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The number of Ontarians being prescribed opioids held steady at about one in seven in 2016 but the amount of the potentially addictive drugs that were actually dispensed trended downward, according to a new study.
The St. Michael’s Hospital study found that about 1.7 million Ontarians were prescribed an opioid for pain in 2016 while another 318,000 were prescribed an opioid for a persistent cough and about 58,000 were given an opioid to treat an addiction.
Though those numbers are in line with recent averages, the study found that the actual amount of opioids dispensed dropped by 18 per cent between January, 2015 and March of this year. That period of time roughly coincides with a rise in concern over the dangers of opioid addiction.
Opioids prescribed to treat pain include codeine, fentanyl, hydromorphone, oxycodone, among others, while opioids prescribed to treat addiction include methadone and buprenorphine/naloxone
“This change in trend was largely driven by lower volumes of long-acting opioids being dispensed over this time, with the volume of immediate-release opioids dispensed remaining stable over our study period,” the report says. “The reason for this lower population exposure to long-acting opioids may stem from changes in the types of opioids being dispensed and public health initiatives in Ontario directing doctors as well as pharmacists on safe use and monitoring of opioids.”
The study found that the monthly percentage of Ontarians dispensed an opioid to treat pain has remained steady at about three per cent over the last five years.
While the number of people being prescribed opioids has not fluctuated considerably, the study says that the decline in the amount of opioids being dispensed is an “encouraging trend” if it in fact means that “physicians and pharmacies are working towards dispensing smaller amounts of opioid at a time.”
“I think to some extent prescribers need to think about how they can make sure that they are only giving these drugs to the right patients and as safely as possible,” Principal Investigator Tara Gomes told CP24 on Tuesday. “In the past there was a real push to just use these drugs, feeling that they were safe and effective for pain, and we are learning now that that wasn’t true and that people can become addicted to them and that they can misuse them.”
Gomes said that while many opioids users purchase their drugs on the black market, some of them are first developing an addiction after being prescribed the drug for a genuine purpose.
She said that for that reason the amount of opioids being prescribed by the province’s doctors should be closely monitored.
“That is what is so complicated about this issue. We have people who are having their first exposure to opioids through prescriptions and we have people who are using them illicitly and sometimes people move between those two groups where they start using a legitimate prescription, become addicted and move into the illicit market.”
In general, the study found that areas with lower numbers of people given opioids for pain also had lower numbers of people given opioids for addiction, though there were exceptions to that.
The study also found several regions, including the Hamilton and Simcoe Muskoka District Health Units, where there was a comparatively high number of opioid-related deaths but lower numbers of opioid prescriptions.
“This could be reflective of greater use of diverted and/or illicit opioid use in these areas,” the study notes.
The study is based on data collected between July, 2012 and March, 2017.
