Trends and Changes in Prescription Opioid Analgesic Dispensing in Canada 2005-2012: an Update with a Focus on Recent Interventions

Overview

Journal BMC Health Serv Res

Publisher Biomed Central

Specialty Health Services

Date 2014 Feb 28

PMID 24572005

Citations 39

Authors

Benedikt Fischer

Wayne Jones

Jurgen Rehm

Affiliations

Soon will be listed here.

Abstract

Background: Prescription opioid analgesic (POA) utilization has steeply increased globally, yet is far higher in established market economies than elsewhere. Canada features the world's second-highest POA consumption rates. Following increases in POA-related harm, several POA control interventions have been implemented since 2010.

Methods: We examined trends and patterns in POA dispensing in Canada by province for 2005-2012, including a focus on the potential effects of interventions. Data on annual dispensing of individual POA formulations--categorized into 'weak opioids' and 'strong opioids'--from a representative sub-sample of 5,700 retail pharmacies across Canada (from IMS Brogan's Compuscript) were converted into Defined Daily Doses (DDD), and examined intra- and inter-provincially as well as for Canada (total).

Results: Total POA dispensing--driven by strong opioids--increased across Canada until 2011; four provinces indicated decreases in strong opioid dispensing; seven provinces indicated decreases specifically in oxycodone dispensing, 2011-2012. The dispensing ratio weak/strong opioids decreased substantively. Major inter-provincial differences in POA dispensing levels and qualitative patterns of POA formulations dispensed persisted. Previous increasing trends in POA dispensing were reversed in select provinces 2011-2012, coinciding with POA-related interventions.

Conclusions: Further examinations regarding the sustained nature, drivers and consequences of the recent trend changes in POA dispensing--including possible 'substitution effects' for oxycodone reductions--are needed.

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