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Changes in opioid and other analgesic use 1995–2010: Repeated cross‐sectional analysis of dispensed prescribing for a large geographical population in S cotland
Author(s) -
Ruscitto A.,
Smith B.H.,
Guthrie B.
Publication year - 2015
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1002/ejp.520
Subject(s) - medicine , analgesic , oxycodone , tramadol , fentanyl , population , opioid , pregabalin , medical prescription , hydrocodone , polypharmacy , cross sectional study , gabapentin , morphine , codeine , odds ratio , anesthesia , pharmacology , environmental health , alternative medicine , receptor , pathology
Background Despite recent concerns about increasing rates of analgesic prescribing, detailed epidemiological studies are lacking. We identified and described changes in the pattern of community‐dispensed prescriptions to the T ayside population, S cotland, between 31st M arch 1995 ( n = 301,020) and 31st M arch 2010 ( n = 311,881). Methods Repeated cross‐sectional analysis of patient‐level population data on dispensed analgesics, stratified by sociodemographic variables; logistic regression to identify factors associated with strong opioid dispensing in 2010. Results The proportion of people currently dispensed any analgesic increased in 2010 (17.9%) compared with 1995 (15.7%). This increase was not equal across drug classes, with paracetamol, opioids and gabapentin/pregabalin showing an increase, but others showing a decrease. Weak opioids were less commonly dispensed in 2010 (8.2% vs. 8.4%) but dispensing of strong opioids increased 18‐fold (3.6% vs. 0.2%), including a five‐fold increase of morphine, fentanyl or oxycodone (0.75% vs. 0.15%). People receiving more non‐analgesic drugs (odds ratio 20.7 if dispensed >14 non‐analgesic medications vs. those dispensed <4) and those living in more deprived areas (OR 1.63 most deprived vs. most affluent) were more likely to receive a strong opioid in 2010.Conclusions Analgesic use rose modestly between 1995 and 2010, but with larger changes within individual classes, only partly reflecting evidence‐based guidance. Dispensing of strong opioids increased dramatically, largely driven by tramadol, although other strong opioids tripled. Polypharmacy and socio‐economic deprivation were strongly associated with strong opioid use. Research is needed to establish the causes, benefits and harms of the increase in analgesic, and especially strong opioid use.