Opioid Prescribing Patterns and Prolonged Opioid Use in Opioid-Naive Adults after Surgical and Emergency Care in Nova Scotia

Abstract

I conducted three studies about opioid prescribing and prolonged opioid use - an important outcome of opioid prescribing for acute pain. In the first study I employed systematic review methodology to summarize risk of prolonged use in surgical, injury/emergency care, and dental settings globally and to identify important risk factors. The second study included 36,716 opioid naive adults who filled opioid prescriptions within 14 days of surgical or emergency care. I described prescribing patterns and estimated prevalence of filling prescriptions >7days’ supply and ≥90MME/day; I explored variation across settings and provider specialty groups. The third study was a retrospective cohort study including 27,665 subjects. I estimated overall risk of prolonged opioid use in Nova Scotia and assessed association with first-prescription factors. Results from this thesis may inform a wide range of stakeholders when interpreted in context of benefits, harms, and patients’ values and preferences.