Grant: Project Grant

The use of prescription opioids has increased markedly in recent years, and Canada is now the second leading consumer of opioids per capita in the world. This has been associated with a dramatic rise in rates of dependence, addiction, and overdose death involving these drugs. This public health crisis has becoming a priority for provincial and national governments, and population-based research in this field has been an important tool for policymakers developing strategies to address this growing threat to public health. Historically, most research has been limited to government-reimbursed prescriptions. However, because most Canadians do not receive government-funded drug coverage, large gaps remain in our understanding of opioid prescribing and its consequences. The introduction in 2012 of Ontario's Narcotic Monitoring System (NMS), which captures all opioid prescriptions in Ontario regardless of payer, offers a novel opportunity to explore opioid prescribing in a truly population-based fashion. Through linkage of this dataset to a broad repository of health care data, we will describe provincial patterns of opioid prescribing, evaluate the real-world impact of existing programs, quantify indicators of inappropriate prescribing and misuse, identify populations at highest risk of overdose and death, and inform policies likely to impact on this crisis. All work will be overseen by a steering committee comprised of patients, researchers and policy-makers to ensure broad relevance, uptake and dissemination. As Canadian decision-makers struggle to develop evidence-based policies to address the growing national opioid crisis, this work will provide a picture of the current state of the opioid epidemic in Ontario and potential areas for change. This research will generate evidence to help inform and evaluate prescribing policies that will have broad implications for public health.