Opioid use in Denmark is decreasing

04 November 2020

Total sales of opioids have decreased by more than 20 per cent in the past four years, and there are now fewer Danes who use the most common type of opioid, tramadol. So reveals two new studies from the Danish Health Data Authority and the Danish Medicines Agency.

A rise in consumption and concerns about dependence have in recent years put focus on the Danish people’s use of a number of morphine-like medicines, the so-called opioids, which are used to treat acute pain in particular.

Since 2015, the total opioid quantity consumed has fallen by more than 20 per cent, while the number of users has fallen by 9 per cent to 441,000 users in 2019. So reveals a new analysis from the Danish Health Data Authority. Most of the users are women, and the typical user is 65 years old.

“The consumption of these addictive medicines is clearly moving in the right direction. Our analysis shows that not only do less people take opioids, they also take them for a shorter period of time or take a lower dose”, said Lars Eriksen Videbæk, Head of Division in the Danish Health Data Authority.

He explains that opioid users are usually started on paracetamol alone or paracetamol and NSAID when tapering off opioids.

New dispensing status has reduced consumption

The reduction in opioid consumption is confirmed by a study conducted jointly by the University of Southern Denmark, the Department of Clinical Pharmacology at Bispebjerg Hospital and the Data Analytics Center of the Danish Medicines Agency. The study looked at the most widely used opioid, tramadol, showing that 32 per 1,000 of the Danish population were treated with tramadol in January 2014. The consumption remained largely the same until 2017 when the media put focus on the consumption, followed up by the Danish Health Authority’s measures and the Danish Health Authority’s risk-minimisation actions, after which it dropped to 18 per 1,000 population as at end-2019.

“The health authorities are highly committed to ensuring that opioids like tramadol are used appropriately and have launched several initiatives over the years. As part of this, the Danish Medicines Agency changed the dispensing status of tramadol and other opioids in 2018 to subject them to stricter monitoring in line with, for example, morphine, and we also introduced stricter rules for the reporting of side effects for tramadol from 2017-2018, said Stine Hasling Mogensen, Scientific Project Manager in the Data Analytics Center of the Danish Medicines Agency.

Development continues in 2020

The consumption of analgesics (painkillers) in Denmark has been high compared to most other Nordic countries. But consumption now seems to move in the right direction.

“The number of people having filled a prescription for opioids in the first nine months of 2020 is at 346,000. In comparison, this figure was about 372,000 in 2019. It indicates that the trend continues, and that the corona pandemic hasn’t necessarily affected consumption”, said Lars Eriksen Videbæk Head of Division in the Danish Health Data Authority.

The analysis of the Danish Health Data Authority is available from this page (in Danish only): Analyses on analgesics (painkillers).

Read the study by the University of Southern Denmark, the Department of Clinical Pharmacology at Bispebjerg Hospital and the Data Analytics Center of the Danish Medicines Agency. Use of tramadol and other analgesics following media attention and risk minimization actions from regulators: a Danish nationwide drug utilization study.

Facts from the analysis of the Danish Health Data Authority:

  • Since 2015, the number of opioid users has fallen by 9 per cent from 484,000 to 441,000 people in 2019. The quantity consumed fell by 21 per cent in the same period.
  • For tramadol alone, the number of users fell by 37 per cent, and the quantity consumed by 36 per cent.
  • From 2015 to 2019, the number of users taking more than the recommended level fell by 16 per cent, and the number of persons categorised as having an ‘inappropriately high consumption’ decreased by 20 per cent.
  • The number of long-term users declined by 21 per cent from 184,000 people in 2015 to 146,000 people in 2019.
  • The majority of users tapering off opioids in 2018 were started on paracetamol only (30 per cent) or paracetamol and NSAID (29 per cent).

Facts from the Danish Medicines Agency’s study:

  • The study identified a fall in the use of tramadol coinciding with the media attention in 2017 and the Danish Health Authority’s measures.
  • This fall continued during and after the Danish Medicines Agency’s risk-minimisation actions effected in 2017-2018.
  • Furthermore, there was a small rise in the number of new users of morphine and oxycodone – but the total consumption of these two substances fell.
  • There was generally no evidence of unintended effects on the use of opioids related to the media attention and the health authorities’ risk-minimisation actions. 

For further information, please contact:

Danish Health Data Authority, Media Relations, on +45 2182 1166 or email: Send an email

Danish Medicines Agency, Media Relations, on +45 2526 5289 or email: Send an email

Anton Pottegård, Professor, University of Southern Denmark, on +45 2891 3340 or email: Send an email

Anne Mette Skov Sørensen, Bispebjerg Hospital, on +45 2890 7469 or email: Send an email

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