Evidence map›Paper›PMID 41145185›Full record

ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2025

Trends in prescription opioid use for pain in Canada: a population-based repeated cross-sectional study of 6 provinces.

Nevena Rebić, Bisola Hamzat, Grace Cheung, Dean T Eurich, Jean-Luc Kaboré, Louis de Léséleuc, Zhaoyu Liu, Houssem Missaoui, Jason R Randall, Dana Shearer and 3 more

Abstract read
In one paragraph

Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026
    Article
  3. Article
  4. Opioid prescribing in Canada: a continued retreat from God's own medicine.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Nevena RebićOntario Drug Policy Research Network (Rebić, Hamzat, Shearer, Yang, Gomes), MAP Centre for Urban Health Solutions, St. Michael's Hospital; Canadian Institute for Health Information (Cheung), Toronto, Ont.; Alberta Drug and Technology Evaluation Consortium (Eurich, Liu, Randall), University of Alberta, Edmonton, Alta.; Institut national d'excellence en santé et services sociaux (Kaboré, Missaoui), Québec, Que.; Pharmaceutical Reviews Program (de Léséleuc) and Post-Market Drug Evaluation Program (Stock), Canada's Drug Agency; ICES (Yang, Gomes), Toronto, Ont.
Bisola HamzatOntario Drug Policy Research Network (Rebić, Hamzat, Shearer, Yang, Gomes), MAP Centre for Urban Health Solutions, St. Michael's Hospital; Canadian Institute for Health Information (Cheung), Toronto, Ont.; Alberta Drug and Technology Evaluation Consortium (Eurich, Liu, Randall), University of Alberta, Edmonton, Alta.; Institut national d'excellence en santé et services sociaux (Kaboré, Missaoui), Québec, Que.; Pharmaceutical Reviews Program (de Léséleuc) and Post-Market Drug Evaluation Program (Stock), Canada's Drug Agency; ICES (Yang, Gomes), Toronto, Ont.
Grace CheungOntario Drug Policy Research Network (Rebić, Hamzat, Shearer, Yang, Gomes), MAP Centre for Urban Health Solutions, St. Michael's Hospital; Canadian Institute for Health Information (Cheung), Toronto, Ont.; Alberta Drug and Technology Evaluation Consortium (Eurich, Liu, Randall), University of Alberta, Edmonton, Alta.; Institut national d'excellence en santé et services sociaux (Kaboré, Missaoui), Québec, Que.; Pharmaceutical Reviews Program (de Léséleuc) and Post-Market Drug Evaluation Program (Stock), Canada's Drug Agency; ICES (Yang, Gomes), Toronto, Ont.
Dean T EurichOntario Drug Policy Research Network (Rebić, Hamzat, Shearer, Yang, Gomes), MAP Centre for Urban Health Solutions, St. Michael's Hospital; Canadian Institute for Health Information (Cheung), Toronto, Ont.; Alberta Drug and Technology Evaluation Consortium (Eurich, Liu, Randall), University of Alberta, Edmonton, Alta.; Institut national d'excellence en santé et services sociaux (Kaboré, Missaoui), Québec, Que.; Pharmaceutical Reviews Program (de Léséleuc) and Post-Market Drug Evaluation Program (Stock), Canada's Drug Agency; ICES (Yang, Gomes), Toronto, Ont.
Jean-Luc KaboréOntario Drug Policy Research Network (Rebić, Hamzat, Shearer, Yang, Gomes), MAP Centre for Urban Health Solutions, St. Michael's Hospital; Canadian Institute for Health Information (Cheung), Toronto, Ont.; Alberta Drug and Technology Evaluation Consortium (Eurich, Liu, Randall), University of Alberta, Edmonton, Alta.; Institut national d'excellence en santé et services sociaux (Kaboré, Missaoui), Québec, Que.; Pharmaceutical Reviews Program (de Léséleuc) and Post-Market Drug Evaluation Program (Stock), Canada's Drug Agency; ICES (Yang, Gomes), Toronto, Ont.
Louis de LéséleucOntario Drug Policy Research Network (Rebić, Hamzat, Shearer, Yang, Gomes), MAP Centre for Urban Health Solutions, St. Michael's Hospital; Canadian Institute for Health Information (Cheung), Toronto, Ont.; Alberta Drug and Technology Evaluation Consortium (Eurich, Liu, Randall), University of Alberta, Edmonton, Alta.; Institut national d'excellence en santé et services sociaux (Kaboré, Missaoui), Québec, Que.; Pharmaceutical Reviews Program (de Léséleuc) and Post-Market Drug Evaluation Program (Stock), Canada's Drug Agency; ICES (Yang, Gomes), Toronto, Ont.
Zhaoyu LiuOntario Drug Policy Research Network (Rebić, Hamzat, Shearer, Yang, Gomes), MAP Centre for Urban Health Solutions, St. Michael's Hospital; Canadian Institute for Health Information (Cheung), Toronto, Ont.; Alberta Drug and Technology Evaluation Consortium (Eurich, Liu, Randall), University of Alberta, Edmonton, Alta.; Institut national d'excellence en santé et services sociaux (Kaboré, Missaoui), Québec, Que.; Pharmaceutical Reviews Program (de Léséleuc) and Post-Market Drug Evaluation Program (Stock), Canada's Drug Agency; ICES (Yang, Gomes), Toronto, Ont.
Houssem MissaouiOntario Drug Policy Research Network (Rebić, Hamzat, Shearer, Yang, Gomes), MAP Centre for Urban Health Solutions, St. Michael's Hospital; Canadian Institute for Health Information (Cheung), Toronto, Ont.; Alberta Drug and Technology Evaluation Consortium (Eurich, Liu, Randall), University of Alberta, Edmonton, Alta.; Institut national d'excellence en santé et services sociaux (Kaboré, Missaoui), Québec, Que.; Pharmaceutical Reviews Program (de Léséleuc) and Post-Market Drug Evaluation Program (Stock), Canada's Drug Agency; ICES (Yang, Gomes), Toronto, Ont.
Jason R RandallOntario Drug Policy Research Network (Rebić, Hamzat, Shearer, Yang, Gomes), MAP Centre for Urban Health Solutions, St. Michael's Hospital; Canadian Institute for Health Information (Cheung), Toronto, Ont.; Alberta Drug and Technology Evaluation Consortium (Eurich, Liu, Randall), University of Alberta, Edmonton, Alta.; Institut national d'excellence en santé et services sociaux (Kaboré, Missaoui), Québec, Que.; Pharmaceutical Reviews Program (de Léséleuc) and Post-Market Drug Evaluation Program (Stock), Canada's Drug Agency; ICES (Yang, Gomes), Toronto, Ont.
Dana ShearerOntario Drug Policy Research Network (Rebić, Hamzat, Shearer, Yang, Gomes), MAP Centre for Urban Health Solutions, St. Michael's Hospital; Canadian Institute for Health Information (Cheung), Toronto, Ont.; Alberta Drug and Technology Evaluation Consortium (Eurich, Liu, Randall), University of Alberta, Edmonton, Alta.; Institut national d'excellence en santé et services sociaux (Kaboré, Missaoui), Québec, Que.; Pharmaceutical Reviews Program (de Léséleuc) and Post-Market Drug Evaluation Program (Stock), Canada's Drug Agency; ICES (Yang, Gomes), Toronto, Ont.
David StockOntario Drug Policy Research Network (Rebić, Hamzat, Shearer, Yang, Gomes), MAP Centre for Urban Health Solutions, St. Michael's Hospital; Canadian Institute for Health Information (Cheung), Toronto, Ont.; Alberta Drug and Technology Evaluation Consortium (Eurich, Liu, Randall), University of Alberta, Edmonton, Alta.; Institut national d'excellence en santé et services sociaux (Kaboré, Missaoui), Québec, Que.; Pharmaceutical Reviews Program (de Léséleuc) and Post-Market Drug Evaluation Program (Stock), Canada's Drug Agency; ICES (Yang, Gomes), Toronto, Ont.
Joanna YangOntario Drug Policy Research Network (Rebić, Hamzat, Shearer, Yang, Gomes), MAP Centre for Urban Health Solutions, St. Michael's Hospital; Canadian Institute for Health Information (Cheung), Toronto, Ont.; Alberta Drug and Technology Evaluation Consortium (Eurich, Liu, Randall), University of Alberta, Edmonton, Alta.; Institut national d'excellence en santé et services sociaux (Kaboré, Missaoui), Québec, Que.; Pharmaceutical Reviews Program (de Léséleuc) and Post-Market Drug Evaluation Program (Stock), Canada's Drug Agency; ICES (Yang, Gomes), Toronto, Ont.
Tara GomesOntario Drug Policy Research Network (Rebić, Hamzat, Shearer, Yang, Gomes), MAP Centre for Urban Health Solutions, St. Michael's Hospital; Canadian Institute for Health Information (Cheung), Toronto, Ont.; Alberta Drug and Technology Evaluation Consortium (Eurich, Liu, Randall), University of Alberta, Edmonton, Alta.; Institut national d'excellence en santé et services sociaux (Kaboré, Missaoui), Québec, Que.; Pharmaceutical Reviews Program (de Léséleuc) and Post-Market Drug Evaluation Program (Stock), Canada's Drug Agency; ICES (Yang, Gomes), Toronto, Ont. Tara.Gomes@unityhealth.to.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNational information on prescription opioid use in Canada is lacking. We sought to examine trends in the incidence and prevalence of prescription opioid dispensing for pain in Canada.

methodsWe conducted a population-based repeated cross-sectional analysis of pharmacy dispensing data from 6 provinces, which captured data from around 80% of Canada's population, between Jan. 1, 2018, and Dec. 31, 2022. We reported monthly population-adjusted rates of new and prevalent recipients of prescription opioids by province and annual provincial population-adjusted rates overall and by age, sex, neighbourhood income quintile, and location of residence. We calculated the proportion of incident recipients receiving guideline-recommended initial opioid doses and prevalent recipients receiving specific opioids indicated for pain (i.e., codeine, hydromorphone, oxycodone, morphine, and fentanyl).

resultsBetween 2018 and 2022, the annual incidence and prevalence of prescription opioid dispensing declined by 7.9% and 11.1%, respectively, across all provinces, with monthly trends showing that Manitoba consistently had the highest, and British Columbia the lowest, rates of prevalent opioid use. In 2022, we found 1 818 680 incident and 2 770 268 prevalent recipients, with incidence ranging from 55.2 (Ontario) to 63.0 (Alberta) per 1000 population and prevalence ranging from 85.1 (Saskatchewan) to 96.3 (Alberta) per 1000 population. Annual rates were higher among females, older adults, and people living in lower-income neighbourhoods and rural regions of Canada. Initial daily doses greater than 50 mg morphine equivalents declined over time, with provincial and temporal differences in the types of opioids prescribed.

interpretationDeclines in initiation and overall dispensing of prescription opioids for pain between 2018 and 2022 aligned with national efforts to promote appropriate opioid prescribing for acute and chronic noncancer pain in Canada.

Indexed as

Analgesics, OpioidDrug PrescriptionsPainPractice Patterns, Physicians'AdolescentAdultAgedCanadaCross-Sectional StudiesFemaleHumansMaleMiddle AgedPrevalenceYoung AdultAnalgesics, Opioid

Identifiers

PMID41145185
PMCPMC12578457

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Registered trials

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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.