Opioid analgesics and related harms

January 01, 0001

Opioid analgesics and related harms

The aim of this study was to document trends in: (i) prescribing of morphine and oxycodone; (ii) hospital separations for overdose; (iii) presentations for treatment of problems associated with these drugs; and (iv) oxycodone- related mortality data in Australia. It consisted of a cross- sectional study analysing prescriptions for morphine and oxycodone based on figures adjusted using Australian Bureau of Statistics estimated resident population and prospectively collected data from: (i) the National Hospital Morbidity Database on hospital separations primarily attributed to poisoning with opioids other than heroin ("other opioids"); (ii) the Alcohol and Other Drug Treatment National Minimum Data Set for treatment episodes where morphine or oxycodone were the primary or other drugs of concern; (iii) the National Coronial Information System on deaths where oxycodone was the underlying cause of death or a contributory factor.

Prescriptions for morphine declined, while those for oxycodone increased. Prescriptions for both were highest among older Australians. Hospital separations for "other opioid" poisoning doubled between the financial years 2005-06 and 2006-07. Treatment episodes for morphine remained stable, while those for oxycodone increased. There were 465 oxycodone-related deaths recorded during 2001-2009.

The researchers concluded: "Oxycodone prescriptions in Australia have increased, particularly among older Australians. The increase may, in part, reflect appropriate prescribing for pain among an ageing population. However we are unable to differentiate non-medical use from appropriate prescribing from this data. In comparison to heroin, the morbidity and mortality associated with oxycodone is relatively low in Australia. There is a continued need for comprehensive training of general practitioners in assessing patients with chronic non-malignant pain and prescribing of opioids for these patients, to minimise the potential for harms associated with use of these medications."

Pain is probably undertreated overall, and it is unfortunate that these helpful agents can be addictive and dangerous.

For the full abstract, click here.

MJA 195(5):280-284, 5 September 2011 © The Medical Journal of Australia 2011
Prescription of opioid analgesics and related harms in Australia. Amanda Roxburgh, Raimondo Bruno, Briony Larance and Lucy Burns. Correspondence to Amanda Roxburgh: [email protected]

Category: HSR. Health Services Research. Z. Social Problems. Keywords: opioid, analgesia, harms, cross-sectional study, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 23 September 2011

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