Premium
Use of other opioids during methadone therapy: a population‐based study
Author(s) -
Kurdyak Paul,
Gomes Tara,
Yao Zhan,
Mamdani Muhammad M.,
Hellings Chelsea,
Fischer Benedikt,
Rehm Jürgen,
Bayoumi Ahmed M.,
Juurlink David N.
Publication year - 2012
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/j.1360-0443.2011.03707.x
Subject(s) - methadone , medicine , medical prescription , oxycodone , interquartile range , opioid , pharmacy , codeine , methadone maintenance , retrospective cohort study , population , emergency medicine , cohort study , anesthesia , family medicine , morphine , pharmacology , environmental health , receptor
Aims To determine the extent to which other opioids are prescribed to patients receiving methadone in Ontario, Canada. Design Retrospective cohort study. Setting Ontario, Canada from 1 April 2003 to 31 March 2010. Participants We studied patients aged 15–64 years with publically funded drug coverage who received at least 30 days of continuous methadone maintenance therapy (MMT). Measurements The proportion of patients who received more than 7 days of a non‐methadone opioid during MMT. A secondary analysis examined the extent to which non‐methadone opioids were prescribed by physicians or dispensed by pharmacies not involved in a patient's MMT. Findings Among 18 759 patients treated with methadone, 3456 (18.4%) received at least one prescription for non‐methadone opioids of more than 7 days' duration. In this group, the median number of non‐methadone opioid prescriptions dispensed per year was 11.9 (interquartile range 4.1–25.0). The most frequently prescribed opioids were codeine and oxycodone. Of the 73 520 non‐methadone opioid prescriptions of more than 7 days' duration, nearly half (45.8%) originated from non‐MMT prescribers and pharmacies. Conclusions Many patients receiving methadone maintenance therapy in Ontario receive overlapping prescriptions for other opioids, often for extended periods. The associated prescribing patterns suggest that many such prescriptions may be duplicitous. The prescribing and dispensing of non‐methadone opioids to patients receiving methadone maintenance therapy is likely to be observed in jurisdictions outside Ontario, Canada.