(132) Long-Term Trajectories of Prescription Opioid Use in New South Wales, Australia

Saturday, August 27, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 806

Presenting Author(s)

Natasa Gisev, PhD
– University of New South Wales, Randwick, New South Wales, Australia

Co-Author(s)

Luke Buizen
– Biostatistician, National Drug and Alcohol Research Centre, UNSW Sydney, Sydney Australia, Australia
Andrea Schaffer, MSc, MBiostat, PhD
– Epidemiologist, University of New South Wales, United Kingdom
Benjamin Daniels
– Centre for Big Data Research in Health, Kensington, New South Wales, Australia
Sallie-Anne Pearson, PhD
– Director, Centre of Research Excellence in Medicines Intelligence, Centre for Big Data Research in Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia, New South Wales, Australia
Timothy Dobbins
– School of Population Health, UNSW Sydney, Sydney Australia, Australia
Fiona Blyth, BSc(Med), MBBS(Hons), MPH, PhD
– Associate Dean, Concord Clinical School, University of Sydney, Sydney, New South Wales, Australia
Sarah Larney
– Université de Montréal and Centre de Recherche du CHUM, Montreal, Canada, Quebec, Canada
David C. Currow
– Faculty of Science, Medicine and Health, University of Wollongong, Wollongong. New South Wales Australia., Australia
Andrew Wilson, MBBS PhD
– Director, Menzies Centre for Health Policy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia, Northern Territory, Australia
Louisa Degenhardt, BA(Psych), MPsychol(Clinical), PhD
– Scientia Professor, National Drug and Alcohol Research Centre, UNSW Sydney, Randwick, New South Wales, Australia

Background: There are known risks of using opioids for extended periods of time. However, less is known about the long-term trajectories of use following opioid initiation.

Objectives: To examine 5-year trajectories of opioid use from the time of opioid initiation and the individual characteristics associated with different trajectories of use.

Methods: A population-based cohort study of people initiating prescription opioids (2003–2018) in New South Wales, Australia, linked to a range of healthcare datasets [POPPY II Cohort]. We used group-based trajectory modelling to determine trajectories of monthly opioid use over 60-months from the date of first opioid initiation. Characteristics of individuals within each trajectory including sociodemographic characteristics, comorbidities, hospitalisations, psychotropic and analgesic medicine use, and type of initial opioid use, were identified.

Results: We identified five trajectories of long-term opioid use among 3,474,490 individuals: two involved very low (74%) or low use (18%), one involved sustained use (3%), one involved moderate decreasing to low use (3%), and one involved low increasing to moderate use (3%). Individuals in the three moderate or sustained opioid use trajectories were older, with more co-morbidities and hospitalisations prior to their first opioid initiation, had higher rates of use of other psychotropic and analgesic medicines, and were initiated on stronger opioids.

Conclusions: Most individuals had relatively low use of opioids over a five-year period. Individuals with sustained or increasing use were older with more co-morbidities and medicine use, likely reflecting a higher prevalence of pain and treatment needs in these individuals.