OBJECTIVES

: Pain is one the most common reasons Canadians seek health care. 1 in 5 adults in Canada experience chronic pain. Opioids, when prescribed and used appropriately, are effective in managing pain. However, inappropriate use of opioids can lead to serious harms such as addiction, poisoning and death. This report examines trends in opioid prescribing, focusing on people who are starting opioids as well as people who are prescribed opioids on a long-term basis.

METHODS

: This report presents trends in opioid prescribing in Ontario, Manitoba, Saskatchewan and B.C. from 2013 to 2018. Claims data used in this report are from CIHI’s National Prescription Drug Utilization Information System (NPDUIS) and Ontario’s Narcotics Monitoring System (NMS). Population data from Statistics Canada was used to calculate proportions and rates.

RESULTS

: In 2018, almost 1 in 8 people (12.3%) were prescribed opioids, compared with 14.3% in 2013. Additionally, fewer people started on prescription opioids. The proportion of those starting on opioid therapy decreased from 9.5% to 8.1% over the study period.

Fewer people are being prescribed opioids on a long-term basis. Of people prescribed opioids, the proportion who were prescribed them on a long-term basis decreased from 19.8% in 2013 to 17.6% in 2018. An increasing number of people prescribed opioids on a long-term basis have tapered to a dose less than 90 MMEs, switched to non-opioid prescription drugs to manage pain or stopped prescription opioids altogether.

CONCLUSIONS

: A variety of initiatives to reduce the harms associated with prescription opioids were implemented over the study period. These initiatives, along with an increased awareness of Canada’s opioid crisis and increased publication of opioid-related harms, are likely influencing the decreasing trends in opioid prescribing.