A nationwide study of the extent and factors associated with fentanyl use in Australia.
OBJECTIVE
To examine fentanyl utilisation in the Australian community and determine the geographic and socio-demographic factors associated with higher rates of fentanyl utilisation.


METHODS
National sales data (supplied by IMS Health) were used to estimate fentanyl utilisation (in pack sales and milligrams) in Australia during 2013, mapped to Australian Bureau of Statistics (ABS) Statistical Local Areas (SLAs) and Remoteness Areas. Socio-demographic characteristics and total population estimates of SLAs were obtained from the ABS. SLA-level data on sex, age distribution, income, occupations involving physical labour and number of pharmacies, were included in linear regression analyses to examine their association with fentanyl use.


RESULTS
An estimated 12.3 kg (or 859,518 packs) of fentanyl was sold across Australia in 2013, equating to an average of 0.55 mg/person over the year. Transdermal patches accounted for the majority (99%; 850,923 packs) of fentanyl sales. South Australia had the highest rate of utilisation per person. Rates of fentanyl utilisation were higher among more remote areas in three jurisdictions. Overall, higher utilisation rates were observed in SLAs that were less populated (β 0.12; p < 0.001) and those with a higher proportion of older people (β 0.12; p < 0.001), low-income households (β 0.12; p < 0.001) and people working in jobs requiring physical labour (β 0.08; p < 0.05).


CONCLUSIONS
Transdermal fentanyl patches account for the majority of fentanyl utilisation in the Australian community. There is marked variation in fentanyl utilisation across geographic areas, with higher use apparent in areas with a higher proportion of older people and indicators of greater socio-economic disadvantage.
['Gisev|Natasa|N|', 'Larance|Briony|B|', 'Cama|Elena|E|', 'Nielsen|Suzanne|S|', 'Roxburgh|Amanda|A|', 'Bruno|Raimondo|R|', 'Degenhardt|Louisa|L|']
D000368:Aged D000701:Analgesics, Opioid D001315:Australia D004363:Drug Utilization D005260:Female D005283:Fentanyl D006801:Humans D008297:Male D012959:Socioeconomic Factors D057968:Transdermal Patch
Fentanyl (MeSH): Analgesics Drug utilization Opioids Pharmacoepidemiology