title: Trends and changes in prescription opioid analgesic dispensing in Canada 2005-2012: an update with a focus on recent interventions.
abstract: BACKGROUND
  Prescription opioid analgesic (POA) utilization has steeply increased globally, yet is far higher in established market economies than elsewhere. Canada features the world's second-highest POA consumption rates. Following increases in POA-related harm, several POA control interventions have been implemented since 2010.
  
  
  METHODS
  We examined trends and patterns in POA dispensing in Canada by province for 2005-2012, including a focus on the potential effects of interventions. Data on annual dispensing of individual POA formulations--categorized into 'weak opioids' and 'strong opioids'--from a representative sub-sample of 5,700 retail pharmacies across Canada (from IMS Brogan's Compuscript) were converted into Defined Daily Doses (DDD), and examined intra- and inter-provincially as well as for Canada (total).
  
  
  RESULTS
  Total POA dispensing--driven by strong opioids--increased across Canada until 2011; four provinces indicated decreases in strong opioid dispensing; seven provinces indicated decreases specifically in oxycodone dispensing, 2011-2012. The dispensing ratio weak/strong opioids decreased substantively. Major inter-provincial differences in POA dispensing levels and qualitative patterns of POA formulations dispensed persisted. Previous increasing trends in POA dispensing were reversed in select provinces 2011-2012, coinciding with POA-related interventions.
  
  
  CONCLUSIONS
  Further examinations regarding the sustained nature, drivers and consequences of the recent trend changes in POA dispensing--including possible 'substitution effects' for oxycodone reductions--are needed.
authors.affiliation: Centre for Applied Research in Mental Health and Addiction (CARMHA), Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada. bfischer@sfu.ca.
authors.forename: Benedikt
authors.initials: B
authors.lastname: Fischer
authors.forename: Wayne
authors.initials: W
authors.lastname: Jones
authors.forename: Jürgen
authors.initials: J
authors.lastname: Rehm
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D002170:Canada / Q000453:epidemiology; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D006801:Humans; D009293:Opioid-Related Disorders / Q000517:prevention & control; D010098:Oxycodone / Q000627:therapeutic use; D010594:Pharmacies / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data* / Q000639:trends
chemical_list: D000701:Analgesics, Opioid; D010098:Oxycodone