Doctors writing more opioid prescriptions for fewer doses
New report also indicates physicians are prescribing fentanyl less often
A new report by the Canadian Institute for Health Information says the number of prescriptions filled for opioid medications has been rising in Canada.
CIHI found the overall number of prescriptions for opioids increased by 6.8 per cent between 2012 and 2016. During the same period, the number of defined daily doses decreased by 4.9 per cent.
Prescription opioids include codeine, oxycodone, morphine and fentanyl.
The rate of their use for treating pain has come under scrutiny as hospitalizations and deaths related to opioid overdoses have increased.
The report noted opioids are most effective for treating moderate and acute pain, such as postoperative pain, and pain related to cancer.
The report also found that 69,587 people in Manitoba, Saskatchewan and British Columbia were prescribed a strong opioid chronically in 2015-16.
People over the age of 65 are prescribed strong opioids most often. One in eight was prescribed a strong opioid on a chronic basis, CIHI found.
A report released in September by the Public Health Agency of Canada counted more than 2,800 apparent opioid-related deaths in 2016; in the first quarter of 2017, at least 602 Canadians died from accidental opioid overdoses.
Between 2012 and 2016, the number of defined daily doses of opioids dispensed in Canada fell from 238 million to 226 million. Adjusted for population growth, the increase in prescriptions dispensed is slightly more than two per cent.
“The good news is that the overall quantity of opioids dispensed in Canada is declining, but the fact that such a large number of people are still being prescribed opioids continues to be a concern,” Michael Gaucher, director of Pharmaceuticals and Health Workforce Information Services at CIHI, said in a statement.
More of the opioids prescribed are deemed “strong” opioids. Hydromorphone, morphine, fentanyl, oxycodone, codeine and tramadol account for 96 per cent of the opioids prescribed, and four of those are usually prescribed for moderate or severe pain, according to CIHI.
At the same time, doctors are prescribing fentanyl less and less often — prescriptions for it fell by nearly seven per cent. Gaucher’s statement said this shows that the fentanyl being abused as a street drug is “more likely coming from illicit sources rather than from prescriptions.”
According to Saskatchewan’s Ministry of Health, in 2016 the total number of prescription dispenses accepted and processed by the Saskatchewan Drug Plan was 327,008. That number does not include prescriptions dispensed in hospital, through special programs or for non-eligible patients whose prescriptions are paid for by other agencies.
Earlier this year, CIHI released a report about the harm the effects of the opioid crisis on the health system. It found an average of 16 hospitalizations per day for opioid poisonings in Canada in 2016-17. The same report found that the rate of hospitalizations for opioid poisonings has increased over the past 10 years.