Skip to main content
SpringerLink
Log in

Use of codeine analgesics in a general population

A Norwegian study of moderately strong analgesics

  • Originals
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

The prescribing of controlled analgesics (codeine, buprenorphine and pentazocine preparations) was studied, using prescriptions from the three pharmacies in the municipality of Tromsø, Norway. All prescriptions dispensed during one year were analysed. The study sample comprised 3083 women (58%) and 2223 men (42%) between 10 and 99 years of age.

About 8% of the population had obtained one or more prescriptions of controlled analgesics. Combined codeine preparations were by far the most frequently prescribed subgroups, and the average amount purchased during 1 year was 30 defined daily doses (DDD).

The sporadic users were in the majority. A few users had purchased high amounts of controlled analgesics. The prevalence of use, the mean number of defined daily doses of analgesics, and the proportion of ‘weekly’ drug users was higher in women than men. The prevalence increased significantly with age, from 0.7 to 22.3% in women and from 0.5 to 14.1% in men. The mean number of DDD during one year also increased with age, from 12.6 to 50.6 DDD in women, and from 6.6 to 40.6 DDD in men.

The users of buprenorphine and pentazocine differed in several aspects from the codeine users. The highest use of combined codeine preparations was seen in elderly people especially in women. Use of lower codeine doses or intermittent treatment with other drugs e.g. plain paracetamol in adequate doses, may be appropriate alternatives reducing the risk of adverse drug reactions such as nausea and constipation.

Monitoring of prescribing and use of controlled analgesics according to certain criteria may uncover possible misuse.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Øydvin K (ed) (1991) The drug consumption in Norway 1986–90. In Norwegian. Norwegian Medical Depot, Oslo

    Google Scholar 

  2. Øydvin K (ed) (1992) The Norwegian Prescription Study In: The drug consumption in Norway 1991. In Norwegian. Norwegian Medical Depot, Oslo

    Google Scholar 

  3. Anonymous (1982) Codeine has been moved to a new prescription category. In Norwegian. Newsletter Nat Centre Medicinal Products Control 1: 3

  4. Ahonen R, Enlund H, Klaukka T, Martikainen J (1991) Consumption of analgesics and anti-inflammatory drugs in the Nordic countries between 1978–88. Eur J Clin Pharmacol 41: 37–42

    Google Scholar 

  5. Ahonen R, Klaukka T, Martikainen J, Enlund H (1993) Use of analgesics and anti-inflammatory drugs in Finland: a cross-sectional analysis in 1976 and 1987. J Soc Adm Pharm 10: 15–22

    Google Scholar 

  6. Nilsson JLG (ed) (1991) Swedish drug statistics 1990. In Swedish. Summaries in English. Apoteksbolaget, Farmaceutiska sektorn, Stockholm

    Google Scholar 

  7. The County Medical Officer of Hordaland (ed) (1991) The prescribing of controlled drugs in Hordaland county november 1989. In Norwegian. The County Medical Officer of Hordaland, Bergen

    Google Scholar 

  8. Gustafsson LL, Boëthius G (1982) Utilization of analgesics from 1970 to 1978. Prescription patterns in the county of Jämtland and in Sweden as a whole. Acta Med Scand 211: 419–425

    Google Scholar 

  9. Ahonen R, Enlund H, Pakarinen V, Riihimäki S (1992) A 1-year follow-up of prescribing patterns of analgesics in primary health care. J Clin Pharm Ther 17: 43–47

    Google Scholar 

  10. Schug SA, Merry AF, Acland RH (1991) Treatment principles for the use of opioids in pain of non-malignant origin. Drugs 42: 228–239

    Google Scholar 

  11. Statistics Norway (1990) Norwegian population statistics 1989, vol II. Universitetsforlaget, Oslo

    Google Scholar 

  12. Øydvin K (ed) (1986) The drug consumption in Norway 1981–85. In Norwegian. Summary in English Norwegian Medical Depot, Oslo

    Google Scholar 

  13. SAS statistical package (1987) SAS/STAT Guide for Personal Computers, 6th edn. SAS Institute Cary, NC, USA

  14. Ready LB, Sarkis E, Turner JA (1982) Self-reported vs actual use of medications in chronic pain patients. Pain 12: 285–294

    Google Scholar 

  15. Berndt S, Maier C, Schütz H-W (1993) Polymedication and medication compliance in patients with chronic non-malignant pain. Pain 52: 331–339

    Google Scholar 

  16. Bergman U, Dahl-Puustinen M (1989) Use of prescription forgeries in a drug abuse surveillance network. Eur J Clin Pharmacol 36: 621–623

    Google Scholar 

  17. Anonymous (1989) Buprenorphine preparations have been moved to a new prescription category — now classified as narcotics. In Norwegian. Newsletter Nat Centre Medicinal Products Control 2: 5

  18. Blackburn JL, Downey FW, Quinn TJ (1990) The Saskatchewan program for rational drug therapy: effects on utilization of mood-modifying drugs. DICP Ann Pharmacother 24: 878–882

    Google Scholar 

  19. Statistics Norway (1987) Health Survey 1985, NOS B692. Universitetsforlaget, Oslo

    Google Scholar 

  20. Eggen AE (1993) The Tromsø study: frequency and predicting factors of analgesic drug use in a free-living population. J Clin Epidemiol 46: 1297–1304

    Google Scholar 

  21. Chrischilles EA, Foley DJ, Wallace RB et al (1992) Use of medications by persons 65 and over: data from the established populations for epidemiologic studies of the elderly. J Gerontol 47: 137–144

    Google Scholar 

  22. Stewart RB, Hale WE, Marks RG (1982) Analgesic drug use in an ambulatory elderly population. DICP 16: 833–836

    Google Scholar 

  23. Chrischilles EA, Lemke JH, Wallace RB, Drube GA (1990) Prevalence and characteristics of multiple analgesic drug use in an elderly study group. J Am Geriatr Soc 38: 979–984

    Google Scholar 

  24. Cartwright A (1990) Medicine taking by people aged 65 or more. Br Med Bull 46: 63–76

    Google Scholar 

  25. Holstein BE, Almind G, Due P, Holst E (1990) Self-reported health situation and drug use among elderly persons. In Danish. Summary in English. Ugeskr Læger 152: 386–391

    Google Scholar 

  26. Afable RF, Ettinger WH (1993) Musculoskeletal disease in the aged. Diagnosis and management. Drugs Aging 3: 49–59

    Google Scholar 

  27. Gilman AG, Rall TW, Nies AS, Taylor P (eds) (1990) The Goodman and Gilman's pharmacological basis of therapeutics, 8th edn. Macmillan, New York

    Google Scholar 

  28. Landahl S (1987) Drug treatment in 70–82-year-old persons. Acta Med Scand 221: 179–184

    Google Scholar 

  29. Kjaersgaard-Andersen P, Nafei A, Skov O, et al (1990) Codeine plus paracetamol versus paracetamol in longer-term treatment of chronic pain due to osteoarthritis of the hip. A randomised, double-blind, multi-center study. Pain 43: 309–318

    Google Scholar 

  30. Rowden AM, Lopez JR (1989) Is codeine addictive? DICP Ann Pharmacother 23: 475–477

    Google Scholar 

  31. Maruta T, Swanson DW, Finlayson RE (1979) Drug abuse and dependency in patients with chronic pain. Mayo Clin Proc 54: 241–244

    Google Scholar 

  32. Ziesat HA (1979) Drug use and misuse in operant pain patients. Addict Behav 4: 263–266

    Google Scholar 

  33. Litman RE, Diller J, Nelson F (1983) Deaths related to propoxyphene or codeine or both. J Forensic Sci 28: 128–138

    Google Scholar 

  34. Jinks MJ, Raschko RR (1990) A profile of alcohol and prescription drug abuse in a high-risk community-based elderly population. DICP Ann Pharmacother 24: 971–975

    Google Scholar 

  35. Rinaldi RC, Steindler AM, Wilford BB, Goodwin D (1988) Clarification and standardization of substance abuse terminology. JAMA 259: 555–557

    Google Scholar 

  36. Sohlberg C (1992) Drug prescribing to intravenous drug addicts. In Norwegian. Norsk Farmaceutisk Tidsskrift 14: 7–9

    Google Scholar 

  37. Holm HA (1993) Controlled drugs — a challenge to doctors. Editorial. In Norwegian. Summary in English. Tidsskr Nor Laegeforen 113: 928–929

    Google Scholar 

  38. Stewart MJ (1991) Effect of scheduling of buprenorphine on drug abuse pattern in Glasgow. BMJ 302: 969

    Google Scholar 

  39. Strang J (1991) Abuse of buprenorphine by snorting. BMJ 302: 969

    Google Scholar 

  40. Chowdhury AN, Chowdhury S (1990) Buprenorphine abuse: report from India. Br J Addict 85: 1349–1350

    Google Scholar 

  41. O'Connors JJ, Moloney E, Travers R, Campbell A (1988) Buprenorphine abuse among opiate addicts. Br J Addict 83: 1085–1087

    Google Scholar 

  42. Bradley CP (1992) Uncomfortable prescribing decisions: a critical incident study. BMJ 304: 294–296

    Google Scholar 

Download references

Author information

Author notes

  1. M. Andrew

    Present address: National Board of Health, N-0032, Oslo, Norway

Authors and Affiliations

  1. Institute of Community Medicine, University of Tromsø, N-9037, Norway

    A. E. Eggen

  2. Department of Pharmacotherapeutics, University of Oslo, N-0316, Norway

    M. Andrew

Authors
  1. A. E. Eggen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Andrew
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Eggen, A.E., Andrew, M. Use of codeine analgesics in a general population. Eur J Clin Pharmacol 46, 491–496 (1994). https://doi.org/10.1007/BF00196103

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00196103

Key words

Search

Navigation