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A complete national cohort study of prescriptions of analgesics and benzodiazepines to cancer survivors in Norway 10 years after diagnosis

Pain Mar 29, 2019

Fredheim OM, et al. - Researchers compared the use of nonopioid analgesics, opioids, and benzodiazepines 10 years after cancer diagnosis in long-term cancer survivors and the age- and sex-adjusted general population via analyzing complete national data from the Cancer Registry of Norway and the Norwegian prescription database. Long-term cancer survivors displayed higher 1-year periodic prevalence of use in all the studied drug classes: opioids (143.5 vs 129.6/1000), paracetamol (88.3 vs 80.7/1000), nonsteroidal anti-inflammatory drugs (229.1 vs 221.7), gabapentinoids (13.4 vs 10.0/1000), benzodiazepines (88.3 vs 77.9/1000), and benzodiazepine-like hypnotics (118.1 vs 97.4/1000). The cancer survivors also exhibited higher prevalence of persistent and high-dose opioid use (>365 defined daily doses [DDDs] and >730 DDDs, respectively, during 365 days, and prescriptions all quarters of the year) than the general population (6.5 vs 4.8/1000 for persistent use and 2.7 vs 1.3/1000 for high-dose use). Only long-acting opioid formulations were provided to less than 10% of persistent and high-dose users. In addition, use of high-dose (>100 DDDs/year) of either benzodiazepines or benzodiazepine-like hypnotics was observed in most long-term cancer survivors with persistent or high-dose opioid use. Nonadherence to guidelines regarding opioid formulation and comedication with other drugs with addictive properties among most of the opioid users is an issue of concern.
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