THE USE OF NARCOTIC ANALGESICS IN HOSPITAL PRACTICE

Summary A survey on the use of parenteral analgesics was carried out in three teaching hospitals and one non-teaching hospital in the Mersey Region. A comparison of the use of narcotics in one teaching hospital and one non-teaching hospital was carried out over a 5 year period (1972 to 1976). A second comparison of narcotic supply in three teaching hospitals was conducted during the period 1974 to 1976 inclusive. Results indicated that over the 5 year period 73,608 doses were used in teaching hospital A and 49,448 doses in the non-teaching hospital. The synthetic group was used most frequently (52.3% and 62.3% of the total in the teaching and the non-teaching hospital respectively). The most popular individual narcotic was the synthetic analgesic pethidine (44.5% in the teaching hospital and 57.1% in the non-teaching hospital). The majority of the total narcotics were used in the surgical wards, which accounted for 28.0% of all narcotics used in the teaching hospital, where the preferred group was the morphine alkaloids. However, in the non-teaching hospital, the synthetic group was preferred of the 55.5% of the total narcotics used in the surgical wards. Comparing the data over the 3 year period (1974 to 1976) it was found that the total number of doses of parenteral narcotics used in the three teaching hospitals A, B and C was 52300,74,737 and 51,153 respectively. The synthetic group was used most frequently in hospitals A and B (49.2% and 45.7% respectively), whilst the morphine alkaloids were preferred in hospital C (52.7% of the total narcotic use). Pethidine, the synthetic analgesic, was the most popular individual narcotic (42.4%) in hospital A, whilst morphine was preferred in hospital B and C (39.3% and 50.8% respectively). The greatest use of narcotics was in surgical wards, which accounted for 26.5%, 32.1% and 39% of all narcotics used in teaching hospitals A, B and C respectively. In hospitals A and C the main group used in these wards was the morphine alkaloids, but the synthetic group was the most popular in hospital B. This and the previous survey show that pethidine, the synthetic analogue, is the most popular drug in both the Mersey and the West Midland regions. However, morphine (including papaveretum) and diamorphine are also widely used. The pattern of use is influenced by the size of the hospital, the percentage of occupancy of hospital beds, the surgical speciality of the hospital and the prescribing habits of clinicians. In order t o substantiate the present findings, the survey should be carried out in many more regions in the country and over a longer period of time. Studies on factors which influence clinicians' prescribinghabits should be included in future surveys.