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Patterns of opioid prescribing to opioid‐naive patients after surgical and emergency care: A population‐based cross‐sectional study using linked administrative databases in Nova Scotia (2017–2019).

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Title: Patterns of opioid prescribing to opioid‐naive patients after surgical and emergency care: A population‐based cross‐sectional study using linked administrative databases in Nova Scotia (2017–2019).
Authors: Merdad, Roah A. (AUTHOR), Asbridge, Mark (AUTHOR), Campbell, Samuel (AUTHOR), Dutton, Daniel J. (AUTHOR), Hayden, Jill A. (AUTHOR)
Source: Drug & Alcohol Review. May2025, Vol. 44 Issue 4, p1124-1137. 14p.
Subjects: Surgery practice, Emergency medical services, Drug administration, Databases, Cross-sectional method, Patient safety, Patients
Geographic Terms: Canada, Nova Scotia
Abstract: Introduction: To describe opioid prescribing patterns for opioid‐naive patients who filled prescriptions after surgical or emergency care. Methods: We conducted a population‐based, cross‐sectional study of opioid‐naive adults who filled opioid prescriptions within 14 days of receiving surgical or emergency care in Nova Scotia, Canada. Using linked administrative databases, we estimated the prevalence of opioid prescriptions with >7 days' supply, ≥90 morphine milligram equivalents (MME)/day or long‐acting opioids. We assessed the association of care setting and specialty with these outcomes. Results: Among 124,515 patients, 36,716 (29.5%) were opioid‐naive. The median opioid supply duration was 3 days (IQR 2–5), the median dose was 50 MME/day (IQR 30–75). Prescriptions for >7 days, ≥90 MME/day or involving long‐acting opioids were filled by 10.9%, 20.2% and 0.7% of the patients, respectively. Hydromorphone (50%) and codeine (26.4%) were the most filled opioids. The emergency care setting had double the odds of filling >7 days' supply (OR 2.13, 95% CI 1.99–2.28), and 69% lower chance of filling ≥90 MME/day (OR 0.31, 95% CI 0.29–0.33) than surgical care. In the surgical care setting, there was significant variation across medical specialties. Otolaryngology was associated with a higher chance of prescribing >7 days' opioid supply than general surgery (OR 4.89, 95% CI 3.86–6.20). Orthopaedic surgery had a higher likelihood of ≥90 MME/day prescriptions (OR 2.92, 95% CI 2.58–3.30) than general surgery. Discussion and Conclusions: Opioid prescribing patterns vary significantly by setting and specialty in Nova Scotia, Canada. Our results emphasise the need for tailored guidelines that consider clinical context and specialty to enhance patient safety and reduce opioid misuse risk. [ABSTRACT FROM AUTHOR]
Copyright of Drug & Alcohol Review is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Patterns of opioid prescribing to opioid‐naive patients after surgical and emergency care: A population‐based cross‐sectional study using linked administrative databases in Nova Scotia (2017–2019).
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  Data: <searchLink fieldCode="AR" term="%22Merdad%2C+Roah+A%2E%22">Merdad, Roah A.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Asbridge%2C+Mark%22">Asbridge, Mark</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Campbell%2C+Samuel%22">Campbell, Samuel</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Dutton%2C+Daniel+J%2E%22">Dutton, Daniel J.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hayden%2C+Jill+A%2E%22">Hayden, Jill A.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Drug+%26+Alcohol+Review%22">Drug & Alcohol Review</searchLink>. May2025, Vol. 44 Issue 4, p1124-1137. 14p.
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  Data: <searchLink fieldCode="DE" term="%22Surgery+practice%22">Surgery practice</searchLink><br /><searchLink fieldCode="DE" term="%22Emergency+medical+services%22">Emergency medical services</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+administration%22">Drug administration</searchLink><br /><searchLink fieldCode="DE" term="%22Databases%22">Databases</searchLink><br /><searchLink fieldCode="DE" term="%22Cross-sectional+method%22">Cross-sectional method</searchLink><br /><searchLink fieldCode="DE" term="%22Patient+safety%22">Patient safety</searchLink><br /><searchLink fieldCode="DE" term="%22Patients%22">Patients</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Canada%22">Canada</searchLink><br /><searchLink fieldCode="DE" term="%22Nova+Scotia%22">Nova Scotia</searchLink>
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  Label: Abstract
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  Data: Introduction: To describe opioid prescribing patterns for opioid‐naive patients who filled prescriptions after surgical or emergency care. Methods: We conducted a population‐based, cross‐sectional study of opioid‐naive adults who filled opioid prescriptions within 14 days of receiving surgical or emergency care in Nova Scotia, Canada. Using linked administrative databases, we estimated the prevalence of opioid prescriptions with >7 days' supply, ≥90 morphine milligram equivalents (MME)/day or long‐acting opioids. We assessed the association of care setting and specialty with these outcomes. Results: Among 124,515 patients, 36,716 (29.5%) were opioid‐naive. The median opioid supply duration was 3 days (IQR 2–5), the median dose was 50 MME/day (IQR 30–75). Prescriptions for >7 days, ≥90 MME/day or involving long‐acting opioids were filled by 10.9%, 20.2% and 0.7% of the patients, respectively. Hydromorphone (50%) and codeine (26.4%) were the most filled opioids. The emergency care setting had double the odds of filling >7 days' supply (OR 2.13, 95% CI 1.99–2.28), and 69% lower chance of filling ≥90 MME/day (OR 0.31, 95% CI 0.29–0.33) than surgical care. In the surgical care setting, there was significant variation across medical specialties. Otolaryngology was associated with a higher chance of prescribing >7 days' opioid supply than general surgery (OR 4.89, 95% CI 3.86–6.20). Orthopaedic surgery had a higher likelihood of ≥90 MME/day prescriptions (OR 2.92, 95% CI 2.58–3.30) than general surgery. Discussion and Conclusions: Opioid prescribing patterns vary significantly by setting and specialty in Nova Scotia, Canada. Our results emphasise the need for tailored guidelines that consider clinical context and specialty to enhance patient safety and reduce opioid misuse risk. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Drug & Alcohol Review is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/dar.14029
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        Text: English
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      – SubjectFull: Emergency medical services
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      – SubjectFull: Drug administration
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      – SubjectFull: Patient safety
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      – SubjectFull: Patients
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      – SubjectFull: Canada
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      – SubjectFull: Nova Scotia
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      – TitleFull: Patterns of opioid prescribing to opioid‐naive patients after surgical and emergency care: A population‐based cross‐sectional study using linked administrative databases in Nova Scotia (2017–2019).
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              Text: May2025
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              Y: 2025
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