PopData is performing data linkage for a research study to determine the prescription patterns of common opioids for patients in BC.
Over 21.5 million opioid prescriptions were dispensed in Canada in 2016, and the trend continues to grow.1 Associated with these prescriptions are risks of addiction and mortality, related to which the BC Coroners Service reported that there were 438 prescription opioid-related overdose deaths between 2005 and 20102.
The College of Physicians and Surgeons of Canada (CPSC) updated its guidelines regarding the safe prescribing of opioids and sedatives in June 2018, emphasizing that patients cannot be dismissed from a practice for current use, requests for, or suspected problematic use of opioids3. Additionally, it noted that patients had to have evidence of great need to warrant opioid prescriptions of over 90 morphine equivalent daily doses (MEDD) 3. However, the validity of using MEDD in public health analyses and pain research has been denounced due to several factors including the lack of a universal equianalgesic conversion calculator and the risk of opioid-related overdose being patient dependent.4
This research study, funded by BC Children’s Hospital Research Institute, aims to provide BC’s health care providers with references in regard to the distribution of individual opioid prescriptions and inform public health initiatives with provincial prescribing trends.
Dr. Douglas Courtemanche, of BC Children’s Hospital and Clinical Professor in the University of British Columbia’s Faculty of Medicine, is the Principal Investigator on the project.
“Our study aims to help address current issues by estimating the distribution of individual opioid prescriptions in BC over 5 years, for common opioid-type drugs. We believe that this information may serve as a reference for practitioners and patients alike to characterize broad prescription patterns,” says Dr. Courtemanche.
This study will also compare the distribution of opioids prescribed by pain specialists to the rest of the provider population, which may provide insight as to when these health care providers should consider consulting or referring patients to a specialist.
The results of this study, alongside the recommendations by the CPSC will serve to clarify the practice of prescribing opioids given our obligation to treat patients regardless of their opioid use.
References
1. Pan-Canadian Trends in the Prescribing of Opioids, 2012 to 2016. Canadian Institute for Health Information; 2017. https://secure.cihi.ca/free_products/pan-canadian-trends-opioid-prescribing-2017-en-web.pdf
2. Prescription Opiate-Related Overdose Deaths 2005-2010. BC Coroners Service; 2013. https://www2.gov.bc.ca/assets/gov/public-safety-and-emergency-services/death-investigation/public-safety-bulletins/2013-may
3. Safe Prescribing of Opioids and Sedatives. College of Physicians and Surgeons of British Columbia; 2018. https://www.cpsbc.ca/files/pdf/PSG-Safe-Prescribing.pdf
4. Fudin J, Pratt Cleary J, Schatman ME. The MEDD myth: the impact of pseudoscience on pain research and prescribing-guideline development. J Pain Res. 2016;9:153-156. doi:10.2147/JPR.S107794
