Rising dispensation of prescription opioids confirmed

August 20, 2011

(Medical Xpress) -- An investigative team led by Simon Fraser University health sciences professor Benedikt Fischer has established that starkly increasing prescription of strong opioids (POs) is driving up dispensation of the painkillers in Canada.

Fischer, also the CIHR/PHAC applied public health chair, notes POs are essential medication for treating severe and chronic pain. But, in recent years, they have been associated with strongly increasing (i.e., misuse and treatment admissions) and mortality (i.e., ) in Canada.

The study, Differences and over-time changes in levels of prescription opioid analgesic dispensing from retail pharmacies in Canada, analyzes dispensing data for opioids-related prescriptions. It is based on a of 2,700 retail pharmacies in 10 provinces between 2005 and 2010. The Pharmacoepidemiology and Drug Safety Journal published the study’s results online in its July 2011 issue.

Based on an analysis of defined daily doses (DDD) of weak and strong POs per 1,000 people set by the World Health Organization (WHO), Canada’s dispensation of the drugs increased by 13.1 per cent. The amount of all dispensed POs rose from 20.3 DDD/1,000 people in 2005 to 23.0 DDD/1,000 people in 2010.

While the volume of dispensed strong POs rose by 42.1 per cent (7.6 to 10.8 DDD/1,000 people), the volume of weak ones dropped slightly by 4.4 per cent (12.7 to 12.2 DDD/1,000 people).

Based on WHO standards, the researchers defined strong POs as hydrocodone, hydromorophone, oxycodone, fentanyl, meperidine, methadone and morphine. The WHO defines codeine and its combination products as weak POs.

The research team included SFU adjunct professor Wayne Jones from the Centre for Applied Research in Mental Health and Addiction (CARMHA) and University of Toronto researchers Murray Krahn and Juergen Rehm.

North America has the highest POs-dispensation rate in the world and previous studies indicate increased dispensation of the is linked to increased POs-related illnesses and deaths. Governments are developing policy measures on how to reduce POs-related harms to public health. They include improved prescription monitoring and guidelines for opioids.

Given harm-related issues and that little is known about why POs dispensation is increasing, the study has a warning.

“Canada currently finds itself at a major policy and practice development juncture in regard to opioid use that, on the one hand, ought to maximize availability of opioid-supported care for chronic and severe pain with optimal standards and outcomes, while minimizing rapidly rising opioid-related problems and harms...

“The quantity and quality of opioids dispensed — different as these are between Canadian provincial jurisdictions — undoubtedly constitute a crucial variable in this challenge, yet key data are currently missing to guide decision making on the basis of evidence. This issue urgently requires further targeted investigation.”

Explore further: IMS Health: Drug spending to jump 30 pct. to $1.3T in 2020

Related Stories

IMS Health: Drug spending to jump 30 pct. to $1.3T in 2020

November 18, 2015

As criticism of soaring prescription drug prices in the U.S. grows, global spending on medicines is expected to rise 3 percent to 6 percent annually for the next five years, according to a new forecast from IMS Health.

How we became the heaviest drinkers in a century

October 27, 2015

I first met alcohol in the late 1980s. It was the morning after one of my parents' parties. My sister and I, aged nine or ten, were up alone. We trawled the lounge for abandoned cans. I remember being methodical: pick one ...

Helping patients follow the script

October 20, 2015

Patients with chronic disease who risk serious illness by not taking their medication correctly are the target of a pilot study to educate community pharmacists.

Recommended for you


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.