Opioids are commonly prescribed following childbirth, but data are lacking on trends in postpartum opioid prescribing over time. We examined whether a highly-publicized 2006 case report questioning the safety of codeine during lactation was associated with changes in postpartum opioid prescribing. We conducted a cross-sectional time series analysis of all publicly-funded prescriptions for opioids to postpartum women in Ontario, Canada from April 1, 2000 to March 31, 2017. The intervention was the publication of a case report in 2006 attributing the death of a breastfeeding neonate to maternal codeine use. The primary outcome was the rate of opioid prescribing to postpartum women. Among postpartum women eligible for prescription drug coverage, 17.5% filled an opioid prescription in the third quarter of 2006 (immediately prior to publication of the case report), with codeine representing 89.8% of all prescriptions. By the fourth quarter of 2010, only 12.2% of postpartum women filled an opioid prescription, representing a decline of 30% (p<0.01), with codeine representing 71.9% of all prescriptions. During this period, we observed sizeable relative increases in the proportion of opioid prescriptions filled for morphine, hydromorphone, and oxycodone. By 2017, among women prescribed opioids postpartum, 39.0% filled a prescription for codeine, while the remainder filled prescriptions for oxycodone (18.6%), morphine (25.5%), and hydromorphone (16.9%). A highly-publicized case report questioning the safety of maternal codeine use during breastfeeding was associated with significant changes in opioid prescribing to postpartum women, including a decline in overall opioid prescribing and a shift from codeine to stronger opioids.<\/p>\n","protected":false},"excerpt":{"rendered":"
Opioids are commonly prescribed following childbirth, but data are lacking on trends in postpartum opioid prescribing over time. We examined whether a highly-publicized 2006 case report questioning the safety of codeine during lactation was associated with changes in postpartum opioid prescribing. We conducted a cross-sectional time series analysis of all publicly-funded prescriptions for opioids to […]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-2497","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Zipursky JS, Pang A, Paterson J, Austin PC, Mamdani M, Gomes T, Ray JG, Juurlink DN. Clin Pharmacol Ther<\/em>. 2021; 110(4):1004-10. Epub 2021 May 25.","source_url":"https:\/\/doi.org\/10.1002\/cpt.2307","ices_scientist":[1100,1325,1252,1282,1385,1338,1137],"site":[6733],"research_program":[6746],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"3B050DD0-3321-49C8-814C-8F6DA40F26A8","sitecore_item_name":"Trends-in-postpartum-opioid-prescribing-a-time-series-analysis","sitecore_field_values":"{\n \"Title\": \"Trends in postpartum opioid prescribing: a time series analysis\",\n \"Short title\": \"Trends in postpartum opioid prescribing:\",\n \"Summary\": \"This study examined whether a highly-publicized 2006 case report questioning the safety of codeine during lactation was associated with changes in postpartum opioid prescribing.\",\n \"Citation\": \"