Opioid Prescriptions Decline in Canada: New Study Reveals Trends

New research indicates a significant decline in opioid prescriptions across Canada. A study published in the Canadian Medical Association Journal reveals that from 2018 to 2022, there was an 8% decrease in the number of new opioid prescriptions initiated by physicians, nurse practitioners, and dentists. Access to legally prescribed opioids also fell by 11% during this period.

The research, conducted by experts from various Canadian health organizations, analyzed data from six provinces. It found notable differences in prescribing patterns; Manitoba consistently had the highest rates of opioid prescriptions, while British Columbia reported the lowest. The study noted that new prescriptions were disproportionately higher among women, older adults, and individuals residing in low-income or rural areas.

In 2022, the most commonly dispensed opioid was codeine, used primarily to treat coughs and mild pain. However, in Quebec and Saskatchewan, a greater quantity of hydromorphone was distributed. This shift highlights the changing landscape of pain management practices in the country.

The rise in opioid prescriptions from the early 2000s until around 2012 had been linked to increased rates of opioid-related harms, according to a 2019 Longwoods report. Although the study indicates that deaths are not directly caused by prescriptions, many individuals first encounter opioids through their healthcare providers.

Dr. Tara Gomes, a key researcher from the Ontario Drug Policy Research Network, emphasized the importance of understanding prescription trends across Canada. She stated that the country previously lacked a “coordinated way” to track these patterns. “We have learned from past mistakes of overprescribing,” Gomes noted, highlighting the need for safer pain management strategies.

The decline in opioid prescriptions is not solely a response to the ongoing opioid crisis but constitutes “one piece of the puzzle,” Gomes explained. She pointed out that while higher prescribing rates have historically increased dependency on opioids, most current fatalities are associated with illicit drug use rather than prescribed medications.

For patients already on opioid prescriptions, Gomes stressed the importance of avoiding abrupt dose reductions. Instead, healthcare providers should offer alternatives, such as non-medication-based supports and anti-inflammatory drugs. The findings also revealed that patients prescribed opioids are starting at lower and safer doses compared to previous years, reflecting a more cautious approach to pain management.

Dr. Alexander Caudarella, CEO of the Canadian Centre for Substance Use and Addiction, expressed concern about the challenges prescribers face when treating individuals with opioid dependency. While the study shows that efforts to reduce prescriptions are effective, he highlighted the need for adequate support systems. “If you just take the prescription away, you might increase the number of people who are using street drugs,” Caudarella warned.

The regional disparities in prescription rates underscore the need for tailored approaches to address the opioid crisis. Caudarella noted that some provinces and territories continue to experience rising death rates, indicating that a “one-size-fits-all” strategy may not be effective.

Dr. Feng Chang, an associate professor at the University of Waterloo’s pharmacy school, found the study’s results unsurprising, attributing them to national initiatives aimed at educating healthcare professionals on responsible prescribing practices. “It prompted a lot of clinicians to really become aware of this topic and look at how they prescribe,” Chang said, highlighting the impact of initiatives like the distribution of naloxone kits by pharmacists.

Gomes expressed hope that the decline in opioid prescriptions will stabilize over the next five to ten years. She emphasized that while reducing prescriptions is crucial, opioids still play a role in clinical practice for pain management when prescribed appropriately. “We don’t want that rate to go down to zero,” she stated, advocating for a balanced approach to opioid use in healthcare.