Prescription of opioids

-Automatic translation

The Directorate of Health supervises prescriptions and promotes the prudent use of medicinal products in Iceland. Due to this supervisory role, the Office has annually analyzed the use of drugs in this category. In light of the news of drug-related deaths, the analysis now was carried out in connection with a working group set up by the Directorate of Health, the Police, the Icelandic Medicines Agency, the Icelandic Health Insurance, and the Iceland Revenue and Customs last April to map the distribution of opioids in Iceland.

The analysis presented by the team can be found in the newly released Talnabrunnur (Icelandic).

Prescriptions

When comparing the trend in opioid use in the first five months of 2023 with the same months of 2014 - 2022, it can be seen that the number of individuals who dispensed at least one prescription in the period January to May 2023 is similar to that in 2020 and 2021. Although the number of people who dispensed opioids in 2022 increased slightly, there was no increase in the dispensed amount of opioids in 2022 compared with previous years.

Since 2020, the number of people who have dispensed opioids has increased from 157 per 1,000 inhabitants in 2020 to 181 per 1,000 in 2022. It should be kept in mind that 10-packs of Parkodine, an opioid in the codeine and paracetamol group, were dispensed without a prescription following the spread of COVID-19 in 2022. This corresponds to roughly 69 thousand individuals dispensing at least one prescription for opioids in 2022, compared to over 57 thousand in 2020. Of the total 69 thousand individuals who dispensed opioids in 2022, roughly 5,600 dispensed only a 10-pack of Parkodine. The increase in the number of people who dispensed opioids in 2022 can therefore be largely attributed to this.

Drug-related deaths

Confirmed information on drug-related deaths for 2022 will not be available until forensic autopsies, drug testing, and police investigations are completed. This is a time-consuming process that generally takes months. Confirmed information on drug-related deaths is published once or twice a year, most recently for the first half of 2022.

Summary

Although there was an increase in the number of people who dispensed opioids in 2022, there was no increase in the dispensed amount of opioids between years. The increase can largely be attributed to the temporary authorization to dispense Parkodine in connection with COVID-19. Figures for the first five months of 2023 do not indicate that usage is different from previous years.

The Directorate of Health, together with other institutions, has taken measures to improve the safety of pain medication in Iceland as well as countermeasures to prevent opioid abuse. When it comes to addiction to opioid drugs, other drugs, and substances, a broad approach is needed from many parties. Consideration must be given to diagnosing of the problem, border control, prevention, treatment, harm reduction, follow-up, and long-term solutions. Short-term solutions are needed, as well as a comprehensive strategy for the future.

Alma D. Möller, Medical Director of Health
mottaka@landlaeknir.is