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. 2018 Jun 18;19(1):30.
doi: 10.1186/s40360-018-0219-0.

Prescription opioid dispensing in New South Wales, Australia: spatial and temporal variation

M Mofizul Islam  1 , Ian S McRae  2 , Soumya Mazumdar  3 , Paul Simpson  4 , Dennis Wollersheim  5 , Kaniz Fatema  6   7   8   9 , Tony Butler  4
Affiliations

Prescription opioid dispensing in New South Wales, Australia: spatial and temporal variation

M Mofizul Islam et al. BMC Pharmacol Toxicol. .

Abstract

Background: Patterns of opioid dispensing often exhibit substantial temporal and geographical variability, which has implications for public health policy decisions and interventions. The study examined recent trends in prescription opioid dispensing and identified high dispensing areas and factors associated with the doses dispensed.

Methods: Three years (1 January 2013-31 December 2015) of dispensing data of prescription opioids in local government areas (LGAs) for New South Wales (NSW), Australia's most populous state, were analyzed. The proportion of individuals who were dispensed opioids was computed for four age-groups. A Chi-square test was used to examine trends over time in proportions of the population who were dispensed opioids in four age-groups. The number of prescriptions over time and quantities in daily defined dose/1000 people/day (denoted DDD) were also examined. LGAs with relatively high levels of dispensing were identified and mapped. A multivariate regression model was used to identify factors associated with DDD.

Results: Overall, codeine, oxycodone and tramadol were the main opioids in terms of DDD, number of prescriptions and number of individuals who were dispensed these medications. Quantity (in DDD), and population dispensed to were consistently higher for women than men over time. Proportions of individuals who were dispensed opioids increased significantly over time in all four age-groups. In the multivariate model, age, urbanization, sex and socio-economic indexes for areas were significantly associated with doses dispensed among opioid users. All areas with very high dispensing were outside major metropolitan areas.

Conclusions: Given that over-use of opioids is a major public health problem and that long-term use has substantial side effects including dependence, it is important to understand spatial patterns of opioid prescribing to enable targeted interventions. Nationwide implementation of real-time drug-monitoring programs and access to monitoring databases from both doctor and pharmacy point-of-care sources may potentially reduce excessive and undue use of opioid.

Keywords: Australia; Dispensing; New South Wales; Opioid; Pain medicine; Prescription opioid.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Human Ethics Committee of La Trobe University (S17–218). All ethical considerations were observed, and personal information were de-identified.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Annual trends in number of scripts between 2013 and 2015
Fig. 2
Fig. 2
LGAs with relatively high dispensing of prescription opioid in 2015. (This map has been developed using bioregional assessment source dataset, available under a Creative Commons Attribution license. Australian Bureau of Statistics (2011) Local Government Areas of Australia. Bioregional Assessment Source Dataset)
Fig. 3
Fig. 3
LGAs with increasing and decreasing trends in quantities (DDD) in year 2013–2015. (This map has been developed using bioregional assessment source dataset, available under a Creative Commons Attribution license. Australian Bureau of Statistics (2011) Local Government Areas of Australia. Bioregional Assessment Source Dataset)
See this image and copyright information in PMC

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