The Atlas of Healthcare Variation opioid domain, published today, shows the rate of use of opioids in each district health board (DHB). See the opioids Atlas here. The Atlas covers only opioids dispensed from community pharmacies and does not include those used in hospitals.
Opioids are used for managing pain, and the Atlas shows significant differences in use between DHBs. To some extent, this will be because DHBs have different populations, with different needs. However, the data is a prompt to DHBs to see where they sit and find out more about why differences exist.
Key trends highlighted by the data include:
- The use of strong opioids (eg, fentanyl, methadone, morphine, oxycodone and pethidine) and weak opioids (eg, tramadol, codeine and dihydrocodeine) has increased significantly between 2011 and 2013.
- The use of oxycodone has significantly decreased from 2011 to 2013.
- Three-fold variation between DHBs was observed in the use of strong opioids and oxycodone, while there was two-fold variation in the use of weak opioids and morphine.
- An average of 17/1000 people in New Zealand received a strong opioid in 2013. This varied three-fold between DHBs.
- People identifying as European or Other ethnicity had two to four times the rate of use of strong opioids than those of Māori, Pacific or Asian ethnicity.
- Use of strong opioids increased significantly with each age group, on average 1 in 10 people aged 80 years and over received an opioid in 2013.
- Women were dispensed significantly more strong opioids than men.
- 14 percent of people receiving a strong opioid received it for 6 or more weeks.
- In 2013, an average of 64/1,000 people in New Zealand received a weak opioid. This varied two fold between DHBs.
- People identifying as European or Other ethnic group received significantly more weak opioids, while Asian peoples received significantly less.
- Use increased significantly with age, up to 1 in 7 people aged 80 years and over received a weak opioid in 2013.
- As with strong opioids, women were dispensed significantly more weak opioids than men.
- In 2013, an average of 11/1,000 people in New Zealand received morphine and use varied two-fold between DHBs.
- Morphine use increased significantly since 2011 – up 10,000 people.
- 14 percent of people receiving morphine received it for 6 weeks or more.
- In 2013, an average of 6.4/1,000 people in New Zealand received oxycodone and use varied three-fold between DHBs.
- Oxycodone use decreased significantly since 2011 – down 5,000 people.
- 12 percent people receiving oxycodone received it for six weeks or more.
- Internationally, New Zealand has one of the highest per capita consumption of strong opioids along with countries such as the United States, Canada, Switzerland, Germany, Austria, Denmark, Australia and the United Kingdom.
The Health Quality & Safety Commission is partnering with DHBs in a national opioid ‘collaborative’ that will run until April 2016, with the aim of reducing harm from opioids in DHB hospitals. The collaborative will enable DHBs to learn from each other, share their experiences and trial improvements that identify best practice.
The Atlas data supports the collaborative by describing current community use of opioids and identifying where there is wide variation between DHBs in rates.