Prescribing of opioid analgesics and related mortality before and after the introduction of long-acting oxycodone

Dhalla, Irfan A.; Mamdani, Muhammad; Sivilotti, Marco L.A.; Kopp, Alex; Qureshi, Omar; Juurlink, David N.

doi:10.1503/cmaj.090784

Cited by 347 publications

(308 citation statements)

References 38 publications

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“…2 The rates of addiction, overdose, and death attributed to opioids doubled from 13.7 per million in 1991 to 27.2 per million in 2004. 3 Unfortunately, non-medical prescription opioid use accounts for 40% of these overdoses. 2 Opioids are an accepted important therapy in the management of post-surgical pain.…”

Section: Résumémentioning

confidence: 99%

Opioid information pamphlet increases postoperative opioid disposal rates: a before versus after quality improvement study

Rose

Sakai

Argue

et al. 2015

Can J Anesth/J Can Anesth

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Purpose Half of postoperative patients are prescribed an opioid, but a majority do not store or dispose of them properly thus risking diversion. We examined the efficacy of an opioid educational pamphlet addressing opioid weaning, storage, and disposal. We hypothesized that the pamphlet would increase the rate of proper opioid disposal, storage, and weaning. Methods This prospective before and after study was conducted at UBC Hospital in primary total hip or knee arthroplasty patients. Adults with American Society of Anesthesiologists physical class I-III, with no addiction history and consuming B 30 mg of morphine equivalents daily were enrolled in the study. Two groups received similar standard management, except the intervention group additionally received the opioid education pamphlet. Patients were contacted four weeks postoperatively to complete a survey. The primary endpoint was to evaluate proper opioid disposal rates. Secondary endpoints were to evaluate opioid storage and weaning rates. Results Two hundred twenty-six patients were enrolled and 172 (76%) completed the survey. Among patients who had discontinued opioids, rates of proper disposal increased from 2/42 (5%) to 12/45 (27%) in those receiving the pamphlet (difference in proportions, 22%; 95% confidence interval (CI), 5 to 38; P = 0.005). Secure opioid storage did not improve in those receiving the opioid pamphlet [before, 18/86 (21%) vs after, 20/86 (23%); difference in proportions, 3%; 95% CI, -11 to 15; P = 0.713]. The proportion of patients weaned from opioids was unchanged by the pamphlet [before, 42/86 (49%) vs after, 45/86 (52%); P = 0.735]. Conclusion The introduction of an education pamphlet significantly improved self-reported proper opioid disposal rates in postoperative patients. RésuméObjectif Un opioïde est prescrit en postopératoire à près de la moitié des patients, mais la majorité d'entre eux ne les conserve pas ni ne les élimine de façon appropriée, ce qui expose au risque de détournement des médicaments. Nous avons examiné l'efficacité d'un dépliant éducatif sur les opioïdes, leur sevrage, conservation et élimination. Nous avons émis l'hypothèse que le dépliant augmenterait les taux de pratique adéquate d'élimination, conservation et sevrage aux opioïdes. Méthodes Cette étude prospective avant et après a été menée à l'hô pital UBC avec des patients ayant subi une arthroplastie de première intention de hanche ou de genou.

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Section: Résumémentioning

confidence: 99%

Opioid information pamphlet increases postoperative opioid disposal rates: a before versus after quality improvement study

Rose

Sakai

Argue

et al. 2015

Can J Anesth/J Can Anesth

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“…However, the rate of opioid prescribing and the number of deaths related to opioids have increased dramatically over the last two decades in Ontario, highlighting safety concerns around these commonly prescribed analgesics. 1,2 Furthermore, the impact of this problem is even more pronounced among younger adults, with premature deaths related to opioids resulting in an extraordinary burden of potential years of life lost. In 2010, nearly one out of every eight deaths among individuals aged 25 to 34 years involved an opioid, demonstrating the public health importance of opioid use.…”

Section: Introductionmentioning

confidence: 99%

Latest trends in opioid-related deaths in Ontario

Gomes¹,

Greaves²,

Martins³

et al. 2017

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“…Twitter participants described observing not only an increased use of opioids over time but also the prescribing of more potent opioids ( Figure 5). 10 Mazer-Amirshahi described similar findings from her recent research on opioid-prescribing trends in adult and pediatric EDs. 8,9 Her studies noted an increase in both the number of opioid prescriptions and the potency of use of opioids in the ED.…”

Section: Summary Of the Online Discussionmentioning

confidence: 56%

The Prescription Opioid Epidemic: Social Media Responses to the Residents’ Perspective Article

Choo

Mazer‐Amirshahi

Juurlink

et al. 2016

Annals of Emergency Medicine

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Prescribing of opioid analgesics and related mortality before and after the introduction of long-acting oxycodone

Cited by 347 publications

References 38 publications

Opioid information pamphlet increases postoperative opioid disposal rates: a before versus after quality improvement study

Opioid information pamphlet increases postoperative opioid disposal rates: a before versus after quality improvement study

Latest trends in opioid-related deaths in Ontario

The Prescription Opioid Epidemic: Social Media Responses to the Residents’ Perspective Article

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