P-475: Trends of opioid utilization in Denmark: a nationwide study

摘要

Introduction: Opioid use has more than doubled over the last decades, and Denmark occupies fifth place in the global ranking. We aimed to describe opioid utilization trends in Denmark. Methods: Nationwide sales data on opioid analgesics were obtained from a national registry of drug sale statistics in Denmark between 1999-2017. Sales trends were stratified according to age, and opioids grouped as 2nd and 3rd line according to potency. Results: Sales of 2nd line opioids increased for ages 0-64 and 65-79 years, and decreased for ages ≥ 80 years (5.9-8.8, 23.8-28.0, and 40.7-38.2 defined daily doses/1000/day, respectively). Sales of 3rd line opioids increased for ages 0-64 years and ≥ 80 years, and decreased for ages 64-79 years (3.5-4.4, 21.0-28.3, and 16.4-15.1 defined daily doses/1000/day, respectively). Tramadol was the most commonly prescribed opioid, the annual users corresponded to 4.6% of the population. Tramadol sales increased disproportionately to 3rd line opioid sales for ages 0-64 years and 65-79 years, increasing 173.9% and 80.4%, respectively, while 3rd line opioids sales increased 25.7% and decreased 7.9%, respectively. No apparent inverse relationship was found comparing sales trends for tramadol with non-steroidal anti-inflammatory drugs (NSAIDs) and codeine. Key conclusions: (1) There is a disproportionate increase in 2nd line opioids compared to 3rd line opioids for the population aged below 80 years in Denmark. (2) Tramadol is the preferred 2nd line opioid, with sales increasing disproportionally to more potent opioids. (3) Tramadol does not seem to have replaced NSAIDs and codeine.