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Background: A Regular General Practitioner Scheme was introduced in Norway in 2001. One aim was to restrict patients from "shopping" doctors and prescription drugs., Material and Methods: Data from The Norwegian Prescription Database (NorPD) for 2004 were used to assess the following: number of physicians each patient had used to obtain prescriptions for a drug, the relationship between number of physicians used and amount of drugs prescribed, and concomitant prescription of opioids and benzodiazepines during the same period to the same patients. The drugs studied were the prescription drugs with potential for abuse; diazepam, carisoprodol and codeine combinations. The information retrieved was compared to that for the supposedly non-addictive drugs esomeprazole, metformine and salbutamol., Results: More than 96 % (96.3 - 98.9) of the patients used one or two physicians for prescriptions of the same drug, and fewer than 0.5 % (0.01 - 0.26) used five or more physicians. However, the proportion of patients who used five or more physicians for the addictive drugs was 9.5 times higher than that for a comparable proportion of patients using the non-addictive drugs. The amount of dispensed drug increased considerably more with the number of physicians used for addictive drugs than for non-addictive drugs, as did the amount of concomitantly dispensed opioids and benzodiazepines., Interpretation: The occurrence of prescription drug shopping in the Norwegian population was limited. Among the few patients who used many physicians for prescription of drugs, the phenomenon was much more frequent for users of addictive drugs than for users of the non-addictive drugs. The study suggests that prescription drug shopping may be an indicator of a drug abuse potential.

Background: Information on treatment facilities for legal drug dependence in Norway is not readily available., Material and Method: In 2001 a questionnaire on the treatment of legal drug dependence was mailed to 254 psychiatric and substance abuse inpatient and outpatient clinics., Results: Of the 189 respondents, 25 psychiatric and 37 substance abuse clinics had treated patients with legal drug dependence in 1999-2000. Several clinics had insufficient registration systems. 34 out of 39 outpatient and 14 out of 35 inpatient clinics used gradual, as opposed to immediate, discontinuation of drug use. Abstention from all addictive drugs was a more common treatment goal for the substance abuse clinics than for the psychiatric clinics. Use of other drugs in the treatment was inconsistent between the different clinics. Half of the clinics claimed to base their treatment on scientific evidence. Only nine of 60 clinics had made systematic evaluations of treatment efficiency., Interpretation: Institutional treatment for legal drug dependence in Norway in 1999-2000 was not well organised, and treatment ideologies and goals were diverse. We recommend one specialised clinic in this field in each of the five regional health administrations.

Background: An increasing number of the centrally acting muscle relaxants were withdrawn from the Norwegian market during the 1988-98 period. The only drug in this group now marketed in Norway is carisoprodol. The National Institute of Forensic Toxicology in Norway analyses all blood samples from suspected drugged drivers. In later years there has been a marked increase in the number of blood samples testing positive for carisoprodol or meprobamate (the major metabolite)., Material and Methods: 480 cases testing positive for central muscle relaxants in the years 1984-1998 were further studied., Results: Compared with blood samples positive primarily for benzodiazepines, there were more women in the group (39% vs. 15%), and fewer drugs and less alcohol were detected., Interpretation: The positive samples may indicate misuse or abuse due to the fact that high drug concentrations and concomitant use of benzodiazepines were frequent. This knowledge should have implications for doctors prescribing centrally acting muscle relaxants.