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Trends in Postpartum Opioid Prescribing: A Time Series Analysis
Jonathan S Zipursky1,2, Andrea Pang3, J Michael Paterson2,3
1Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Clinical Pharmacology and Therapeutics
|May 25, 2021
Summary
A 2006 report on codeine safety during breastfeeding led to significant changes in postpartum opioid prescribing. Overall opioid use declined, with a notable shift from codeine to stronger pain medications for mothers.
Area of Science:
- Pharmacology and Therapeutics
- Public Health
- Maternal Health
Background:
- Opioid analgesics are frequently prescribed after childbirth.
- Limited data exist on long-term trends in postpartum opioid utilization.
- The safety of codeine for breastfeeding mothers has been a concern.
Purpose of the Study:
- To investigate the impact of a 2006 case report on postpartum opioid prescribing patterns.
- To analyze trends in the types of opioids prescribed to women after delivery.
Main Methods:
- Cross-sectional time series analysis of opioid prescriptions in Ontario, Canada (2000-2017).
- Examined changes in prescribing rates and drug choice following a specific intervention (2006 case report).
- Focused on publicly funded prescriptions for postpartum women.
Main Results:
- Postpartum opioid prescriptions decreased by 30% between 2006 and 2010.
- Codeine's share of postpartum opioid prescriptions dropped from 89.8% to 71.9% during the same period.
- Prescriptions for morphine, hydromorphone, and oxycodone increased significantly, indicating a shift to stronger analgesics.
Conclusions:
- A publicized 2006 report on codeine safety was associated with reduced postpartum opioid prescribing.
- The intervention prompted a shift away from codeine towards other, stronger opioid medications.
- These findings highlight the influence of safety concerns on clinical prescribing practices in the postpartum period.
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