International opioid consumption.

The aim of the present study was to analyse the opioid consumption in the 10 most opioid-consuming countries in relation to the Danish consumption. The results revealed, that the total opioid consumption has increased in all of the 10 most opioid consuming countries (range 26-1423%). In Denmark, the total opioid consumption increased 353% from 1981 to 1993, exceeding 1.45 million defined daily doses per 1 million inhabitants in 1993, which is the highest in the world. Of these, morphine accounted for 39%, methadone 22%, ketobemidone 21% and buprenorphine 14%. The consumption of long-acting opioids (morphine sustained release, methadone, buprenorphine) and short acting opioids (others) increased 1427% and 105%, respectively. Analysis of a sample of 1854 prescriptions made by general practitioners for opioids revealed, that less than 10% of the prescriptions were issued for cancer pain conditions. In conclusion of other countries consider Denmark as worthy of imitation concerning opioid treatment in cancer pain, attention should be paid to the pattern of the Danish opioid consumption, which is outstanding with respect to quantity.