Prescriptions of opioids to children and adolescents; a study from a national prescription database in Norway.

Background: Analgesics are among the groups of drugs most frequently prescribed to children and adolescents. The prevalence of opioid use in children and adolescents is, however, not known.

Aim: The primary aim was to determine the 1-year periodic prevalence of opioid dispension in Norwegian children and adolescents below 18 years of age. The secondary aim was to determine to which extent children and adolescents receive opioids for acute or chronic pain.

Methods: All pharmacies in Norway submit data electronically to the Norwegian Prescription Database on all dispensed prescriptions. All prescriptions to any individual are identified with a pseudonym. All Norwegians who were dispensed opioids from 2004 to 2007 are included in the study.

Results: In 2004, 6386 children and adolescents received opioid dispensions, a number which had increased by 35% to 8607 in 2007. These numbers correspond to an increase in 1-year periodic prevalence from 0.59 to 0.79%. Each year during the study period, approximately 95% of the patients received only one or two opioid dispensions. Only 262 Norwegian children and adolescents below 18 years of age received opioid dispensions in three successive years from 2005 to 2007. About 93-95% of children and adolescents receiving opioids each year received the weak opioid codeine.

Conclusions: The 1-year periodic prevalence of opioid use in Norwegian children and adolescents is only one-sixteenth of the previously reported prevalence in the Norwegian adult population. Children and adolescents primarily receive opioids for acute pain.