Patterns of opioid use (codeine, morphine or meperidine) in the Canadian population over time: analysis of the Longitudinal National Population Health Survey 1994–2011

Objective This study aimed to investigate cohort effects in selected opioids use and determine whether cohort differences were associated with changes in risk factors for use over time.Design This study presents secondary analyses of a longitudinal survey panel of the general population that collect...

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Main Authors: Elizabeth M Badley, Y Raja Rampersaud, Mayilee Canizares, J Denise Power
Format: Article
Language:English
Published: BMJ Publishing Group 2019-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/7/e029613.full
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author Elizabeth M Badley
Y Raja Rampersaud
Mayilee Canizares
J Denise Power
author_facet Elizabeth M Badley
Y Raja Rampersaud
Mayilee Canizares
J Denise Power
author_sort Elizabeth M Badley
collection DOAJ
description Objective This study aimed to investigate cohort effects in selected opioids use and determine whether cohort differences were associated with changes in risk factors for use over time.Design This study presents secondary analyses of a longitudinal survey panel of the general population that collected data biannually.Setting Data from the Canadian Longitudinal National Population Health Survey 1994–2011.Population This study included 12 542 participants from the following birth cohorts: post-World War I (born 1915–1924), pre-World War II (born 1925–1934), World War II (born 1935–1944), Older Baby Boom (born 1945–1954), Younger Baby Boom (born 1955–1964), Older Generation X (born 1965–1974) and Younger Generation X (born 1975–1984).Main outcome Responses to a single question asking about the use of codeine, morphine or meperidine in the past month (yes/no) were examined.Results Over and above age and period effects, there were significant cohort differences in selected opioids use: each succeeding recent cohort had greater use than their predecessors (eg, Gen Xers had greater use than younger baby boomers). Selected opioids use increased significantly from 1994 to 2002, plateauing between 2002 and 2006 and then declining until 2011. After accounting for cohort and period effects, there was a decline in use of these opioids with increasing age. Although pain was significantly associated with greater selected opioids use (OR=3.63, 95% CI 3.39 to 3.94), pain did not explain cohort differences. Cohort and period effects were no longer significant after adjusting for the number of chronic conditions. Cohort differences in selected opioids use mirrored cohort differences in multimorbidity. Use of these opioids was significantly associated with taking antidepressants or tranquillisers (OR=2.52, 95% CI 2.27 to 2.81 and OR=1.60, 95% CI 1.46 to 1.75, respectively).Conclusions The findings underscore the need to consider multimorbidity including possible psychological disorders and associated medications when prescribing opioids (codeine, morphine, meperidine), particularly for recent birth cohorts. Continued efforts to monitor prescription patterns and develop specific opioid use guidelines for multimorbidity appear warranted.
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spelling doaj-art-cd4b9a2ef14d4d49a8778f7ebffe0e5c2025-08-20T02:07:04ZengBMJ Publishing GroupBMJ Open2044-60552019-07-019710.1136/bmjopen-2019-029613Patterns of opioid use (codeine, morphine or meperidine) in the Canadian population over time: analysis of the Longitudinal National Population Health Survey 1994–2011Elizabeth M Badley0Y Raja Rampersaud1Mayilee Canizares2J Denise Power32 Arthritis Community Research and Evaluation Unit, Krembil Research Institute, University Health Network, Toronto, Ontario, CanadaArthritis Program, Krembil Research Institute, Division of Orthopaedics, University Health Network, Toronto, Ontario, Canada1 Arthritis Program, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada1 Arthritis Program, Krembil Research Institute, University Health Network, Toronto, Ontario, CanadaObjective This study aimed to investigate cohort effects in selected opioids use and determine whether cohort differences were associated with changes in risk factors for use over time.Design This study presents secondary analyses of a longitudinal survey panel of the general population that collected data biannually.Setting Data from the Canadian Longitudinal National Population Health Survey 1994–2011.Population This study included 12 542 participants from the following birth cohorts: post-World War I (born 1915–1924), pre-World War II (born 1925–1934), World War II (born 1935–1944), Older Baby Boom (born 1945–1954), Younger Baby Boom (born 1955–1964), Older Generation X (born 1965–1974) and Younger Generation X (born 1975–1984).Main outcome Responses to a single question asking about the use of codeine, morphine or meperidine in the past month (yes/no) were examined.Results Over and above age and period effects, there were significant cohort differences in selected opioids use: each succeeding recent cohort had greater use than their predecessors (eg, Gen Xers had greater use than younger baby boomers). Selected opioids use increased significantly from 1994 to 2002, plateauing between 2002 and 2006 and then declining until 2011. After accounting for cohort and period effects, there was a decline in use of these opioids with increasing age. Although pain was significantly associated with greater selected opioids use (OR=3.63, 95% CI 3.39 to 3.94), pain did not explain cohort differences. Cohort and period effects were no longer significant after adjusting for the number of chronic conditions. Cohort differences in selected opioids use mirrored cohort differences in multimorbidity. Use of these opioids was significantly associated with taking antidepressants or tranquillisers (OR=2.52, 95% CI 2.27 to 2.81 and OR=1.60, 95% CI 1.46 to 1.75, respectively).Conclusions The findings underscore the need to consider multimorbidity including possible psychological disorders and associated medications when prescribing opioids (codeine, morphine, meperidine), particularly for recent birth cohorts. Continued efforts to monitor prescription patterns and develop specific opioid use guidelines for multimorbidity appear warranted.https://bmjopen.bmj.com/content/9/7/e029613.full
spellingShingle Elizabeth M Badley
Y Raja Rampersaud
Mayilee Canizares
J Denise Power
Patterns of opioid use (codeine, morphine or meperidine) in the Canadian population over time: analysis of the Longitudinal National Population Health Survey 1994–2011
BMJ Open
title Patterns of opioid use (codeine, morphine or meperidine) in the Canadian population over time: analysis of the Longitudinal National Population Health Survey 1994–2011
title_full Patterns of opioid use (codeine, morphine or meperidine) in the Canadian population over time: analysis of the Longitudinal National Population Health Survey 1994–2011
title_fullStr Patterns of opioid use (codeine, morphine or meperidine) in the Canadian population over time: analysis of the Longitudinal National Population Health Survey 1994–2011
title_full_unstemmed Patterns of opioid use (codeine, morphine or meperidine) in the Canadian population over time: analysis of the Longitudinal National Population Health Survey 1994–2011
title_short Patterns of opioid use (codeine, morphine or meperidine) in the Canadian population over time: analysis of the Longitudinal National Population Health Survey 1994–2011
title_sort patterns of opioid use codeine morphine or meperidine in the canadian population over time analysis of the longitudinal national population health survey 1994 2011
url https://bmjopen.bmj.com/content/9/7/e029613.full
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