Abstract
Aims: Our objective was to explore the use of codeine analgesics in individual patients in Norway, giving special attention to the 10% who consume the highest amounts. Methods: We retrieved data from the Norwegian Prescription Database on patients who were dispensed at least one codeine analgesic prescription during 2006. We looked at age and gender specific 1-year periodic prevalence. The 10% of codeine users who were prescribed the highest amounts of the drug that year were further characterized. Age and gender distribution and concurrent high consumption of other potential drugs of abuse were also considered. Results: In the year 2006, a total of 386,836 individuals filled at least one prescription for codeine analgesics from Norwegian pharmacies, excluding cancer patients. The crude prevalence for the use of codeine analgesics was 7.3% and 9.3% of the male and female Norwegian population, respectively. Twelve percent of women and 9% of men who filled a codeine prescription received 120 defined daily doses (DDD) or more of codeine analgesics in 2006 (moderate to high consumers). Fifty percent of those patients (21,759) were also dispensed large amounts of benzodiazepines or carisoprodol over the same period. In comparison, only ten percent of patients who received fewer than 120 DDD of codeine analgesics were dispensed large amounts of benzodiazepines or carisoprodol. Conclusions: A high percentage of the Norwegian population used codeine analgesics. One-year prevalence use of codeine increased with age and was higher for women at all ages. Our study showed that codeine use was mainly sporadic, but that a relatively large sub-group of users were dispensed repeated prescriptions of the drug in combination with other potential drugs of abuse. Key Words: Codeine analgesics, Norwegian Prescription Database, prevalence, dispensed quantity, concurrent use, high consumers, abuse.
Highlights
Codeine is an opiate used for the treatment of mild to moderate pain.There are large variations between European countries in the quantity and type of opioids used [1,2]
Our analysis further focused on prevalence and population characteristics of the 10% of users of codeine who were prescribed the highest amounts of the drug, referred to below as “moderate/high users”
40% of the users received fewer than 12 defined daily doses (DDD) per year and 75% received fewer than 50 DDD per year
Summary
Codeine is an opiate used for the treatment of mild to moderate pain.There are large variations between European countries in the quantity and type of opioids used [1,2]. Drug sale statistics show that Norway has a high consumption of both codeine and morphine, while the sales of tramadol are low compared to the other Nordic countries [3]. These variations may be explained by differences in national treatment guidelines and drug reimbursement systems. Fixed combinations of analgesics containing codeine and paracetamol (acetaminophen) are widely prescribed in Norway [4] The use of these analgesics is more common in Norway than in other European countries [1,2,3], and accounts for more than 99% of the overall codeine consumption in the country
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