title: To what extent does a cohort of new users of weak opioids develop persistent or probable problematic opioid use?
abstract: When opioid therapy is initiated for a new pain condition, it may be unknown whether the pain will persist beyond the time of tissue healing. The aim of this study was to determine the prevalence of prescription patterns indicating persistent and/or problematic opioid use in a cohort of opioid-naive patients starting therapy with weak opioids. Data were drawn from the nationwide Norwegian Prescription Database. The study population was all new users of opioids receiving prescriptions of a weak opioid in 2005 for nonmalignant pain. This cohort was followed until December 2008. In order to be classified as having probable problematic opioid use, patients had to meet all of the following criteria: received opioids at least once every year from 2005 to 2008 and in 2008; (1) were dispensed more than 365 defined daily doses (DDDs) of opioids; (2) received opioid prescriptions from more than 3 doctors; and (3) were dispensed more than 100 DDDs of benzodiazepines. There were 245,006 persons who were new users of weak opioids in 2005 (216,902 codeine, 26,326 tramadol, 1778 dextropropoxyphene). There were 17,252 (7% of new users) who received a prescription for opioids at least once each of the 3 following years. Of these subjects, 686 patients were dispensed more than 365 DDDs of opioids in 2008 and are probably persistent users. There were 191 subjects who met our criteria for probable problematic opioid use. In a cohort of new opioid users who started treatment with weak opioids, only 0.3% and 0.08% developed prescription patterns indicating persistent opioid use and problematic opioid use, respectively.
authors: Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway Norwegian Centre for Addiction Research, University of Oslo, Norway Department of Pharmacy, University of Tromsø, Norway Department of Pain and Complex Disorders, St. Olav's University Hospital, Trondheim, Norway Pain and Palliation Research Group, Institute of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway Department of Emergency Medicine, Telemark Hospital, Skien, Norway.
authors: Svetlana
authors: S
authors: Skurtveit
authors: Kari
authors: K
authors: Furu
authors: Petter
authors: P
authors: Borchgrevink
authors: Marte
authors: M
authors: Handal
authors: Olav
authors: O
authors: Fredheim
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000145:classification; D015331:Cohort Studies; D016208:Databases, Factual / Q000706:statistics & numerical data; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D009293:Opioid-Related Disorders / Q000453:epidemiology*; D010146:Pain / Q000188:drug therapy* / Q000453:epidemiology*; D011336:Probability; D012189:Retrospective Studies
chemical_list: D000701:Analgesics, Opioid