Grant: Catalyst Grant: Personalized Health Catalyst Grants

Chronic non-cancer pain (CNCP) affects 1/5 Canadians and its human and economical burdens are enormous. CNCP is poorly managed, with medications such as opioids being one of few tools available to family doctors who do not have easy access to multidisciplinary teams. Nonetheless, little good quality data exist on who benefits from opioid therapy or is at risk of opioid abuse. In parallel, the ongoing opioid crisis referring to waves of opioid overdoses in North America has led clinicians and governmental instances to adopt an increasingly conservative approach to the use of opioids. This however is not without consequence for CNCP patients. These elements have led this research team to propose in depth examination of opioid therapy in CNCP patients using a unique methodology that combines Quebec health administrative data banks with an existing registry of 8,650 patients with CNCP (Quebec Pain Registry). While individually none of these data banks can adequately answer certain questions about the impact of opioid crisis on CNCP patients, their combination will provide rich and unique data. Most notably, this pairing will provide accurate and precise information on opioid prescriptions, pain diagnosis, pain severity, quality of life, and mood. We will use advanced statistical methods to (a) identify different patient subgroups who are most and least likely to benefit from opioid therapy and identify predictors of treatment response, (b) examine the frequency and risk factors of opioid doctor shopping behaviors (one form of opioid abuse), and (c) examine the impact of the opioid crisis on opioid prescriptions and related serious adverse events in Quebec. Identifying factors associated with opioid treatment response and risk of abuse can lead to significant improvements in pain management practices and in the condition of CNCP patients while providing a safe and responsible framework for the use of opioids as a therapeutic tool.