statistics & numerical data / Q000639:trends; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology
D000701:Analgesics, Opioid; D010098:Oxycodone; D011431:Dextropropoxyphene; D005283:Fentanyl