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.
Key words: Opioid analgesics, chronic pain, incidence, prevalence, inappropriate prescribing
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.
Mots clés: opioïdes analgésiques, douleur chronique, incidence, prévalence, prescriptions inappropriées
Footnotes
Conflict of Interest: None to declare.
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