The recent and ongoing opioid crisis in the United States (US) and Canada has led to increased opioid-related overdoses and has been declared a public health emergency. In the US, 47,600 drug overdose deaths involving an opioid occurred in 2018 alone. In Canada, 16,364 opioid-related deaths occurred between January 2016 and March 2020. Most of these overdoses were driven primarily by illicitly manufactured fentanyl but prescription opioids were also responsible for some of these deaths.
goal
Doctor shopping can be defined as the behaviour of visiting different prescribers and/or pharmacies to obtain large amounts of opioids and suggests opioid use problems. This study aimed at assessing the prevalence of opioid doctor shopping among patients with chronic non-cancer pain (ie, pain lasting ≥3 months) attending multidisciplinary pain clinics in Quebec, Canada.
methodology
A total of 2191 patients, from the Quebec Pain Registry, with chronic non-cancer pain with at least one opioid dispensation within the 12 months following the index date were included.
Main findings
Among the included patients, 15 (0.7%) presented at least one episode of doctor shopping. Among these doctor-shoppers, 9 (60.0%) exhibited only 1 episode.
Opioid doctor shopping was practiced by less than 1% of patients with chronic non-cancer pain attending multidisciplinary pain clinics suggesting a low risk of non-medical use.
take home message
Opioids remain useful medications that should be prescribed for patients with chronic noncancer pain, without current or past substance use disorder and without other active psychiatric disorders, who have persistent problematic pain despite optimized nonopioid therapy, as suggested by the Guidelines.
