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Pain Research and Management
Volume 13 (2008), Issue 5, Pages 395-400
Original Article

Prevalence of Opioid Dispensings and Concurrent Gastrointestinal Medications in Quebec

Rachel E Williams,1 Nevzeta Bosnic,2 Carolyn T Sweeney,3 Ashlee W Duncan,3 Kristen B Levine,4 Michael Brogan,2 and Suzanne F Cook3

1Worldwide Epidemiology, GlaxoSmithKline, Collegeville, Pennsylvania, USA
2Brogan Inc, Ottawa, Ontario, Canada
3Worldwide Epidemiology, GlaxoSmithKline, Research Triangle Park, North Carolina, USA
4Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

Copyright © 2008 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


BACKGROUND: Opioids are frequently prescribed for moderate to severe pain. A side effect of opioid usage is the inhibition of gastrointestinal (GI) motility, known as opioid-induced bowel dysfunction (OBD). OBD is typically treated prophylactically with laxatives and/or acid suppressants.

AIM: The present study describes the prevalence of outpatient opioid dispensing, opioid patient demographics, and concomitant dispensing of opioids and GI medications in the Quebec Public Prescription Drug Insurance Plan in 2005.

METHODS: Using a retrospective cohort design, opioid dispensings were identified using claims and reimbursement data. Laxative and acid suppressant dispensings were also identified. Concurrent use was defined as having at least one ‘GI medication-exposed day’ overlapping an ‘opioid-exposed day’.

RESULTS: More than 11% of the drug plan population was dispensed an opioid in 2005, and dispensings increased with age. Approximately two-thirds of patients who received an opioid were given codeine. Approximately one-third of opioid patients were concomitantly dispensed a GI medication, yet only 2% were dispensed a laxative.

CONCLUSIONS: Although the GI side effects of opioids are well known, these side effects appear to increase with age and duration of opioid use. Opioid-related side effects, particularly OBD, should be effectively managed so as not to lead to the cessation of opioid therapy.