Opioid prescriptions among Sami and non-Sami with chronic pain: The SAMINOR 2 Questionnaire Survey and the Norwegian Prescription Database

Figures & data

Figure 1. Flow chart of inclusion in the study population of opioid prescriptions among Sami and non-Sami with chronic musculoskeletal pain: The SAMINOR 2 Questionnaire Survey and the Norwegian Prescription Database.

Table 1. Baseline characteristics of Sami and non-Sami women reporting chronic musculoskeletal pain by ethnicity: the SAMINOR 2 Questionnaire Survey (2012, n = 2879).

	All women (n = 2879)	Sami (n = 621)	Non-Sami (n = 2258)	P-value^b
Age (years), mean (SD)a	48.8 (12.9)	48.3 (13.2)	49.0 (12.8)	.29^a
Educational level, % (n)				<.001^b
Primary school	14.2 (403)	13.7 (84)	14.3 (319)
Secondary school	27.6 (785)	20.7 (127)	29.5 (658)
College/university 1–3 years	26.3 (749)	27.4 (168)	26.0 (581)
College/university ≥4 years	31.9 (909)	38.3 (235)	30.2 (674)
Alcohol intake, % (n)				<.001^b
Seldom/never	38.7 (1095)	46.6 (285)	36.5 (810)
Monthly	26.1 (737)	19.0 (116)	28.0 (621)
Weekly	35.2 (997)	34.4 (210)	35.5 (787)

Abbreviations: SD, standard deviation; ^aComparing Sami and non-Sami by two-sample t-test; ^bComparing Sami and non-Sami by Pearson’s chi-square test. Missing values, Education level: n = 33 (1.1%); Missing values alcohol intake: n = 50 (1.7%).

Table 2. Baseline characteristics of Sami and non-Sami men reporting chronic musculoskeletal pain by ethnicity: the SAMINOR 2 Questionnaire Survey (2012, n = 1859).

	All men (n = 1859)	Sami (n = 405)	Non-Sami (n = 1454)	P-value^b
Age (years), mean (SD)a	52.2 (12.0)	52.3 (11.5)	52.2 (12.1)	.89^a
Educational level, % (n)				.69^b
Primary school	21.9 (403)	22.0 (88)	21.9 (315)
Secondary school	35.7 (657)	37.8 (151)	35.2 (506)
College/university 1–3 years	23.0 (423)	22.8 (91)	23.1 (332)
College/university ≥4 years	19.3 (355)	17.5 (70)	19.8 (285)
Alcohol intake, % (n)				.62
Seldom/never	28.5 (519)	28.2 (112)	28.5 (407)
Monthly	36.7 (669)	35.0 (139)	37.2 (530)
Weekly	34.8 (635)	36.8 (146)	34.3 (489)

Abbreviations: SD, standard deviation; ^aComparing Sami and non-Sami by two-sample t-test; ^bComparing Sami and non-Sami by Pearson’s chi-square test. Missing values, education level: n = 28 (1.5%); Missing values, alcohol intake: n = 36 (1.9%).

Table 3. Filled prescriptions of opioids categorised in four groups according to Defined Daily Dose (DDD^d), among Sami and non- Sami women who reported chronic musculoskeletal pain, the SAMINOR 2 Questionnaire Survey (2012) and the Norwegian Prescription Database (2012–2019).

		Sami				Non-Sami
		No prescriptions	≤180 DDD 1 prescription	≤180 DDD 2 or more prescriptions	>180 DDD	No prescriptions	≤180 DDD 1 prescription	≤180 DDD 2 or more prescriptions	>180 DDD
Year	n	% (n)	% (n)	% (n)	% (n)	% (n)	% (n)	% (n)	% (n)	P-value^a
2012^b	2879	81.3 (505)	7.2 (45)	9.0 (56)	2.4 (15)	79.8 (1802)	9.9 (223)	8.5 (193)	1.8 (40)	.18
2013^b	2868	80.6 (499)	7.6 (47)	9.5 (59)	2.3 (14)	79.5 (1788)	9.4 (211)	9.2 (208)	1.9 (42)	.53
2014^b	2859	78.6 (485)	9.7 (60)	9.2 (57)	2.4 (15)	80.1 (1796)	9.6 (216)	7.6 (170)	2.7 (60)	.59
2015^b	2846	78.6 (485)	9.9 (61)	8.9 (55)	2.6 (16)	78.1 (1741)	11.8 (263)	7.7 (171)	2.4 (54)	.46
2016^b	2830	80.2 (493)	9.3 (57)	7.8 (48)	2.8 (17)	80.1 (1775)	9.2 (204)	8.4 (186)	2.3 (50)	.87
2017^b	2814	80.0 (489)	8.7 (53)	8.2 (50)	3.1 (19)	80.2 (1766)	9.2 (202)	8.3 (182)	2.4 (53)	.79
2018^c	2812	79.7 (486)	9.5 (58)	8.7 (53)	2.1 (13)	77.8 (1714)	11.8 (259)	8.3 (182)	2.1 (47)	.48
2019^c	2806	82.9 (505)	5.7 (35)	9.4 (57)	2.0 (12)	80.9 (1777)	9.1 (201)	7.5 (165)	2.5 (54)	.03
2012–2019 combined	2806	49.8 (303)	16.9 (103)	25.6 (156)	7.7 (47)	44.9 (987)	17.9 (393)	30.0 (659)	7.2 (158)	.11
2012–2019 combined, weak opioids^d	2806	50.4 (307)	17.1 (104)	24.8 (151)	7.7 (47)	45.7 (1004)	18.0 (396)	29.4 (647)	6.8 (150)	.08
2012–2019 combined, strong opioids^e	2806	94.9 (578)	2.3 (14)	2.1 (13)	0.7 (4)	92.7 (2037)	2.5 (55)	3.8 (84)	1.0 (21)	.19

Abbreviations: DDD, Defined Daily Dose; ^aComparing Sami and non-Sami by Pearson’s chi-square test; ^bexcluded persons who died, emigrated, or received palliative treatment; ^cexcluded persons who died or received palliative treatment. ^dWeak opioids includes ATC codes N02AJ, N02AX02; ^eStrong opioids includes ATC codes N02AA, N02AB, N02AC, N02AD01 N02AE, N02AG, N02AX06.

Table 4. Filled prescription of opioids categorised in four groups according to Defined Daily Dose (DDD^d), among Sami and non-Sami men who reported chronic musculoskeletal pain, the SAMINOR 2 Questionnaire Survey (2012) and the Norwegian Prescription Database (2012–2019).

		Sami				Non-Sami
		No prescriptions	≤180 DDD 1 prescription	≤180 DDD 2 or more prescriptions	>180 DDD	No prescriptions	≤180 DDD 1 prescription	≤180 DDD 2 or more prescriptions	>180 DDD
Year	N	% (n)	% (n)	% (n)	% (n)	% (n)	% (n)	% (n)	% (n)	P-value^a
2012^b	1859	80.5 (326)	8.6 (35)	9.4 (38)	1.5 (6)	81.2 (1181)	9.1 (133)	7.9 (115)	1.7 (25)	.79
2013^b	1845	81.3 (327)	9.2 (37)	8.5 (34)	1.0 (4)	82.8 (1195)	8.7 (125)	6.8 (98)	1.7 (25)	.48
2014^b	1833	81.8 (328)	8.2 (33)	9.0 (36)	1.0 (4)	82.4 (1180)	8.4 (121)	7.6 (109)	1.5 (22)	.70
2015^b	1813	81.6 (324)	11.1 (44)	6.3 (25)	1.0 (4)	79.9 (1131)	10.2 (145)	8.4 (119)	1.5 (21)	.47
2016^b	1788	81.5 (317)	9.8 (38)	7.5 (29)	1.3 (5)	82.1 (1149)	8.1 (114)	8.1 (113)	1.6 (23)	.72
2017^b	1775	81.7 (317)	9.0 (35)	8.0 (31)	1.3 (5)	84.1 (1166)	7.3 (101)	7.1 (98)	1.6 (22)	.59
2018^c	1766	81.1 (314)	9.6 (37)	8.3 (32)	1.0 (4)	81.7 (1127)	9.9 (136)	6.8 (94)	1.6 (22)	.66
2019^c	1760	83.4 (322)	8.8 (34)	6.2 (24)	1.6 (6)	85.4 (1174)	7.6 (105)	5.2 (729)	1.7 (23)	.75
2012–2019 combined	1760	46.1 (178)	19.2 (74)	28.0 (108)	6.7 (26)	47.6 (654)	18.3 (252)	27.5 (378)	6.6 (90)	.96
2012–2019 combined, weak opioids^d	1760	46.9 (181)	18.7 (72)	27.7 (107)	6.7 (26)	48.8 (670)	18.3 (251)	26.7 (367)	6.3 (86)	.93
2012–2019 combined, strong opioids^e	1760	94.0 (363)	3.4 (13)	2.3 (9)	0.3 (1)	94.0 (1292)	1.9 (26)	3.6 (49)	0.5 (7)	.19

Abbreviations: DDD, Defined Daily Dose; ^aComparing Sami and non-Sami by Pearson’s chi-square test. ^bexcluded persons who died, emigrated, or received palliative treatment, ^cexcluded persons who died or received palliative treatment; ^dWeak opioids includes ATC codes N02AJ, N02AX02; ^eStrong opioids includes ATC codes N02AA, N02AB, N02AC, N02AD01, N02AE, N02AG, N02AX06.

Table 5. The association between filled prescriptions of opioids and Sami ethnicity among women and men who reported chronic musculoskeletal pain. The SAMINOR 2 Questionnaire Survey (2012) and the Norwegian Prescription Database (2012–2019).

Year	≤180 DDD 1 prescription	P-value	≤180 DDD 2 or more prescriptions	P-value	>180 DDD	P-value
Women	AOR^a		AOR^a		AOR^a
2012	.72	.06	.99	.20	1.4	.32
2013	.79	.19	1.1	.70	1.2	.49
2014	1.1	.76	1.3	.13	.95	.87
2015	.95	.77	1.2	.25	1.1	.72
2016	.96	.80	.89	.50	1.3	.39
2017	.95	.77	1.0	.90	1.3	.29
2018	.92	.61	.96	.81	1.3	.44
2019	.62	.01	1.2	.35	.79	.47
2012–2019	.87	.29	.77	.02	.96	.81
Men
2012	.95	.80	1.2	.31	.88	.78
2013	1.1	.54	1.3	.28	.59	.33
2014	.92	.71	1.2	.48	.65	.44
2015	1.1	.65	.69	.11	.67	.46
2016	1.2	.29	.89	.62	.79	.64
2017	1.3	.15	1.2	.56	.84	.73
2018	.97	.84	1.1	.54	1.1	.87
2019	1.1	.53	1.2	.45	.79	.63
2012–2019	1.1	.72	1.0	.78	.99	.96

Abbreviations: DDD, Defined Daily Dose; AOR, adjusted odds ratio; ^aadjusted for age, educational level, and alcohol consumption; Notes: Results are from multinomial logistic regression with opioid use in four categories as dependent variable (“no opioids” as reference), and Sami ethnicity as exposure (non-Sami as reference).

Data availability statement

Data is stored at Services for sensitive data (TSD). The data underlying this article cannot be shared publicly due to the ethical and legal contract with the Regional Committee for Medical and Health Research Ethics (REK-Sør-Øst, number 23,394), the SAMINOR Project Board, UiT the Arctic University of Norway, the Norwegian Centre for Research Data (NSD), Statistics Norway (SSB) and the Norwegian Prescription Database (NorPD).