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Patterns and trends in long-term opioid use for non-cancer pain in British Columbia, 2005–2012

  • Quantitative Research
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Abstract

OBJECTIVES: We aimed to calculate trends in incidence and prevalence rates of long-term opioid use for non-cancer pain, as well as to describe the characteristics of long-term opioid users and their patterns of opioid use.

METHODS: We used population-based linked health care and socio-demographic administrative data for British Columbia (BC) between 2005 and 2012. We included individuals who had at least one episode of long-term opioid use during the study period and who were not cancer or palliative care patients.

RESULTS: Long-term users comprised only 10% of all individuals prescribed opioids for non-cancer pain, but accounted for 64% of all opioid prescriptions and 87% of all morphine equivalents dispensed in BC during this period. While the incidence rate did not significantly change, the prevalence rate increased by 27% for men and 22% for women. In 2012, there were 3.80 (3.72–3.88) new long-term opioid users per 1,000 men and 4.42 (4.34–1.51) new users per 1,000 women. At the same time, there were 18.3 (95% CI 18.1–18.5) existing long-term users per 1,000 men and 21.7 users (95% CI 21.5–21.9) per 1,000 women. Overall, 2.4% of BC residents were long-term users of prescription opioids in 2012. Most long-term users had one continuous episode of use spanning multiple years. Almost two thirds took opioids every other day or more frequently.

CONCLUSION: There is a growing population of long-term opioid users for non-cancer pain in BC, with higher incidence and prevalence rates observed among women than among men.

Résumé

OBJECTIFS: Nous avons cherché à calculer les tendances dans les taux d’incidence et de prévalence de l’usage à long terme d’opioïdes contre la douleur non cancéreuse, ainsi qu’à décrire les caractéristiques des consommateurs à long terme d’opioïdes et leurs types d’usage d’opioïdes.

MÉTHODE: Nous avons utilisé les données administratives sociodémographiques et de soins de santé liées à la population de la Colombie-Britannique (C.-B.) de 2005 à 2012. Nous avons inclus les personnes ayant eu au moins un épisode d’usage à long terme d’opioïdes durant la période de l’étude et qui n’étaient pas des patients cancéreux ni aux soins palliatifs.

RÉSULTATS: Les consommateurs à long terme ne représentaient que 10% des personnes à qui l’on avait prescrit des opioïdes contre la douleur non cancéreuse, mais ils avaient reçu 64% des prescriptions d’opioïdes et 87% de tous les équivalents de morphine distribués en C.-B. durant la période de l’étude. Le taux d’incidence n’a pas changé de manière significative, mais le taux de prévalence a augmenté de 27% chez les hommes et de 22% chez les femmes. En 2012, il y avait 3,80 (3,72–3,88) nouveaux consommateurs à long terme d’opioïdes pour 1 000 hommes et 4,42 (4,34–1,51) nouvelles consommatrices pour 1 000 femmes. Simultanément, il y avait 18,3 (IC de 95% 18,1–18,5) consommateurs à long terme existants pour 1 000 hommes et 21,7 consommatrices à long terme existantes (IC de 95% 21,5–21,9) pour 1 000 femmes. Dans l’ensemble, 2,4% des résidents de la C.-B. étaient des consommateurs à long terme d’opioïdes d’ordonnance en 2012. La plupart des consommateurs à long terme avaient eu un épisode continu de consommation sur plusieurs années. Près des deux tiers prenaient des opioïdes tous les deux jours ou plus souvent.

CONCLUSION: Il existe une population croissante de consommateurs à long terme d’opioïdes contre la douleur non cancéreuse en C.-B., et l’on observe des taux d’incidence et de prévalence plus élevés chez les femmes que chez les hommes.

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Authors and Affiliations

  1. School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada

    Kate Smolina PhD, Emilie J. Gladstone MPH & Steven G. Morgan PhD

  2. Department of Family Practice, University of British Columbia, Vancouver, BC, Canada

    Kimberly Rutherford MD

Authors
  1. Kate Smolina PhD
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  2. Emilie J. Gladstone MPH
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  3. Kimberly Rutherford MD
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  4. Steven G. Morgan PhD
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Correspondence to Steven G. Morgan PhD.

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Conflict of Interest: None to declare.

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Smolina, K., Gladstone, E.J., Rutherford, K. et al. Patterns and trends in long-term opioid use for non-cancer pain in British Columbia, 2005–2012. Can J Public Health 107, e404–e409 (2016). https://doi.org/10.17269/CJPH.107.5413

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  • DOI: https://doi.org/10.17269/CJPH.107.5413

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