There has been a dramatic rise in the prescription of strong opioid oxycodone in Australia in the past decade and there is now a "pressing" need to monitor its efficacy and harm, according to a new study.
Published in this month's issue of the Internal Medicine Journal, the study of fifteen years of Australian prescribing data found that prescription of oxycodone was growing in all dose ranges, particularly in low dose preparations, while scripts for morphine, tramadol and codeine had either plateaued or decreased.
The analysis of PBS data between 1992 and 2007 revealed that prescriptions for opioids had almost tripled from 2.4 million to 7 million scripts, with the number of opioid preparations growing from 11 to 70.
The number of actual medications available had also doubled from four to eight during that period, the study by researchers from the University of Sydney and Sydney's Royal Prince Alfred Hospital found.
According to the study, codeine was the predominant opioid prescribed during the nineties but has seen a decline since 1999.
Tramadol saw a rapid initial increase in use since being listed on the PBS in 2000 but has since plateaued.
Oxycodone use rose slowly until 2000 when, the researchers found, it saw a "dramatic increase" which is yet to plateau.
"There has been a striking increase in the prescription of opioids in Australia, particularly of oxycodone, in the last decade," the study's authors wrote.
"There is a need for a coordinated approach to clinical trials and effective pharmacovigilance to properly identify the long-term risks and benefits of opioids in [chronic non-malignant pain].
"There is a need for more comprehensive and regular monitoring of use, and consideration of changes to regulation of prescribing to diminish misuse, with monitoring of the impact of such changes.
"This would inform prescribers, consumers and policy makers in decision making around opioid use and improve quality use of these medicines."