International Trends in Opioid Prescribing by Age and Sex from 2001 to 2019: An Observational Study Using Population-Based Databases from 18 Countries and One Special Administrative Region

Adrienne Y L Chan; Shahram Bahmanyar; Kebede Beyene; Greta Bushnell; Bruce Carleton; Amy Hai Yan Chan; Sharon Cook; Stephen Crystal; Kari Furu; Svetla Gadzhanova; Patricia García Poza; Rosa Gini; Sabrina Giometto; Jeff Harrison; Ulrike Haug; Christine Hsu; Harpa Lind Hjördísar Jónsdóttir; Joe Kai; Øystein Karlstad; Ju Hwan Kim; Kiyoshi Kubota; Edward Chia-Cheng Lai; Hyesung Lee; Wallis C Y Lau; Kathy H Li; Ersilia Lucenteforte; Géric Maura; Anke Neumann; Virginia Pate; Anton Pottegård; Nadeem Qureshi; Lotte Rasmussen; Johan Reutfors; Elizabeth E Roughead; Leena Saastamoinen; Tsugumichi Sato; Oliver Scholle; C C M Schuiling-Veninga; Chin-Yao Shen; Ju-Young Shin; Til Stürmer; Katja Taxis; Marco Tuccori; Stephen Weng; Kirstie H T W Wong; Helga Zoega; Kenneth K C Man; Ian C K Wong

doi:10.1007/s40263-025-01215-2

International Trends in Opioid Prescribing by Age and Sex from 2001 to 2019: An Observational Study Using Population-Based Databases from 18 Countries and One Special Administrative Region

Adrienne Y L Chan, Shahram Bahmanyar, Kebede Beyene, Greta Bushnell, Bruce Carleton, Amy Hai Yan Chan, Sharon Cook, Stephen Crystal, Kari Furu, Svetla Gadzhanova, Patricia García Poza, Rosa Gini, Sabrina Giometto, Jeff Harrison, Ulrike Haug, Christine Hsu, Harpa Lind Hjördísar Jónsdóttir, Joe Kai, Øystein Karlstad, Ju Hwan KimKiyoshi Kubota, Edward Chia-Cheng Lai, Hyesung Lee, Wallis C Y Lau, Kathy H Li, Ersilia Lucenteforte, Géric Maura, Anke Neumann, Virginia Pate, Anton Pottegård, Nadeem Qureshi, Lotte Rasmussen, Johan Reutfors, Elizabeth E Roughead, Leena Saastamoinen, Tsugumichi Sato, Oliver Scholle, C C M Schuiling-Veninga, Chin-Yao Shen, Ju-Young Shin, Til Stürmer, Katja Taxis, Marco Tuccori, Stephen Weng, Kirstie H T W Wong, Helga Zoega, Kenneth K C Man^*, Ian C K Wong^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

OBJECTIVE: To characterize multinational trends and patterns of opioid analgesic prescribing by sex and age.

DESIGN, SETTING, AND PARTICIPANTS: We studied opioid analgesic prescribing from 2001 to 2019 with common protocol using population-based databases from eighteen countries and one special administrative region.

MAIN OUTCOME MEASURES: We measured opioid prescribing by geographical region, sex and age, estimating annual prevalent, incident, and nonincident opioid prescribing per 100 population with a 95% confidence interval (CI) and meta-analyzed the multinational and regional opioid prescribing with a random-effects model. Time trends were reported through average annual absolute changes, estimated using linear mixed models. We further explored the effect of sex and age on prevalent opioid prescribing in the multivariable analysis.

RESULTS: Over 248 million individuals were included. Pooled multinational opioid prescribing prevalence was 9.0% amongst included countries/regions. Opioid prescribing prevalence in 2015 ranged from 2.7% in Japan to 19.7% in Iceland. Average annual absolute changes in opioid prescribing prevalence per year ranged from - 1.53% (95% CI - 2.06, - 1.00; United States Medicaid) to + 1.24% (95% CI 1.02, 1.46; South Korea). Pooled multinational incident opioid prescribing (4.9%; 95% CI 4.1, 5.9) was higher than pooled multinational nonincident opioid prescribing (3.7%; 95% CI 2.9, 4.8). The female sex and older age were associated with higher opioid prescribing. Main limitations of this study include the absence of data from study duration or individuals not covered by the data sources and the lack of information on medication adherence and indication.

CONCLUSIONS: Opioid prescribing remains unbalanced across geographical regions; however, results suggest a tendency to convergence across countries/regions. Differences in opioid prescribing by sex and age were identified.

Original language	English
Number of pages	13
Journal	Cns Drugs
DOIs	https://doi.org/10.1007/s40263-025-01215-2
Publication status	E-pub ahead of print - 1-Sept-2025

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Chan, A. Y. L., Bahmanyar, S., Beyene, K., Bushnell, G., Carleton, B., Chan, A. H. Y., Cook, S., Crystal, S., Furu, K., Gadzhanova, S., García Poza, P., Gini, R., Giometto, S., Harrison, J., Haug, U., Hsu, C., Hjördísar Jónsdóttir, H. L., Kai, J., Karlstad, Ø., ... Wong, I. C. K. (2025). International Trends in Opioid Prescribing by Age and Sex from 2001 to 2019: An Observational Study Using Population-Based Databases from 18 Countries and One Special Administrative Region. Cns Drugs. Advance online publication. https://doi.org/10.1007/s40263-025-01215-2

@article{61afbd7ced7d4951bd5ba7c5ab170991,

title = "International Trends in Opioid Prescribing by Age and Sex from 2001 to 2019: An Observational Study Using Population-Based Databases from 18 Countries and One Special Administrative Region",

abstract = "OBJECTIVE: To characterize multinational trends and patterns of opioid analgesic prescribing by sex and age.DESIGN, SETTING, AND PARTICIPANTS: We studied opioid analgesic prescribing from 2001 to 2019 with common protocol using population-based databases from eighteen countries and one special administrative region.MAIN OUTCOME MEASURES: We measured opioid prescribing by geographical region, sex and age, estimating annual prevalent, incident, and nonincident opioid prescribing per 100 population with a 95\% confidence interval (CI) and meta-analyzed the multinational and regional opioid prescribing with a random-effects model. Time trends were reported through average annual absolute changes, estimated using linear mixed models. We further explored the effect of sex and age on prevalent opioid prescribing in the multivariable analysis.RESULTS: Over 248 million individuals were included. Pooled multinational opioid prescribing prevalence was 9.0\% amongst included countries/regions. Opioid prescribing prevalence in 2015 ranged from 2.7\% in Japan to 19.7\% in Iceland. Average annual absolute changes in opioid prescribing prevalence per year ranged from - 1.53\% (95\% CI - 2.06, - 1.00; United States Medicaid) to + 1.24\% (95\% CI 1.02, 1.46; South Korea). Pooled multinational incident opioid prescribing (4.9\%; 95\% CI 4.1, 5.9) was higher than pooled multinational nonincident opioid prescribing (3.7\%; 95\% CI 2.9, 4.8). The female sex and older age were associated with higher opioid prescribing. Main limitations of this study include the absence of data from study duration or individuals not covered by the data sources and the lack of information on medication adherence and indication.CONCLUSIONS: Opioid prescribing remains unbalanced across geographical regions; however, results suggest a tendency to convergence across countries/regions. Differences in opioid prescribing by sex and age were identified.",

author = "Chan, \{Adrienne Y L\} and Shahram Bahmanyar and Kebede Beyene and Greta Bushnell and Bruce Carleton and Chan, \{Amy Hai Yan\} and Sharon Cook and Stephen Crystal and Kari Furu and Svetla Gadzhanova and \{Garc{\'i}a Poza\}, Patricia and Rosa Gini and Sabrina Giometto and Jeff Harrison and Ulrike Haug and Christine Hsu and \{Hj{\"o}rd{\'i}sar J{\'o}nsd{\'o}ttir\}, \{Harpa Lind\} and Joe Kai and {\O}ystein Karlstad and Kim, \{Ju Hwan\} and Kiyoshi Kubota and Lai, \{Edward Chia-Cheng\} and Hyesung Lee and Lau, \{Wallis C Y\} and Li, \{Kathy H\} and Ersilia Lucenteforte and G{\'e}ric Maura and Anke Neumann and Virginia Pate and Anton Potteg{\aa}rd and Nadeem Qureshi and Lotte Rasmussen and Johan Reutfors and Roughead, \{Elizabeth E\} and Leena Saastamoinen and Tsugumichi Sato and Oliver Scholle and Schuiling-Veninga, \{C C M\} and Chin-Yao Shen and Ju-Young Shin and Til St{\"u}rmer and Katja Taxis and Marco Tuccori and Stephen Weng and Wong, \{Kirstie H T W\} and Helga Zoega and Man, \{Kenneth K C\} and Wong, \{Ian C K\}",

note = "{\textcopyright} 2025. The Author(s).",

year = "2025",

month = sep,

day = "1",

doi = "10.1007/s40263-025-01215-2",

language = "English",

journal = "Cns Drugs",

issn = "1172-7047",

publisher = "ADIS INT LTD",

}

Chan, AYL, Bahmanyar, S, Beyene, K, Bushnell, G, Carleton, B, Chan, AHY, Cook, S, Crystal, S, Furu, K, Gadzhanova, S, García Poza, P, Gini, R, Giometto, S, Harrison, J, Haug, U, Hsu, C, Hjördísar Jónsdóttir, HL, Kai, J, Karlstad, Ø, Kim, JH, Kubota, K, Lai, EC-C, Lee, H, Lau, WCY, Li, KH, Lucenteforte, E, Maura, G, Neumann, A, Pate, V, Pottegård, A, Qureshi, N, Rasmussen, L, Reutfors, J, Roughead, EE, Saastamoinen, L, Sato, T, Scholle, O, Schuiling-Veninga, CCM, Shen, C-Y, Shin, J-Y, Stürmer, T, Taxis, K, Tuccori, M, Weng, S, Wong, KHTW, Zoega, H, Man, KKC & Wong, ICK 2025, 'International Trends in Opioid Prescribing by Age and Sex from 2001 to 2019: An Observational Study Using Population-Based Databases from 18 Countries and One Special Administrative Region', Cns Drugs. https://doi.org/10.1007/s40263-025-01215-2

TY - JOUR

T1 - International Trends in Opioid Prescribing by Age and Sex from 2001 to 2019

T2 - An Observational Study Using Population-Based Databases from 18 Countries and One Special Administrative Region

AU - Chan, Adrienne Y L

AU - Bahmanyar, Shahram

AU - Beyene, Kebede

AU - Bushnell, Greta

AU - Carleton, Bruce

AU - Chan, Amy Hai Yan

AU - Cook, Sharon

AU - Crystal, Stephen

AU - Furu, Kari

AU - Gadzhanova, Svetla

AU - García Poza, Patricia

AU - Gini, Rosa

AU - Giometto, Sabrina

AU - Harrison, Jeff

AU - Haug, Ulrike

AU - Hsu, Christine

AU - Hjördísar Jónsdóttir, Harpa Lind

AU - Kai, Joe

AU - Karlstad, Øystein

AU - Kim, Ju Hwan

AU - Kubota, Kiyoshi

AU - Lai, Edward Chia-Cheng

AU - Lee, Hyesung

AU - Lau, Wallis C Y

AU - Li, Kathy H

AU - Lucenteforte, Ersilia

AU - Maura, Géric

AU - Neumann, Anke

AU - Pate, Virginia

AU - Pottegård, Anton

AU - Qureshi, Nadeem

AU - Rasmussen, Lotte

AU - Reutfors, Johan

AU - Roughead, Elizabeth E

AU - Saastamoinen, Leena

AU - Sato, Tsugumichi

AU - Scholle, Oliver

AU - Schuiling-Veninga, C C M

AU - Shen, Chin-Yao

AU - Shin, Ju-Young

AU - Stürmer, Til

AU - Taxis, Katja

AU - Tuccori, Marco

AU - Weng, Stephen

AU - Wong, Kirstie H T W

AU - Zoega, Helga

AU - Man, Kenneth K C

AU - Wong, Ian C K

PY - 2025/9/1

Y1 - 2025/9/1

N2 - OBJECTIVE: To characterize multinational trends and patterns of opioid analgesic prescribing by sex and age.DESIGN, SETTING, AND PARTICIPANTS: We studied opioid analgesic prescribing from 2001 to 2019 with common protocol using population-based databases from eighteen countries and one special administrative region.MAIN OUTCOME MEASURES: We measured opioid prescribing by geographical region, sex and age, estimating annual prevalent, incident, and nonincident opioid prescribing per 100 population with a 95% confidence interval (CI) and meta-analyzed the multinational and regional opioid prescribing with a random-effects model. Time trends were reported through average annual absolute changes, estimated using linear mixed models. We further explored the effect of sex and age on prevalent opioid prescribing in the multivariable analysis.RESULTS: Over 248 million individuals were included. Pooled multinational opioid prescribing prevalence was 9.0% amongst included countries/regions. Opioid prescribing prevalence in 2015 ranged from 2.7% in Japan to 19.7% in Iceland. Average annual absolute changes in opioid prescribing prevalence per year ranged from - 1.53% (95% CI - 2.06, - 1.00; United States Medicaid) to + 1.24% (95% CI 1.02, 1.46; South Korea). Pooled multinational incident opioid prescribing (4.9%; 95% CI 4.1, 5.9) was higher than pooled multinational nonincident opioid prescribing (3.7%; 95% CI 2.9, 4.8). The female sex and older age were associated with higher opioid prescribing. Main limitations of this study include the absence of data from study duration or individuals not covered by the data sources and the lack of information on medication adherence and indication.CONCLUSIONS: Opioid prescribing remains unbalanced across geographical regions; however, results suggest a tendency to convergence across countries/regions. Differences in opioid prescribing by sex and age were identified.

AB - OBJECTIVE: To characterize multinational trends and patterns of opioid analgesic prescribing by sex and age.DESIGN, SETTING, AND PARTICIPANTS: We studied opioid analgesic prescribing from 2001 to 2019 with common protocol using population-based databases from eighteen countries and one special administrative region.MAIN OUTCOME MEASURES: We measured opioid prescribing by geographical region, sex and age, estimating annual prevalent, incident, and nonincident opioid prescribing per 100 population with a 95% confidence interval (CI) and meta-analyzed the multinational and regional opioid prescribing with a random-effects model. Time trends were reported through average annual absolute changes, estimated using linear mixed models. We further explored the effect of sex and age on prevalent opioid prescribing in the multivariable analysis.RESULTS: Over 248 million individuals were included. Pooled multinational opioid prescribing prevalence was 9.0% amongst included countries/regions. Opioid prescribing prevalence in 2015 ranged from 2.7% in Japan to 19.7% in Iceland. Average annual absolute changes in opioid prescribing prevalence per year ranged from - 1.53% (95% CI - 2.06, - 1.00; United States Medicaid) to + 1.24% (95% CI 1.02, 1.46; South Korea). Pooled multinational incident opioid prescribing (4.9%; 95% CI 4.1, 5.9) was higher than pooled multinational nonincident opioid prescribing (3.7%; 95% CI 2.9, 4.8). The female sex and older age were associated with higher opioid prescribing. Main limitations of this study include the absence of data from study duration or individuals not covered by the data sources and the lack of information on medication adherence and indication.CONCLUSIONS: Opioid prescribing remains unbalanced across geographical regions; however, results suggest a tendency to convergence across countries/regions. Differences in opioid prescribing by sex and age were identified.

U2 - 10.1007/s40263-025-01215-2

DO - 10.1007/s40263-025-01215-2

M3 - Article

C2 - 40889082

SN - 1172-7047

JO - Cns Drugs

JF - Cns Drugs

ER -

International Trends in Opioid Prescribing by Age and Sex from 2001 to 2019: An Observational Study Using Population-Based Databases from 18 Countries and One Special Administrative Region

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