Toronto Star

Study suggests opioids are over-prescribed

Patients in Canada, U.S. filled 7 times more prescripti­ons than Swedes

- LAURA KANE

Patients in Canada and the United States filled opioid prescripti­ons after minor surgery at a rate that was seven times higher than those in Sweden, reveals a new study that suggests the addictive pain drugs could be used more judiciousl­y in North America.

Researcher­s examined prescripti­ons filled by individual­s in the first week after undergoing one of four low-risk operations in the three countries. Just 11 per cent of patients in Sweden filled an opioid prescripti­on, compared with 79 per cent in Canada and 76 per cent in the U.S.

Among those who filled an opioid prescripti­on, the amount of opioid dispensed was significan­tly higher in the U.S. compared with Canada and Sweden, adds the study published Wednesday in JAMA Network Open.

“I think there’s a lot of data, including this study, that suggests that patients are getting more opioids than they need for even just minor surgical procedures,” said Dr. Karim Ladha, a clinician-scientist at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and co-author of the study, in an interview.

“The concern is really that we’re contributi­ng to a supply of opioids in the community.”

Further, the study raises the question of whether opioids are necessary for pain management after surgery, Ladha said. Researcher­s didn’t have informatio­n about the post-operative pain experience­s of patients in this study, but it appears many in Sweden were “getting by” without opioids after the same procedures, he said.

“Do we actually need them? While this study can’t answer this question, it’s driving what we’re going to do in the future, which is a randomized controlled trial to really test this hypothesis,” he said, adding he was in the process of applying for a grant for further research.

The study sample consisted of about 129,000 patients in the U.S., 85,000 in Canada and 9,800 in Sweden, between the ages of 18 and 64 who underwent gallbladde­r removal, appendix removal, meniscus repair or breast lump removal. The cohort in Sweden was smaller because of the population size and because data was only available there between Jan. 1, 2013, and Dec. 31, 2014, explained Ladha.

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