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This document contains information from multiple studies on opioid use and prescribing trends: - A national survey from 1997-2007 found increases in opioid prescribing rates, with the highest rates (over 80 prescriptions per 100 persons) seen in those aged 61-80. - Cohort and longitudinal studies from multiple countries showed increases in defined daily doses of opioids like morphine, codeine, and pethidine from the late 1980s through early 2000s. - Studies analyzed trends in prescribing of different classes of pain medications like opioids, NSAIDs, and acetaminophen alone or in combination.
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- 1. 1997 2007
- 3. 3
- 5. 80+ 61-80 <20 21-60
- 6. 6
- 7. N= 1,172,115 23 = (national survey) (population-based) (Cohort analysis) ... (longitudinal study)
- 8. A school of fishes is not yours 8
- 9. it depends on how you are fishing! 8
- 10. Defined Daily Dose (DDD) Opioids DDD morphine= 30 mg pethidine=100 mg codeine=400 mg 9
- 11. 300 pethidine codeine 225 morphine 1987-2002 150 75 0 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
- 12. 1,891 Italy 121 1,892 total DDD Taiwan 168 morphine DDD 4,550 Germany 574 1994-1998 27,942 Switzerland 1,763 27,748 UK 2,569 29,701 Denmark 6,993 39,316 Ireland 2,454 0 8,000 16,000 24,000 32,000 40,000 de?ned daily dose/million
- 17. COX2 NSAID Acetaminophen
- 23. I Pethidine Tramadol Morphine Fentanyl NSAID ketorolac
- 25. III NSAID ketorolac non-ketorolac 45
- 32. II opioid NSAID NSAID opioid ketorolac non- ketorolac
- 36. IV 2003 2004
- 37. 1997 2007 36
- 38. Paradox I
- 39. Paradox I
- 40. Paradox II
- 41. Paradox II
- 45. 41