Changing patterns of opioid initiation for pain management in Ontario, Canada

A population-based cross-sectional study

In response to the evolving evidence about the safety of prescription opioids, national guidelines and quality standards were developed and released in 2017 to support safe and appropriate opioid use. An important recommendation from these documents was that people starting opioids to manage pain should not be given an initial opioid dose higher than 50 milligrams of morphine equivalents (MME) per day because higher doses are associated with increased risks of continued opioid use, opioid use disorder and opioid overdose.

This study sought to characterize how well opioid initiation practices aligned with opioid prescribing recommendations before and following the release of a national guideline.

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