Odsbu Ingvild, Handal Marte, Hjellvik Vidar, Borchgrevink Petter C, Clausen Thomas, Nesvåg Ragnar, Skurtveit Svetlana
Tidsskr Nor Laegeforen. 2022 Feb 14;142(3). doi: 10.4045/tidsskr.21.0659. Print 2022 Feb 15.
Long-term use of opioids may have undesirable consequences. We have investigated long-term opioid use in patient groups that were prescribed opioids for various indications (chronic pain, palliative care, other (white prescriptions, not generally covered by the Norwegian National Insurance Scheme)) as well as the groups' concomitant use of some other addictive medications.
Persons registered in the Norwegian Prescription Database with at least one filled prescription of an opioid in the period 2011-19 were included. Long-term use in a calendar year was defined as the dispensing of > 180 defined daily doses or > 4 500 mg oral morphine equivalents distributed over at least 3 periods of 3 months.
The number of long-term opioid users was 50 422 in 2011 and 59 996 in 2019 (10.1 and 10.7 % of all opioid users). The number who received opioids on blue prescription (partly covered by the Norwegian National Insurance Scheme) for chronic pain increased in the period by 9 952 persons, but the majority (n=38 006, 63.3 %) continued to receive opioids exclusively on white prescription in 2019. A total of 15 623 (41.1 %) and 14 881 (39.2 %), respectively, of the long-term opioid users who received opioids solely on white prescription in 2019 also received benzodiazepines and Z-hypnotics in the same year. Of the 23 967 long-term users who also received benzodiazepines, 88 % were dispensed opioids and benzodiazepines on the same day at least once in 2019.
Prolonged prescribing of opioids on white prescription and concurrent prescribing of other addictive drugs may indicate undesirable use with no clear indication.
长期使用阿片类药物可能会产生不良后果。我们调查了因各种适应症（慢性疼痛、姑息治疗、其他（白色处方，挪威国家保险计划通常不涵盖））而开具阿片类药物的患者群体中长期使用阿片类药物的情况，以及这些群体同时使用其他一些成瘾性药物的情况。
纳入2011 - 2019年期间在挪威处方数据库中登记且至少有一张阿片类药物处方配药记录的人员。日历年中的长期使用定义为在至少3个3个月时间段内配发超过180个限定日剂量或超过4500毫克口服吗啡当量。
2011年长期阿片类药物使用者数量为50422人，2019年为59996人（分别占所有阿片类药物使用者的10.1%和10.7%）。在此期间，因慢性疼痛而通过蓝色处方（部分由挪威国家保险计划覆盖）接受阿片类药物治疗的人数增加了9952人，但2019年大多数人（n = 38006，63.3%）仍仅通过白色处方接受阿片类药物治疗。2019年仅通过白色处方接受阿片类药物治疗的长期阿片类药物使用者中，分别有15623人（41.1%）和14881人（39.2%）同年还接受了苯二氮䓬类药物和Z类催眠药。在23967名同时接受苯二氮䓬类药物治疗的长期使用者中，88%在2019年至少有一次在同一天配发了阿片类药物和苯二氮䓬类药物。
白色处方长期开具阿片类药物以及同时开具其他成瘾性药物可能表明存在无明确指征的不当使用情况。
