Trends in the dispensing of opioids for pain and concurrent benzodiazepine use among First Nations People in Ontario, Canada, from 2013 to 2021

Objectives — To investigate dispensing trends and the characteristics of First Nations People in Ontario dispensed an opioid for pain and concurrent benzodiazepine treatment.

Methods — We conducted a population-based serial cross-sectional study by quarter of registered (Status) First Nations People in Ontario who were dispensed an opioid for pain between April 1, 2013, and December 31, 2021. We reported quarterly trends in prevalent and incident opioid dispensing (rates per 1000 people), and the prevalence of concurrent benzodiazepine use among individuals receiving opioids for pain. For the final year (2021), we stratified rates by age, place of residence (within or outside First Nations communities), and sex.

Results — Between 2013 and 2021, the quarterly rate of opioid dispensing for pain decreased by 25.0% among First Nations People in Ontario, from 74.7 to 56.0 per 1000 people. In stratified analyses for the year 2021, opioid use for pain was more frequent among First Nations People living outside versus within First Nations communities (118.2 vs. 91.2 per 1000, respectively) and among females relative to males (124.6 and 93.9 per 1000, respectively). Concurrent prescription benzodiazepine use among First Nations People receiving a prescription opioid for pain decreased from 20.9% in Q2 2013 to 16.7% in Q4 2021. In stratified analyses, concurrent use was more prevalent among females, adults aged ≥ 65 years, and First Nations People living outside First Nations communities.

Conclusion — Opioid analgesic prescribing patterns for First Nations People living in Ontario indicate a decrease in both overall prescribing rates and concurrent benzodiazepine use.