National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia. a.roxburghATunsw.edu.au
Med J Aust. 2011 Sep 5;195(5):280-4. doi: 10.5694/mja10.11450.
To document trends in: (i) prescribing of morphine and oxycodone; (ii) hospital separations for overdose; (iii) presentations for treatment of problems associated with these drugs; and (iv) oxycodone-related mortality data in Australia.
Cross-sectional study analysing prescriptions for morphine and oxycodone based on figures adjusted using Australian Bureau of Statistics estimated resident population and prospectively collected data from: (i) the National Hospital Morbidity Database on hospital separations primarily attributed to poisoning with opioids other than heroin ("other opioids"); (ii) the Alcohol and Other Drug Treatment National Minimum Data Set for treatment episodes where morphine or oxycodone were the primary or other drugs of concern; (iii) the National Coronial Information System on deaths where oxycodone was the underlying cause of death or a contributory factor.
Population-adjusted numbers of (i) prescriptions for morphine and oxycodone by 10-year age group, (ii) hospital separations for "other opioid" poisoning, and (iii) treatment episodes related to morphine or oxycodone; and (iv) number of oxycodone-related deaths.
Prescriptions for morphine declined, while those for oxycodone increased. Prescriptions for both were highest among older Australians. Hospital separations for "other opioid" poisoning doubled between the financial years 2005-06 and 2006-07. Treatment episodes for morphine remained stable, while those for oxycodone increased. There were 465 oxycodone-related deaths recorded during 2001-2009.
Oxycodone prescriptions in Australia have increased, particularly among older Australians. The increase may, in part, reflect appropriate prescribing for pain among an ageing population. However we are unable to differentiate non-medical use from appropriate prescribing from this data. In comparison to heroin, the morbidity and mortality associated with oxycodone is relatively low in Australia. There is a continued need for comprehensive training of general practitioners in assessing patients with chronic non-malignant pain and prescribing of opioids for these patients, to minimise the potential for harms associated with use of these medications.
记录以下方面的趋势：（i）吗啡和羟考酮的处方；（ii）因过量用药而住院的人数；（iii）因这些药物相关问题而就诊治疗的人数；以及（iv）澳大利亚与羟考酮相关的死亡率数据。
本研究采用横断面研究，根据澳大利亚统计局估计的居民人口数对吗啡和羟考酮的处方数据进行了调整，并利用以下数据进行了分析：（i）国家医院发病率数据库中主要归因于除海洛因以外的阿片类药物（“其他阿片类药物”）中毒的住院分离数据；（ii）酒精和其他药物治疗国家最低数据集中，吗啡或羟考酮是主要药物或其他关注药物的治疗病例；（iii）国家验尸信息系统中，羟考酮是根本死因或促成因素的死亡数据。
（i）10 岁年龄组的吗啡和羟考酮处方人数、（ii）因“其他阿片类药物”中毒而住院的人数、（iii）与吗啡或羟考酮相关的治疗病例；以及（iv）羟考酮相关的死亡人数。
吗啡的处方数量下降，而羟考酮的处方数量增加。这两种药物的处方数量在年龄较大的澳大利亚人中最高。2005-06 财政年度至 2006-07 财政年度期间，因“其他阿片类药物”中毒而住院的人数增加了一倍。吗啡的治疗病例保持稳定，而羟考酮的治疗病例增加。在 2001-2009 年期间记录了 465 例羟考酮相关死亡病例。
澳大利亚的羟考酮处方数量增加，尤其是在年龄较大的澳大利亚人中。这种增加可能部分反映了人口老龄化导致的疼痛治疗的适当处方。然而，我们无法从这些数据中区分非医疗用途和适当的处方。与海洛因相比，在澳大利亚，与羟考酮相关的发病率和死亡率相对较低。因此，仍需要对全科医生进行全面培训，以评估患有慢性非恶性疼痛的患者，并为这些患者开具阿片类药物，以最大程度地减少与使用这些药物相关的潜在危害。
