Persistent use of high-dose opioids and other addictive medications.

Background: Persistent use of high-dose opioids increases the risk of overdose, particularly when used in combination with other sedatives. The aim of the study was to examine the number of people with persistent use of high-dose opioids in 2011 and 2019, the proportion who received the opioids on a 'blue prescription' (heavily subsidised prescription) and the proportion with concurrent persistent use of benzodiazepines and z-hypnotics.

Material and method: Persistent use of high-dose opioids was defined as the dispensing of more than two defined daily doses or 50 mg of oral morphine equivalents of opioids per day, in at least three out of four quarters. Data from 2011 and 2019 were obtained from the Norwegian Prescription Database.

Results: In 2011 and 2019, a total of 7010 (142 per 100,000 population) and 12,199 patients (228 per 100,000 population), respectively, were given high-dose opioids for persistent use. In 2011, 31 % of these patients received at least one opioid blue prescription; in 2019, the proportion was 51 %. In 2011, 45 % of patients receiving high-dose opioids for persistent use also received over 100 defined daily doses of benzodiazepines, and 35 % received over 100 defined daily doses of z-hypnotics. The corresponding figures for 2019 were 30 % and 32 %.

Interpretation: The proportion of the population receiving high-dose opioids for persistent use was higher in 2019 than in 2011.