Volume 136, Issue 6 e70040
ORIGINAL ARTICLE

Trends in Postoperative Opioid Use in Norway 2011–2018: A Nationwide Registry-Based Study

Per-Jostein Samuelsen

Corresponding Author

Per-Jostein Samuelsen

Regional Medicines Information and Pharmacovigilance Centre (RELIS), University Hospital of North Norway, Tromsø, Norway

Correspondence:

Per-Jostein Samuelsen ([email protected])

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Vidar Hjellvik

Vidar Hjellvik

Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway

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Ingvild Odsbu

Ingvild Odsbu

Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway

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Audun Stubhaug

Audun Stubhaug

Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway

Department of Clinical Medicine, University of Oslo, Oslo, Norway

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Svetlana Skurtveit

Svetlana Skurtveit

Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway

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Sara Magelssen Vambheim

Sara Magelssen Vambheim

Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway

Department of Clinical Medicine, University of Oslo, Oslo, Norway

Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway

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First published: 27 April 2025

Funding: P.-J.S. was partly funded by a personal grant from the Northern Norway Regional Health Authority (Helse Nord HNF1610-21). S.M.V. was funded by the Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway. S.O.S., I.O. and V.H. were partly funded by the Research Council of Norway (320360). The authors were otherwise funded by their respective institutions.

ABSTRACT

Little is known about the overall trends in postoperative opioid use in a Nordic setting. We investigated the trends in Norway between 2011 and 2018. We linked the Norwegian Prescription Database, the Norwegian Patient Registry, the Cancer Registry of Norway and the Cause of Death Registry. Postoperative opioid use was defined as the first opioid dispensing per year within 14 days of a NOMESCO Classification of Surgical Procedure code. We excluded patients with cancer or opioid maintenance therapy. We calculated period prevalence (Norwegian population ≥ 15 years as the denominator), substance distribution, initial amount and proportion of long-acting formulations. Among 746 435 postoperative opioid users ≥ 15 years, the period prevalence increased from 27.0/1000 in 2011 to 30.0/1000 in 2018 (long-term use: 2.0 to 3.3/1000). Codeine was most frequent (67%) in 2011, while codeine and tramadol were equally dispensed (41% and 43%) in 2018; oxycodone increased from 3% to 12%. The initial amount increased for opioids as a group but declined for oxycodone (1236 morphine milligram equivalents [MME]/patient to 914 MME/patient) and tramadol (233 MME/patient to 219 MME/patient). Long-acting depot formulations increased from 5% to 12%. Over time, postoperative opioid use increased, with a shift toward more tramadol and oxycodone in lower initial amounts, and increased use of long-acting formulations.

Conflicts of Interest

The authors declare no conflicts of interest.

Data Availability Statement

The cohort is derived from individual-level data from national health and population registries. The authors are not allowed, by law, to publicly share these data. Therefore, the authors cannot make these data fully available to the public. The authors may share statistical code.

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