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Low-dose transdermal buprenorphine – long-term use and co-medication with other potentially addictive drugs

Authors

  • A. NORDBØ,

    1. Department of Palliative Medicine, Division of Oncology, Oslo University Hospital, Oslo, Norway
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  • S. SKURTVEIT,

    1. Department of Pharmacoepidemiology, Division of Epidemiology, The Norwegian Institute of Public Health, Oslo, Norway
    2. Norwegian Centre for Addiction Research, Faculty of Medicine, University of Oslo, Oslo, Norway
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  • P. C. BORCHGREVINK,

    1. Pain and Palliation Research Group, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
    2. National Competence Centre for Complex Symptom Disorders, St. Olav University Hospital, Trondheim, Norway
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  • S. KAASA,

    1. Pain and Palliation Research Group, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
    2. Department of Oncology, St. Olav University Hospital, Trondheim, Norway
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  • O. M. FREDHEIM

    Corresponding author
    1. National Competence Centre for Complex Symptom Disorders, St. Olav University Hospital, Trondheim, Norway
    • Pain and Palliation Research Group, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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Address:

Olav Magnus S. Fredheim

Department of Pain and Complex Symptom Disorders

St. Olav University Hospital

Olav Kyrresgt. 17

7006 Trondheim

Norway

e-mail: olav.m.fredheim@ntnu.no

Abstract

Introduction

Recently, low-dose transdermal buprenorphine (LD-TD-BUP) was introduced for treatment of patients with chronic non-malignant pain. The primary aim of this study was to determine the proportion of patients who were prescribed LD-TD-BUP for non-malignant pain who became long-term users. The secondary aim was to determine the proportion of patients who co-medicated with other opioids or benzodiazepines during treatment with LD-TD-BUP.

Methods

Data were drawn from the Norwegian Prescription Database that covers all prescriptions dispensed at pharmacies to the entire Norwegian population (4.7 million inhabitants). The study population consisted of all patients who were dispensed at least one prescription of LD-TD-BUP from its introduction in November 2005 to 31 December 2008. Patients who were dispensed more than 24 patches (≥ 6 months) were defined as long-term users. Reimbursement codes were used to stratify patients as having cancer pain or non-malignant pain.

Results

Among new users of LD-TD-BUP for non-malignant pain (n = 13,451), only 22% became long-term users, while 44% were only dispensed one prescription. Among long-term users who were opioid naive when LD-TD-BUP was initiated, 43% co-medicated with other opioids or benzodiazepines, compared with 82% of those who previously had used opioids.

Conclusion

Three years after introduction, 0.4% of the Norwegian population had been dispensed LD-TD-BUP. Only one-fifth had become long-term users. Those who used opioids before the first dispension of LD-TD-BUP co-medicated with other potentially addictive drugs to a much higher degree compared with those who were opioid naive.

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