Sammanfattning
Purpose
The purpose of this study was to detect changes in use of benzodiazepines and z-hypnotics among
patients in opioid maintenance treatment (OMT) after the introduction of national clinical guidelines
for OMT patients in 2010.
Materials and methods
Data were obtained from the Norwegian Prescription Database. We studied individuals in OMT in a
period before the introduction of the guidelines (2008-2009) - period 1, and/or after the introduction of
the guidelines (2010-2011) - period 2. Patients were followed for 12 months after their first OMT
dispensing. The results are presented as the one-year prevalence and amount of drug measured as
sum of defined daily doses of benzodiazepines and z-hypnotics together, or divided into anxiolytics
and hypnotics in the period before and after the introduction of the guidelines.
Results
There was an increase in use of benzodiazepines and z-hypnotics from the 1st to the 2nd period.
There was no gender differences in prevalence and prevalence increased with age. There were large
differences in prevalence between different counties during the 1st period (from 10 to 69 %). This
variation was reduced in the 2nd period, by an increase in the prevalence in counties with the lowest
prevalence. More than 30% of those who were prescribed hypnotics and anxiolytics were heavy
users defined as individuals dispensed > 400 defined daily doses. There was a high degree of co-
medication between different types of benzodiazepines and / or z-hypnotics.
Conclusion
There has been a slight increase in use from the 1st to the 2nd period. Prevalence differences
between counties were reduced. This suggests that the guidelines have served their purpose
regarding to reduction in regional differences. This was however due to an increase in prevalence in
the lower using counties.