Krüger Cecilia, Franck Johan, Widing Härje, Hällgren Jonas, Gissler Mika, Westman Jeanette
Department of Neurobiology, Care sciences and Society, Karolinska Institutet, Huddinge, Sweden.
The Stockholm Centre for Dependency Disorders, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
Commun Med (Lond). 2025 Sep 17;5(1):390. doi: 10.1038/s43856-025-01135-8.
Opioids are essential medicines for pain management; however, long-term use is associated with negative outcomes, including addiction. The aim of the study was to analyze the risk of long-term use after an initial opioid prescription and examine associated sociodemographic and health care-related risk factors.
We identified a strictly defined, five-year opioid-naïve population of adults aged 18-64 years who received an initial opioid prescription between 2016 and 2020 in Swedish national registers. We modeled the association between individual characteristics and odds of long-term ( > 3 months) versus short-term ( ≤ 3 months) use, and odds of different durations of use ( > 3-6, >6-12, and >12 months) using logistic regression analyses.
Of 754,982 opioid-naïve individuals with an initial opioid prescription, 8.1% use opioids long-term. Individuals treated for a recent external injury have lower odds of long-term opioid use (e.g., >12 vs ≤3 months: OR 0.55, 95% CI 0.52-0.59), whereas those who initiated treatment in primary care have higher odds (e.g., >12 vs ≤3 months: OR 3.02, 95% CI 2.90-3.14). Individuals with a history of substance use disorders and greater use of psycholeptic drugs have higher odds of long-term use. Sociodemographic factors, including older age, lower education level, and not cohabiting are also associated with longer durations of use.
Of opioid-naïve individuals, 8.1% develop long-term prescription opioid use, with higher odds among individuals with psychiatric history and whose opioid treatment initiated in primary care. Careful evaluation of patient health and regular follow-up are essential to reduce the risk of long-term opioid use.
阿片类药物是疼痛管理的基本药物；然而，长期使用会带来包括成瘾在内的负面后果。本研究的目的是分析首次开具阿片类药物处方后长期使用的风险，并研究相关的社会人口统计学和医疗保健相关风险因素。
我们在瑞典国家登记册中确定了一个严格定义的、五年内未使用过阿片类药物的18 - 64岁成年人群体，他们在2016年至2020年期间接受了首次阿片类药物处方。我们使用逻辑回归分析对个体特征与长期（> 3个月）与短期（≤ 3个月）使用的几率以及不同使用时长（> 3 - 6个月、> 6 - 12个月和> 12个月）的几率之间的关联进行建模。
在754,982名首次开具阿片类药物处方的未使用过阿片类药物的个体中，8.1%长期使用阿片类药物。近期受过外伤治疗的个体长期使用阿片类药物的几率较低（例如，> 12个月与≤ 3个月相比：比值比0.55，95%置信区间0.52 - 0.59），而在初级保健机构开始治疗的个体几率较高（例如，> 12个月与≤ 3个月相比：比值比3.02，95%置信区间2.90 - 3.14）。有物质使用障碍病史且更多使用精神抑制药物的个体长期使用的几率更高。社会人口统计学因素，包括年龄较大、教育水平较低和未婚同居，也与更长的使用时长相关。
在未使用过阿片类药物的个体中，8.1%会长期使用处方阿片类药物，有精神病史且在初级保健机构开始接受阿片类药物治疗的个体几率更高。仔细评估患者健康状况并定期随访对于降低长期使用阿片类药物的风险至关重要。
