Related Experiment Video
Updated: Jul 20, 2025
An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
Prescription of oxycodone versus codeine after childbirth and risk of persistent opioid use: a population-based
Jonathan S Zipursky1, Karl Everett2, Tara Gomes2
1Department of Medicine (Zipursky), Sunnybrook Health Sciences Centre; Institute of Health Policy, Management, and Evaluation (Zipursky, Gomes, Paterson, Austin, Mamdani, Ray), University of Toronto; ICES Central (Everett, Gomes, Paterson, Li, Austin, Mamdani, Ray, Zipursky); Keenan Research Centre of the Li Ka Shing Knowledge Institute (Gomes, Mamdani), St. Michael's Hospital; Leslie Dan Faculty of Pharmacy (Gomes, Mamdani), University of Toronto; Sunnybrook Research Institute (Austin, Juurlink, Zipursky); Department of Medicine (Ray), St. Michael's Hospital, Toronto, Ont. Jonathan.Zipursky@sunnybrook.ca.
Background:
Oxycodone is increasingly prescribed for postpartum analgesia in lieu of codeine owing to concerns regarding the neonatal safety of codeine during lactation. We examined whether initiation of oxycodone after delivery was associated with an increased risk of persistent opioid use relative to initiation of codeine.
Methods:
We conducted a population-based cohort study of people who filled a prescription for either codeine or oxycodone within 7 days of discharge from hospital after delivery between Sept. 1, 2012, and June 30, 2020. The primary outcome was persistent opioid use, defined as 1 or more additional prescriptions for an opioid within 90 days of the first postpartum prescription and 1 or more additional prescriptions in the 91 to 365 days thereafter. We used inverse probability of treatment weighting to assess the risk of persistent postpartum opioid use, comparing people who initiated oxycodone with those who initiated codeine.
Results:
Over the 8-year study period, we identified 70 607 people who filled an opioid prescription within 7 days of discharge from hospital: 21 308 (30.2%) received codeine and 49 299 (69.8%) oxycodone. Compared with people who filled a prescription for codeine, receipt of oxycodone was not associated with persistent opioid use (relative risk [RR] 1.04, 95% confidence interval [CI] 0.91-1.20). We found an association between a prescription for oxycodone and persistent use after vaginal delivery (RR 1.63, 95% CI 1.31-2.03), but not after cesarean delivery (RR 0.85, 95% CI 0.73-1.00).
Interpretation:
Initiation of oxycodone (v. codeine) was not associated with an increased risk of persistent opioid use, except after vaginal delivery.
Related Concept Videos
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
01:20Opioid Analgesics: Morphine and Other Natural Cogeners
01:25Analgesia and Pain Management
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
01:02Prescription, Nonprescription and Orphan Drugs
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
01:25Drug Classes and Categories