Canadian Medical Association Journal reports a continuing decline in the number of opioid prescriptions in most Canadian provinces
A study published in the Canadian Medical Association Journal (CMAJ.ca) shows there has been a "progressive decline" in dispensing of prescription opioids in Canada in recent years, which suggests that the national push toward safer prescribing methods has had an impact.
The study is titled "Trends in prescription opioid use for pain in Canada: a population-based repeated cross-sectional study of six provinces" and outlines how there are indications of safer prescribing and dispensing, but there is still not enough information to provide solid data to the medical community or policy makers, said the study.
"National information on prescription opioid use in Canada is lacking. We sought to examine trends in the incidence and prevalence of prescription opioid dispensing for pain in Canada," the study said.
The study was carried out by collecting data from six provinces over a four-year period from Jan. 1, 2018 to Dec. 31, 2022 where the researchers conducted a population-based repeated cross-sectional analysis of pharmacy dispensing data.
Data was captured from 80 per cent of the population, said the study.
The researchers collected data on opioids prescribed to recipients by province, by age and sex, neighbourhood incomes and residence locations. Additional data was gathered to calculate the proportion of drug recipients receiving opioid doses and of drug recipients receiving specific opioids indicated for pain (i.e., codeine, hydromorphone, oxycodone, morphine, and fentanyl).
The study found that between 2018 and 2022, the annual incidence and prevalence of prescription opioid dispensing declined by 7.9 per cent and 1.1 per cent, respectively, across all provinces in the study. (British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Quebec)
The study said monthly trends showed that Manitoba consistently had the highest opioid use rate, and British Columbia had the lowest.
Researchers also found in 2022, there were varying usage rates by province -- 55.2 users per 1,000 population in Ontario, 85.1 users per 1,000 population in Saskatchewan, 63 per 1,000 population in Alberta and 60 users per 1,000 population in Quebec.
The study also said annual usage rates were higher among females, older adults, and people living in lower-income neighbourhoods and rural regions of Canada. Initial daily doses greater than 50 mg morphine equivalents declined over time, with provincial and temporal differences in the types of opioids prescribed, said the study.
The authors said in conclusion their study provided valuable information about the decline in opioid dispensing and the trends in different parts of Canada.
"Our findings suggest that national efforts to promote opioid stewardship and safer opioid prescribing for acute and chronic noncancer pain over the past decade have had an impact. Ongoing monitoring is needed to ensure that policies and guidelines promote safe and appropriate opioid prescribing without leaving patients with inadequate pain management that may increase reliance on unregulated drug markets," said the conclusion statement.
The full text version of the study can be found online here.