BACKLASH IN THE TREATMENT OF CANCER PAIN - USE OF OPIOID ANALGESICS IN A FINNISH GENERAL-HOSPITAL IN 1987, 1991, AND 1994

Finland belongs to the group of countries in which the consumption of strong opioids is low. This seems to reflect the general qualify of ca ncer pain treatment. During the last 10 years, many efforts have been made to improve the treatment of cancer lain in Finland. To assess one parameter of change, the present study compared the quantity of opioi d and nonopioid analgesics used in the treatment of terminal cancer pa in in a Finnish general hospital in 1987, 1991, and 1994. Specifically the records of all patients who died of cancer in Kymenlaakso Central Hospital (KCH) in 1991 and in 1994 and during the last 6 months of 19 87 were reviewed to acquire information about the use of analgesic med ication. The total proportion of cancer patients receiving analgesic m edication on a regular basis was 39% in 1987, 63% in 1991, and 52% in 1994. The mean daily dose of strong opioids changed from 24 mg in 1987 to 58 mg in 1991, and to 43 mg in 1994. These data suggest a possible backlash in prescribing practices during recent years. In spite Of va rious efforts to improve the treatment of cancer pain, the medical rec ords demonstrate a decline in prescribing of the drugs needed for this treatment. (C) U.S. Cancer Pain Relief Committee, 1997.