title: A preliminary study of patients on repeat prescriptions of opioid and non-opioid analgesics.
abstract: BACKGROUND
  Available literature suggests that problems due to dependence do not result from the use of low doses of low-potency opioids used for short periods of time, but no studies looked at the effect of their long-term use.
  
  
  OBJECTIVE
  The main objective of the study was to discover whether those patients on long-term low-potency opioids, and those on non-opioid analgesics, could suffer the problems of tolerance and dependence. The study also explored the validity of applying DCR-10 criteria to a non-problematic population of analgesic users in identifying drug-dependent patients in primary care.
  
  
  METHODS
  The prevalence of potential dependence amongst long-term users was assessed by a semi-structured questionnaire applying the DCR-10 criteria for Dependence Syndrome. The sample consisted of 38 randomly selected patients, drawn from four practices in North Cheshire, who had been on continuous repeat prescriptions of low-potency opioids, compound analgesics containing them and non-opioid analgesics (non-steroidal anti-inflammatory drugs - NSAIDs) for a minimum of one year, without any problems becoming apparent either to the patients or to their GPs.
  
  
  RESULTS
  Approximately 3.6% of the North Cheshire GP practice population, predominantly elderly people, were shown to be on either opioid and/or non-opioid analgesics continuously for at least one year. An estimated 31% and 40% of patients on NSAIDs and low-potency opioids respectively fulfilled the DCR-10 criteria for Dependence Syndrome. With the exception of the criterion of 'impaired control' (odds ratio 4; P < 0.05), the DCR-10 criteria are equally likely to be reported in both groups.
  
  
  CONCLUSIONS
  An unexpectedly high incidence of dependence was found, not only on opioids but also within the NSAIDs group. The findings may have resulted, at least in part, from an undetermined DCR-10 specificity.
authors.forename: I E
authors.initials: IE
authors.lastname: Salib
keywords: Long-TERM Prescribing Primary Care Low-POTENCY Opioids Non-STEROIDAL Anti-INFLAMMATORY Drugs Nsaids Repeat Prescriptions Compound Analgesics