Describing long‐term opioid use utilizing Nordic prescription registers—A Norwegian example

Abstract

Previous studies have de ned long-term opioid use in varying ways, decreasing comparability, reproducibility and clinical applicability of the research. Based on recent systematic reviews, we aimed to estimate long-term opioid use de ned as use persisting more than three months using one of the Nordic prescription registers. We used the Norwegian Prescription Register (NorPD) to extract data on all opioid dispensations between January 1st 2004 and October 31st 2019. New users of opioids (washout 365 days) were de ned as long-term users if they lled two criteria: 1) they had ≥2 dispensations of opioids, 91-180 days apart; 2) days 0-90 included ≥90 dispensed administration units (e.g., tablets) of opioids. Overall, there were 2,543,224 new users of opioids during the study period. Of these, 354,666 (13.9%) lled the criteria for long-term opioid use at least once. Compared to those who did not ll the criteria (short-term users), long-term users were older, more likely women, and used tramadol, oxycodone, and buprenorphine more frequently as their rst opioid. In conclusion, we found that 1/7 of opioid users continued use longer than 3 months. Future outcome research should identify the clinically most important dose requirements for long-term opioid use criteria.

Childhood trauma and the use of opioids and other prescription analgesics in adolescence and young adulthood: The HUNT Study

“…The count measure for each developmental stage was chosen based on the knowledge that prescription opioid use is relatively rare among adolescents and young adults and that very few will meet the criteria of previously used definitions for persistent use. 32 , 33 Prescriptions with a reimbursement code indicating palliative care (−90) were excluded. 48 , 49…”

Cohort Description: Preventing an Opioid Epidemic in Norway – Focusing on Treatment of Chronic Pain (POINT) – A National Registry-Based Study

“…Incident opioid use was defined by a washout period of 365 days, during which no opioid dispensations were allowed. See Hamina et al 24 for a detailed explanation of the cohort formation methods.…”

“…Utilising the methodology for defining long-term opioid use described in this article, Hamina et al found that one in seven persons who were dispensed opioids used them longer than three months at some time point during 2004–2019, with little change in the prevalence and incidence of long-term opioid use during the follow-up. 24 The work to identify risk factors for becoming a long-term opioid user and the consequences of long-term opioid use will continue throughout the coming years.…”

Long‐term opioid treatment and endocrine measures in chronic non‐cancer pain patients

“…For instance, from 2000 to 2017, the prevalence of CNCP in Denmark increased from 19.5% to 27.8% (Ekholm et al, 2022). This is a serious public health issue particularly when associated with indiscriminate use of prescribed opioids (Birke et al, 2016; Hamina et al, 2022; Ju et al, 2022).…”

“…According to an estimate based on recent growth in opioid consumption in Norway, approximately 14% of all new opioid users progress to long‐term use (Hamina et al, 2022), which is concerning given the limited evidence of efficacy of long‐term opioid treatment (L‐TOT) for chronic non‐cancer pain (Busse et al, 2018; Currow et al, 2016; Krebs et al, 2018; Sehgal et al, 2013) and the numerous opioid‐related adverse events that have been reported in this population (Els et al, 2017).…”