Opioid Prescriptions Decline Across Canada: Study Reveals Trends

A new national study shows a significant decline in opioid prescriptions across Canada, a trend that may continue in the coming years. Research conducted by various Canadian health organizations indicates that new opioid prescriptions decreased by 8 percent from 2018 to 2022. Furthermore, general access to legally prescribed opioids fell by 11 percent during the same period.

The study analyzed shared data from six provinces, revealing notable variations in opioid prescribing rates. Manitoba had the highest prescribing rates, while British Columbia reported the lowest. It was found that new prescriptions were notably higher among women, older adults, and individuals living in low-income or rural communities. In 2022, codeine emerged as the most commonly dispensed opioid across most provinces, except in Quebec and Saskatchewan, where hydromorphone was more prevalent.

The rise in opioid prescriptions in the early 2000s contributed to an increase in opioid-related harms. A 2019 report from Longwoods highlighted the association between overprescribing and rising rates of addiction and overdose. Although the current decline in prescriptions is not directly attributed to the ongoing opioid crisis, it represents a crucial step towards addressing the issue. According to Dr. Tara Gomes, a researcher with the Ontario Drug Policy Research Network and co-author of the study published in the Canadian Medical Association Journal, there has been a lack of coordinated tracking of opioid prescription patterns across Canada.

Learning from Past Mistakes

Dr. Gomes emphasized that healthcare professionals have “learned” from the mistakes of overprescribing in the past. The intent of the study was to analyze prescription trends and identify effective methods for ensuring safe pain management. She noted, “I think the study reflects efforts that have been made to promote more careful and appropriate prescribing across the country and shows that those efforts have been working.”

The study also revealed that patients prescribed opioids are starting at lower and safer doses compared to previous years. Dr. Gomes remarked that this approach aims to provide adequate pain relief while minimizing the risk of dependency. She stressed the importance of shared decision-making between prescribers and patients, particularly in maintaining a balance between effective treatment and the risk of addiction.

Concerns about Dependency and Alternatives

Dr. Alexander Caudarella, CEO of the Canadian Centre for Substance Use and Addiction, expressed concerns about prescribers’ apprehensions in treating patients who are dependent on opioids. He highlighted that removing prescriptions without offering alternatives could inadvertently increase the number of individuals turning to illicit drugs. “If you just take the prescription away, you might be increasing the number of people who are using street drugs,” he cautioned.

The report’s findings also underscore the complex nature of the opioid crisis, which varies significantly across provinces. Dr. Caudarella pointed out that some regions are experiencing rising death rates despite the national decline in prescriptions. He emphasized the necessity for tailored approaches rather than a blanket strategy to address the crisis effectively.

Dr. Feng Chang, an associate professor at the University of Waterloo’s pharmacy school, noted that the study’s outcomes were not unexpected, given the national initiatives aimed at educating healthcare professionals on appropriate prescribing practices. Chang remarked on the increasing awareness among clinicians regarding opioid prescription and the distribution of naloxone kits, which have become crucial in addressing opioid overdoses.

Looking ahead, Dr. Gomes expressed her desire to see the decline in opioid prescriptions stabilize over the next five to ten years. She reiterated the importance of ensuring that opioids remain available for patients who require them, stating, “We don’t want that rate to go down to zero because opioids do have a place in clinical practice for helping to manage pain.”

As Canada continues to grapple with the complexities of opioid prescriptions, the findings from this study provide valuable insights into current trends and the ongoing efforts to promote safer prescribing practices.