Determinants of prescription opioid use: Population-based evidence from Finland

Abstract

Background and aims

Previous studies have shown that prescription opioid use is more common in socio-economically disadvantaged communities in the United States. This study examined the area and individual-level determinants of prescription opioid use in Finland during the period 1995–2016.

Design

Logistic regression analysis using nation-wide data on filled opioid-related prescriptions dispensed at Finnish pharmacies and covered by National Health Insurance. Opioid consumption was linked, using personal identification codes, to population-based data maintained by Statistics Finland, which records individual background and area-level characteristics.

Setting and participants

Working-age population aged between 15 and 64 years in Finland during the periods 1995–2007 (n = 4 315 409) and 2009–16 (n = 4 116 992).

Measurements

Annual prescription opioid use was measured using defined daily doses (DDD) and whether people used opioids during a year.

Findings

Prescription opioid use increased in Finland from 1995 to 2016 (from less than 1 to 7%), but the increase was explained by the change in the treatment of codeine-based opioids in National Health Insurance. The area-level unemployment rate was positively correlated with the share of opioid users at the municipal level (r = 0.36; P < 0.001). In comparison with being employed, being outside the labour force was associated with increased opioid use in 1995–2007 [odds ratio (OR) = 2.22, 95% confidence interval (CI) = 2.10–2.36] and non-codeine opioid use in 2009–16 (OR = 2.16, 95% CI = 2.06–2.27), but not with codeine opioid use in 2009–16.

Conclusions

Prescription opioid use in Finland appears to be more common among low socio-economic status people, similar to the United States and the United Kingdom.

Publication Information

Böckerman, P., Haapanen, M., Hakulinen, C., Karhunen, H., & Maczulskij, T. (2021), Determinants of prescription opioid use: Population-based evidence from Finland, Addiction, 116(1), 170–175.

• ISSN: 0965-2140, e-ISSN: 1360-0443