Contemporary prescription opioid use for pain among Canadian Armed Forces Veterans in Ontario

Abstract: Approximately 50% of Canadian Veterans live with chronic pain, more than double the rate in the general population. Opioids are commonly prescribed for chronic non-cancer pain, but provide only modest improvements in pain, physical function, and sleep. Opioids are also associated with important dose-dependent harms, including opioid use disorder (OUD), overdose, and death. Accordingly, the 2017 Canadian guideline strongly recommends against opioids as first-line therapy for chronic non-cancer pain, and weakly recommends against prescribing ≥50 milligrams of morphine or equivalent/day at initiation, and to consider voluntary tapering with legacy patients prescribed ≥90 MME/day. This report summarizes trends in opioid prescriptions for pain, treatment for OUD, and opioid-related overdoses between 2013 and 2019 among Canadian Armed Forces Veterans living in Ontario who were released between 1990 and 2019 using routinely collected data. Data from a matched cohort of Ontario non-Veterans are included for comparison. These datasets were linked using unique encoded identifiers and analyzed at ICES. Details about the cohorts and opioid use indicators have been previously reported.

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