ArticleOpen medicine : a peer-reviewed, independent, open-access journal2011
Trends in opioid use and dosing among socio-economically disadvantaged patients.
Article in Open medicine : a peer-reviewed, independent, open-access journal, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
77 citing papers in PubMed, 2 syntheses or guidelines pooled it, 157 citations in OpenAlex.
- Determinants of increased opioid-related mortality in the United States and Canada, 1990-2013: a systematic review.American journal of public health · 2014Pooled it
- Canadian guideline for safe and effective use of opioids for chronic noncancer pain: clinical summary for family physicians. Part 1: general population.Canadian family physician Medecin de famille canadien · 2011Guideline
- Trial
- A Randomized Controlled Trial Evaluating the Effects of Diosmin in the Treatment of Radicular Pain.BioMed research international · 2017Trial
- Pharmacological and toxicological profile of opioid-treated, chronic low back pain patients entering a mindfulness intervention randomized controlled trial.Journal of opioid managementTrial
- Article
- Income-Based Disparities in Opioid Prescription Dispensing Among Public Drug Plan Beneficiaries in Canada from 2010 to 2018: A Population-Based and Sex-Stratified Retrospective Study.Drugs - real world outcomes · 2025Article
- Impact of opioid-related disorders on complications in patients undergoing bariatric surgery: a propensity score-matched analysis of the national inpatient sample.Surgical endoscopy · 2024Article
- Healthcare provider knowledge, beliefs, and attitudes regarding opioids for chronic non-cancer pain in North America prior to the emergence of COVID-19: A systematic review of qualitative research.Canadian journal of pain = Revue canadienne de la douleur · 2023Review
- Shifts in substance use patterns among a cohort of people who use opioids after delisting of OxyContin in BC, Canada: An interrupted time series study.The International journal on drug policy · 2022Article
- Stepping up to the Canadian opioid crisis: a longitudinal analysis of the correlation between socioeconomic status and population rates of opioid-related mortality, hospitalization and emergency department visits (2000-2017).Health promotion and chronic disease prevention in Canada : research, policy and practice · 2022Article
- Does Socioeconomic Status or Methamphetamine Use Affect Discharge Opioid Requirements in Burn-Injured Patients?Journal of burn care & research : official publication of the American Burn Association · 2022Article
- Less Well-Known Consequences of the Long-Term Use of Opioid Analgesics: A Comprehensive Literature Review.Drug design, development and therapy · 2022Review
- The relationship between patients' income and education and their access to pharmacological chronic pain management: A scoping review.Canadian journal of pain = Revue canadienne de la douleur · 2022Article
- Inches, Centimeters, and Yards: Overlooked Definition Choices Inhibit Interpretation of Morphine Equivalence.The Clinical journal of pain · 2021Article
- Comparison of Crude Population-Level Indicators of Opioid Use and Related Harm in New Zealand and Ontario (Canada).Pain and therapy · 2021Article
- Opioids and Chronic Pain: An Analytic Review of the Clinical Evidence.Frontiers in pain research (Lausanne, Switzerland) · 2021Review
- Palliative Care for People Living With Heart Disease-Does Sex Make a Difference?Frontiers in cardiovascular medicine · 2021Review
- Trends in risky prescriptions of opioid analgesics from 2011 to 2015 in Northern Germany.Journal of psychopharmacology (Oxford, England) · 2020Article
- All-cause mortality among males living with and without HIV initiating long-term opioid therapy, and its association with opioid dose, opioid interruption and other factors.Drug and alcohol dependence · 2020Observational
17 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOpioid therapy for patients with chronic nonmalignant pain remains controversial, primarily because of safety concerns and the potential for abuse. The objective of this study was to examine trends in opioid utilization for nonmalignant pain among recipients of social assistance and to explore the relation between dose of analgesic and mortality.
methodsUsing a cross-sectional study design, we characterized annual trends in prescriptions for and daily dose of opioid analgesics between 2003 and 2008 for beneficiaries (aged 15 to 64 years) of Ontario's public drug plan. We defined moderate, high and very high dose thresholds as daily doses of up to 200, 201 to 400, and more than 400 mg oral morphine (or equivalent), respectively. In an exploratory cohort study, we followed, over a 2-year period, patients who received at least one prescription for an opioid in 2004 to investigate the relation between opioid dose and opioid-related mortality.
resultsOver the study period, opioid prescribing rates rose by 16.2%, and 180 974 individuals received nearly 1.5 million opioid prescriptions in 2008. Also by 2008, the daily dose dispensed exceeded 200 mg morphine equivalent for almost a third (32.6%) of recipients of long-acting oxycodone but only 20.3% of those treated with fentanyl or other long-acting opioids. Among patients for whom high or very high doses of opioids were dispensed in 2004, 19.3% of deaths during the subsequent 2 years were opioid-related, occurring at a median age of 46 years. Two-year opioid-related mortality rates were 1.63 per 1000 population (95% confidence interval [CI] 1.42-1.85) among people with moderate-dose prescriptions, 7.92 per 1000 population (95% CI 5.25-11.49) among those with high-dose prescriptions, and 9.94 per 1000 population (95% CI 2.78-25.12) among those with very-high-dose prescriptions.
interpretationAmong socio-economically disadvantaged patients in Ontario, the use and dose of opioids for nonmalignant pain has increased substantially, driven primarily by the use of long-acting oxycodone and, to a lesser extent, fentanyl. The findings of our exploratory study suggested a strong association between opioid-related mortality and the dose of opioid dispensed.
Indexed as
Identifiers
22046214PMC3205807W2144143810What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.