Killing pain?: a population-based registry study of the use of prescription analgesics, anxiolytics, and hypnotics among all children, adolescents and young adults in Norway from 2004 to 2019
Open accessAbstract
The ongoing opioid epidemic has been a global concern for years, increasingly due to its heavy toll on young people's lives and prospects. Few studies have investigated trends in use of the wider range of drugs prescribed to alleviate pain, psychological distress and insomnia in children, adolescents and young adults. Our aim was to study dispensation as a proxy for use of prescription analgesics, anxiolytics and hypnotics across age groups (0-29 years) and sex over the last 15 years in a large, representative general population. The study used data from a nationwide prescription database, which included information on all drugs dispensed from any pharmacy in Norway from 2004 through 2019. Age-specific trends revealed that the prevalence of use among children and adolescents up to age 14 was consistently low, with the exception of a substantial increase in use of melatonin from age 5. From age 15-29, adolescents and young adults used more prescription drugs with increasing age at all time points, especially analgesics and drugs with higher potential for misuse. Time trends also revealed that children from age 5 were increasingly dispensed melatonin over time, while adolescents from age 15 were increasingly dispensed analgesics, including opioids, gabapentinoids and paracetamol. In contrast, use of benzodiazepines and z-hypnotics slightly declined in young adults over time. Although trends were similar for both sexes, females used more prescription drugs than their male peers overall. The upsurge in use of prescription analgesics, anxiolytics and hypnotics among young people is alarming.Trial registration The study is part of the overarching Killing Pain project. The rationale behind the Killing Pain research was pre-registered through ClinicalTrials.gov on April 7, 2020. Registration number NCT04336605; https://clinicaltrials.gov/ct2/show/record/NCT04336605 .
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Individuals suffering from chronic pain are at increased risk for the use and potential misuse of hypnotics to alleviate pain-induced insomnia.
“Individuals suffering from chronic pain are at increased risk for the use—and potential misuse—of hypnotics to alleviate pain-induced insomnia.”
From Z-drug abuse and dependence: Clinical guideline of the Brazilian Academy of Neurology for diagnosis and management (2025) · cites this paper as [53]
The Introduction describes pain and insomnia as often co-occurring concerns among young people and identifies z-hypnotics as drugs with misuse potential. The Discussion mentions hypnotic treatment for insomnia. Neither section establishes that people with chronic pain have an increased risk of using or misusing hypnotics, or that their insomnia is pain-induced. (LLM, conf=0.81)
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- Authors
- Stangeland, H., Handal, M., Skurtveit, S. O., Aakvaag, H. F., Dyb, G., Wentzel-Larsen, T., Baumann-Larsen, M., Zwart, J. A., Storheim, K., & Stensland, S. Ø.
- Affiliations
- Oslo University Hospital (NO)
- Norwegian Institute of Public Health (NO)
- Norwegian Centre for Violence and Traumatic Stress Studies (NO)
- University of Oslo (NO)
- Corresponding author
- Stangeland, Helle
- ORCID
- Venue
- European Child & Adolescent Psychiatry
- Published
- 2022-08-27
- Volume
- 32
- Issue
- 11
- Pages
- 2259-2270
- ISSN
- 1018-8827 (ISSN-L)
- 1435-165X
- PMC
- PMC9419914
- OpenAlex
- W4293348902
- Cited by
- 21
- References
- 47
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 2 · 2023: 5
- FWCI
- 3.53
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- European Child & Adolescent Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
- Funders
- Dam Foundation (2020/FO283043)
- University of Oslo
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- prescription analgesics, anxiolytics, hypnotics, opioid epidemic, children, adolescents, young adults, melatonin, benzodiazepines, gabapentinoids, paracetamol, sex differences in drug use
- MeSH terms
- Adolescent, Adult, Analgesics, Analgesics, Opioid, Child, Child, Preschool, Female, Humans, Hypnotics and Sedatives, Infant, Infant, Newborn, Male, Melatonin, Norway, Pain, Drug Prescriptions, Registries, Anti-Anxiety Agents, Prescription Drugs, Prescriptions, Young Adult
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