New data released by the Canadian Institute for Health Information (CIHI) shows that about 8% fewer people in Ontario, Saskatchewan and British Columbia* were prescribed opioids in 2018 than in 2013, while the number of people starting opioids decreased by nearly 10%. The results suggest that about 220,000 fewer people in these provinces were prescribed opioids in 2018, while approximately 175,000 fewer people started on opioids.
Last year, looking at available data from Ontario, Manitoba, Saskatchewan and British Columbia, about 1 in 8 people were prescribed opioids, while about 1 in 12 people started a new opioid therapy. Fewer people took opioids on a long-term basis, while more people on long-term opioid therapy were prescribed smaller doses. Long-term therapy is defined as prescribing someone opioids for 90 days in a 100-day period.
Many initiatives, including Canadian opioid prescribing guidelines, provincial prescription monitoring programs and changes to prescription coverage, have been implemented to help reduce opioid harms. These initiatives and increased awareness about opioid harms are likely influencing prescribing trends. However, it is challenging to attribute specific initiatives to data trends since many initiatives have been implemented across the country at different times.
“The changes in opioid prescribing are due to several factors, including fewer people starting opioids. The decline in new starts is an encouraging trend and may suggest that the Canadian opioid guidelines are informing prescribing. When prescribed and used appropriately, opioids are effective drugs that play an important role in pain management.” — Michael Gaucher, Director, Pharmaceuticals and Health Workforce Information Services, CIHI
“CIHI’s report identifies information gaps and highlights the need to continue to extend the breadth of coverage and connectivity among opioid prescription monitoring programs across the country. The reduction in prescriptions’ durations and the total amount of opioids prescribed is likely influenced by the first Canadian opioid guideline from 2010, as well as other knowledge translation efforts. However, it continues to be challenging to ensure that patients who will benefit from opioids still receive them. There is no diagnostic coding to identify patients with chronic pain, so it is difficult to establish whether prescribing has been appropriate.”— Dr. Norm Buckley, Professor, Department of Anesthesia; Scientific Director, Michael G. DeGroote Institute for Pain Research and Care; and Director, Michael G. DeGroote National Pain Centre; McMaster University
* The data used in this study covers opioid prescribing for Ontario, Manitoba, Saskatchewan and British Columbia; these provinces represent about 60% of Canadians. CIHI had access to data from these 4 provinces on all prescription opioids dispensed in community pharmacies. Manitoba data was available from 2016 onward only, so it was excluded from calculations on previous years.
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