Opioid prescriptions in Ontario have jumped by 5% since 2013, study finds

The number of opioid prescriptions filled in Ontario has jumped by five per cent in two years up to 9.2 million prescriptions in 2015-2016, according to data released by the province's health advisory arm Wednesday.

Health Quality Ontario's report raises questions not only about the increasing reliance on opioids in pain management, but also noted that certain areas of the province seem to prescribe opioids more frequently.

"The variation by ... region presented in this report appears to demonstrate variable prescribing practices throughout the province," it found.

The report pulled the number of prescriptions for opioids including morphine, codeine, fentanyl patches, oxycodone and hydromorphone from the province's Narcotics Monitoring System, a database that tracks opiates dispensed at Ontario pharmacies.

It did not, however, take into account opioids prescribed in hospitals or prisons.

The report comes just a week after theCanadian Medical Association Journal published new guidelines foropioidprescription, an attempt, its authors said, to try to deal with theopioidcrisis across the country.

Those guidelines are recommendations and not regulatory requirements.

Overdose deaths

Health Quality Ontario's study began inthe 2013-2014 fiscal year.

In 2015, at least 551 people died from opioid overdose in Ontario, an increase fromfrom 421 in 2010.

It's unclear how many of those overdoses came as a result of illegal drug use orthe recreational use ofprescription drugs.

Alternative therapies

But Health Quality Ontario suggested physicians can look at alternative treatmentsfor chronic pain, unless it's terminal cancer, whichcould include a combination of physiotherapy or other medication.

"The effectiveness of opioids for chronic pain beyond 12 weeks has not been reliably established through randomized controlled trials," the report said.

Only about 24 per cent of people who filled an opioid prescription during the first three months of 2016received a supply of medication for a period of two weeks or less, according to the report's findings.

In general, the higher the dose, the more likely it is that a patient is being harmed more than helped.- Dr. David Juurlink, drug safety researcher

The research raises questions about the costs and benefits of opioiduse to patients, a drug safety researcher says.

In the report, Dr. David Juurlink noted that the side-effects of opioids including constipation, the possibility of dependenceand disorientation should prompt physicians to prescribe them in small doses.

"In general, the higher the dose, the more likely it is that a patient is being harmed more than helped by therapy," he said in the report. "This is a good reason to consider a gradual taper to lower doses."

Provincial response

Ontario Health Minister Eric Hoskinssaid in a statement on Wednesday that the report's findings would be "helpful to our government as we continue to strengthen our response to the opioid crisis."

Hoskins also outlinedsteps already being taken by his government, including reaching out to doctors, nurses and regulatory colleges for health professions that dispense opioids,to ensure they are familiar with the updatedCanadian Guideline for Opioids for Chronic Non-Cancer Pain.

• 'People are dying out there': New guidelines for prescribing opioids encourage doctors to put down the pad

Hoskinsalso said he plans to meet with a group Ontario mayors on June 12 as part of a larger consultation process to address the opioid crisis.