Indicators of publicly funded prescription opioid use among persons with traumatic spinal cord injury in Ontario, Canada

The Journal of Spinal Cord Medicine, 2023 · DOI: 10.1080/10790268.2021.1969503 · Published: January 1, 2023

Spinal Cord Injury Pain Management Public Health

Simple Explanation

This study examines opioid use among individuals with traumatic spinal cord injuries (TSCI) in Ontario, Canada, who are eligible for the provincial drug plan. It aims to understand how many of these individuals use prescription opioids in the year following their injury. The research uses administrative data to identify factors that predict opioid use in this population. It looks at things like age, sex, pre-existing health conditions, and length of hospital stay to see how they relate to opioid prescriptions. The findings highlight that a significant proportion of individuals with TSCI are prescribed opioids after their injury. The study identifies specific factors that increase the likelihood of opioid use, such as being male, having COPD, and prior opioid use.

Study Duration

April 2004 to March 2015

Participants

934 individuals with traumatic spinal cord injury eligible for the provincial drug program

Evidence Level

Not specified

Key Findings

1
Over half (55%) of individuals with TSCI who are eligible for Ontario's public drug program used opioids in the year following their injury.
2
Being male, having chronic obstructive pulmonary disease (COPD), and having used prescription opioids before the injury were significantly associated with receiving opioids after TSCI.
3
Shorter hospital stays after the initial injury were also identified as a significant risk factor for outpatient opioid use.

Research Summary

This study investigated the prevalence and predictors of publicly funded prescription opioid use among individuals with traumatic spinal cord injury (TSCI) in Ontario, Canada. The study found that over half of the individuals with TSCI who were eligible for Ontario's public drug program used opioids in the year following their injury. Being male, having COPD, and previous opioid use were significant predictors. The authors conclude that further research is needed to understand the short-term and long-term risks and benefits of opioid use in this vulnerable population, given the paucity of existing research and the potential for adverse events.

Practical Implications

Targeted Interventions

Healthcare providers should consider targeted interventions for individuals with TSCI who are male, have COPD, or have a history of opioid use, as these factors increase the risk of post-injury opioid use.

Optimizing Hospital Stay

Evaluate the impact of length of initial hospital stay and rehabilitation services on long-term opioid use to potentially reduce reliance on opioids for pain management after TSCI.

Further Research

Prioritize further research to understand the risks and benefits of opioid use in the TSCI population, addressing the current lack of evidence and the potential for adverse events.

Study Limitations

1
The study population is limited to individuals eligible for Ontario's public drug program, which may limit generalizability.
2
The study did not capture the specific indication for opioid prescriptions.
3
The data only captures dispensed prescription opioids, excluding illicit or over-the-counter opioid use.

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