In 2017, the ODPRN was funded by the Canadian Institutes for Health Research (CIHR) to establish an Ontario Opioid Drug Observatory with the goal of bringing together knowledge users, researchers and data to inform and evaluate opioid policy across Ontario. As the opioid crisis has worsened, this need for evidence has grown and evolved. Through the innovative work of the OODO, we have supported the linkage of all opioid prescriptions, opioid-related deaths, and pharmacy-dispensed naloxone to other health administrative databases across the province; the largest, most complete linked repository of data related to opioid use and related harms in Canada.
The ODPRN has conducted important research in this area since 2008 which has helped inform policy in the area [learn more about past opioid research here]. Most research conducted in this area in Ontario has been limited to studying government-reimbursed prescriptions. However, because most Canadians do not receive publicly-funded drug coverage, we have had large gaps in our understanding of opioid prescribing and its consequences.
Through linkage of a broad repository of health care data, the work of the OODO has three broad objectives:
- Patterns of Use and Harm: To conduct ongoing analysis of trends in prescription opioid use and opioid-related harm (overdoses, infections, brain injuries) in Ontario and evaluate the impact of new drug policies and the COVID-19 pandemic on these measures.
- Access to Treatment and Harm Reduction Strategies: To evaluate the safety, effectiveness, and barriers to accessing different forms of treatment for opioid use disorder (OUD) and harm reduction strategies (naloxone, safer opioid supply) across the province.
- Pathways through Care: To assess how rapid access to treatment and primary care impact future patterns of healthcare use and patient outcomes among people hospitalized for serious opioid-related outcomes.
The use of high-dose opioids for chronic pain has raised concerns around opioid-related harms, including accidental overdose and death.
Guidelines in the U.S and Canada, released in March 2016 and May 2017 respectively, now suggest that for the treatment of chronic non-cancer pain, clinicians should generally avoid prescribing doses above 90 milligrams of morphine or equivalent (MME) per day. For patients already receiving higher doses, guidelines also encourage gradual tapering of doses to the lowest effective dose.
This study looks at the impact of the introduction of new clinical opioid guidelines and opioid policies on the prevalence of potential rapid opioid dose tapering over time in Ontario, Canada.
Access the full article and associated resources:
The Ontario Prescription Opioid Tool allows public access to data related to indicators for opioid prescribing in the province from 2012 onwards. It uses data from the Narcotics Monitoring System (NMS), which captures all opioid prescriptions dispensed in retail pharmacies across Ontario.
This tool was made to complement Public Health Ontario’s interactive tool on opioid-related harms and will be updated on an approximately quarterly basis.
If you are interested in this work and would like to receive updates, please fill out this form.