More than 11-fold increase in dispensing

A Queensland study examining opioid dispensing and prescribing to all adults over a 21-year period found some interesting results

The number of people dispensed opioids in Queensland increased more than 11-fold in two decades, according to a new study published in the Medical Journal of Australia.

However most prescriptions were in a low-dose range, and high-dose opioids prescribing declined over time.

Research led by Dr Adeleke Adewumi, Senior Pharmacist at Maryborough Hospital and PhD graduate from The University of Queensland, analysed Monitoring of Drugs of Dependence System (MODDS) data for adult Queensland residents who were dispensed opioids between January 1997 and December 2018.

Over the 21-year period, Dr Adewumi and co-authors found that the number of patients dispensed opioids increased more than 11-fold – from 28,299 in 1997 to 322,307 in 2018.

The number of Queensland medical practitioners who prescribed opioids also increased from 4,537 to 20,226.

However Dr Adewumi said dosages of opioids within the state were most frequently on the lower end of the scale.

“The number of people dispensed dosages associated with increased risk of accidental overdose has declined since 2004,” Dr Adewumi said.

“Our findings indicate that most Queensland medical practitioners prescribe lower opioid doses, and that the proportion prescribing lower doses has increased since 2004 specifically.”

During the study period, more than 1.9 million people (68% of people dispensed opioids) were dispensed doses of less than 20 MME per day.

“The proportion of practitioners who prescribed opioids at doses of 100 morphine milligram equivalents (MME) or more per day peaked in 2003,” Dr Adewumi said.

“Many pain specialists now recommend less than 100mg per day for no more than 90 days to reduce the likelihood of addiction, dependence and overdose.

“Similarly, the number of doctors prescribing 50 to less than 100 MME per day also peaked in 2003.

“Doses greater than 50 MME per day are associated with an increased risk of accidental overdose, however this risk remains small and has declined over time.

“By 2018, there was an observed decline in prescriptions over 100 MME per day due to stricter health policies for doctors, which significantly reduced the number of practitioners prescribing even 50–100 MEE doses.”

See the research letter in the MJA

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