Nearly a quarter of Ontario opioid prescriptions exceeded guidelines: Study
TORONTO — Nearly a quarter of first-time opioid prescriptions in Ontario from April 2015 to March 2016 exceeded recommended dose limits introduced in 2017.
Researchers say 23.9 per cent of initial opioid prescriptions in Ontario during that time had a daily dose of more than 50 milligram morphine equivalents.
That’s more than the threshold set last year for North American physicians treating chronic non-cancer pain with opioids like oxycodone, hydromorphone and the fentanyl patch.
The year-old guidelines suggest opioids be restricted to less than the equivalent of 90 milligrams of morphine per day, and ideally to less than 50 mg. They replaced previous guidelines released in 2010 that suggested doctors could use a “watchful dose” of the equivalent of 200 mg of morphine daily.
Researchers at the Institute for Clinical Evaluative Sciences and St. Michael’s Hospital examined initial opioid prescriptions for more than 650,000 Ontarians. Their work was published Wednesday in the journal Pain.
Lead author Tara Gomes says the findings highlight the need to consider alternative pain management options for some patients, such as physiotherapy and cognitive behavioural therapy.
Dental pain accounted for nearly one in four new opioid prescriptions, but the study found these were “generally of short duration and low dose.”
Meanwhile, one in six were for postsurgical pain, and more than 40 per cent of those patients were prescribed more than the equivalent of 50 mg of morphine daily. At least 25 per cent of prescriptions for hip and knee surgery were the equivalent of 90 mg of morphine daily, or more.
Gomes says Ontarians taking an opioid for the first time for knee, hip and shoulder surgeries and for Caesarean sections received among the highest doses.
“Across all clinical indications, a high percentage of people received daily doses of more than 50MME and prescription lengths exceeding seven days, a combination which has been associated with opioid-related adverse events and long-term opioid use,” Gomes said Wednesday in a release.
“Given this, we need to think about alternative pain management options. This data can help us understand the types of services — like physiotherapy and cognitive behavioural therapy — that might be appropriate to help avoid our reliance on opioids for some indications.”
Researchers identified six main reasons for taking opioids: the most frequent reason was dental pain at 23.2 per cent of prescriptions, followed by postsurgical pain at 17.4 per cent, musculoskeletal pain at 12.0 per cent, trauma-related pain at 11.2 per cent, cancer or palliative care at 6.5 per cent, and other types of pain at 17.7 per cent.
Overall, 12 per cent — or 78,481 individuals — could not be linked to any of the six groups.
Gomes says one in eight Ontarians was dispensed an opioid in 2016 and that Ontario has seen a four-fold increase in overdose deaths in the last 25 years.
#canadiannews #worldnews #headlinenews and stories from around the world
USA Today News Headlines
- Texas school shooting: Gunman targeted my daughter because she rejected him, grieving mom says
- Mother of Texas school shooting survivor says gunman killed students as they hid in closet
- This new smartphone feature should be used by every driver, from teen to seasoned commuter
- Harry and Meghan's wedding reception: See her new dress, and that Jaguar
- Did (possibly pregnant) Pippa Middleton steal the show at another royal wedding?
- 'Saturday Night Live' imagines Bishop Michael Curry's response to the royal wedding
- Russia investigations could affect midterm congressional elections, experts say
- Mountain lion kills one man, injures another east of Seattle
- Texas shooting suspect won’t face death penalty, could be paroled
- Tina Fey's 'Saturday Night Live' monologue was crashed with star-studded cameos
- LeBron James carves up Celtics in Game 3 with passes 'only one person' would even try
- Fantasy baseball waiver wire: Nationals surprisingly promote phenom Juan Soto
- Pope Francis to create 14 new cardinals in June
- Tampa Bay Rays' Sergio Romo gets first career start, makes history against Angels
- Scenes from Meghan Markle and Prince Harry's royal wedding
- Why rising gas prices won't last, even after Trump ends Iran nuclear deal
- Justify's Preakness win raises more questions heading into Belmont
- Democrats ramp up efforts to turn more red seats blue in the South in the wake of recent successes
- Still friends! Prince Harry's ex-girlfriends Chelsy Davy, Cressida Bonas attend wedding
- Bishop Michael Curry quotes MLK, Jr. at royal wedding
USA News Headlines
- 'All that was going through my head was get out'
- Texas official blames shooting on too many exits and entrances
- These are the victims of the shooting
- Suspect tells investigator he spared people he liked
- Student who was shot in head speaks out
- Opinion: Something was different about this
- Trump really wants the (North Korean) show to go on
- Mueller has a lot of options besides indicting Trump. Here they are
- Air Force apologizes for 'Yanny' or 'Laurel' tweet
- Cuomo presses Giuliani on informants claim
- Trump administration to bar abortions at facilities receiving federal family funds
- Richard Branson considers this one of his biggest mistakes
- 'China's SpaceX' launches first private rocket
- The drones that fly 24/7, no humans needed
- Help me! Raccoon rescued from storm drain
- Teen fighting for the rights of gun owners
- Woman trapped by mud has died
- Teacher finds 6-year-old chewing on bag of cocaine
- Man lives his last days on Mississippi River
- Hardware employees save woman's life
ABC NEWS Headlines
- Santa Fe shooting victim's mother says daughter turned down suspect's advances
- Cougar kills mountain biker, injures fellow rider
- Increasing lava flow prompts new evacuations, first injury since eruption
- Wife of man charged in blast probe died in 'mysterious case'
- Over 2 dozen people rushed to hospital after bad reaction to synthetic weed
- Community mourns the 10 victims killed as authorities probe motive behind massacre
- Stormy weather moves into Midwest as East dries out
- Teacher's aide among 10 victims killed in Texas high school shooting
- The Latest: Wounded student attends school baseball game
- WATCH: Texas Lt. Gov. Dan Patrick on Santa Fe High School mass shooting
- WATCH: Parents who lost children in school shootings respond to tragedy in Texas
- WATCH: 1 person killed, 1 injured in mountain lion attack in Washington state
- WATCH: New details emerge on how the Texas school shooting was carried out
- WATCH: Workers left dangling after scaffold collapse in Atlanta
- WATCH: The moments from the Royal wedding
- WATCH: Explosion rocking a chemical plant near Houston
- WATCH: Alleged Santa Fe HS shooter charged with capital murder
- WATCH: New eruption from the summit of Kilauea puts dozens more homes in danger
- WATCH: Students wipe away tears as they return to Santa Fe High School
- WATCH: What we know about the Sante Fe High School alleged shooter
24-year-old suspect in custody after shooting in Brockville apartment
Brockville Police say a 24-year-old man is facing several gun-related charges after a shooting atRead More
U.S. criticizes China’s militarization of disputed waters
BEIJING — The Pentagon criticized what it called China’s “continued militarization” of island outposts inRead More