prince edward island prescription monitoring report narcotics · monitored drug trends 2014-2018...

Prince Edward IslandPrescription

Monitoring ReportNarcotics

(Opioids & Monitored Drugs)

TABLE OF CONTENTS

PAGELetter

2018 Drug Narcotic Awareness110,142 prescriptions were filled for 35,919 individuals

2018 Drug Narcotic AwarenessA summary of 2018’s top 5 monitored drugs prescribed in the Opioid category

2018 Drug Narcotic AwarenessA summary of the top 5 monitored drugs prescribed in the Benzodiazepines category

2018 Prescriber Narcotic AwarenessThere were 581 practitioners who issued prescriptions for monitored drugs that were dispensed in 2018

Monitored Drugs - Overall Stats by Calendar Year

Monitored Drug Trends 2014-2018Drug Utilization Stats

Opioid Prescription Dispenses, morphine milligram equivalents (MME) per person, PEI, fiscal years 2010 to 2018

Summary of Top 5 Narcotics (Opioid) Category

Monitored Drug Trends 2014-2018Top 5 Opioid Category

Summary of Select Narcotics (Opioid) Category

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5

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8

9

10

11

12

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Prince Edward Island Prescription Monitoring Report • Narcotics (Opioid & Monitored Drugs)

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As Minister of Health and Wellness, I would like to thank all those who worked on

the development of this important report.

The Prescription Monitoring Report for Narcotics builds on the existing efforts

that PEI has made in addressing opioid misuse and abuse over the last decade.

Establishing regular reporting for the province’s Prescription Monitoring Program

(PMP) for narcotics was a recommendation of the of the PEI Action Plan to

Prevent and Mitigate Opioid-related Overdoses and Deaths, and a positive step

forward in our ongoing commitment to address opioid abuse.

The importance of the PMP has increased in the last few years with the ongoing

challenges occurring across the country and the growing misuse of medications

for pain management. The PMP helps health care professionals support individuals

who may be at risk, and prevent and reduce associated harms.

We look forward to continuing our work with Health PEI and our community

partners in support of a healthier population. We are working to build a Prince

Edward Island where all residents can lead healthy and productive lives, where

wellness is valued and where families can thrive.

Honourable James Aylward

Minister of Health and Wellness

HealthPEI

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

45,000

50,000

55,000

0

60,000

65,000

70,000

Narcotics (opioids)

(# of Drugs - 44)

Targeted (benzodiazepines)

(# of Drugs - 18)

Controlled (stimulants)

(# of Drugs - 11)

Tramadol(# of Drugs - 2)

# o

f In

div

idu

als

/ # o

f P

resc

rip

tio

ns

18,356PHNs

63,341Scripts

11,731PHNs

3,758PHNs

29,865Scripts

13,636Scripts

3,300 Scripts2,074 PHNs

3.45Script/PHN

2.55Script/PHN

3.63Script/PHN

1.59Script/PHN

2018 Drug Narcotic Awareness110,142 prescriptions were filled for 35,919 individuals

DESCRIPTION: Number of prescriptions for monitored drugs and the number of people (PHNs) prescribed monitored drugs in 2018.

ANALYSIS: Narcotics (Opioids) were the most prescribed class of monitored drug in 2018.

NOTE: Monitored drugs are categorized according to federal classification codes.

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# of Prescriptions # of Individuals

Acet W/Codeine (Tylenol 1,2,3,4) Methadone Morphine

Oxycodone (Percocet) Hydromorphone (Dilaudid)

13,208

11,9739,740

9,603

5,862

7,971

3,383

945

3,575

1,815



Lorazepam TemazepamAlprazolamClonazepam Diazepam

15,283

5,667

2,461

2,185

1,802

7,5822,065

911

861641

DESCRIPTION: Top 5 prescribed opioids in 2018 and the number of individuals prescribed for.

ANALYSIS: Acetaminophen with codeine was the most prescribed opioid in 2018. Acetaminophen with codeine is generally the medication of choice for mild to moderate pain.

NOTE: N/A

5




Acet W/Codeine (Tylenol 1,2,3,4) Methadone Morphine


13,208

11,9739,740

9,603

5,862

7,971

3,383

945

3,575

1,815



Lorazepam TemazepamAlprazolamClonazepam Diazepam

15,283

5,667

2,461

2,185

1,802

7,5822,065

911

861641

DESCRIPTION: Top 5 prescribed benzodiazepines in 2018 and the number of individuals prescribed for.

ANALYSIS: Lorazepam was the most prescribed benzodiazepine. Lorazepam is mainly prescribed for mild anxiety.

NOTE: N/A

6


2018 Prescriber Narcotic AwarenessThere were 581 practitioners who issued prescriptions for monitored drugs that were dispensed in 2018

276

65

342

32

2,822

361,594

67

101,805

381

Physicians# of Prescriptions # of Practitioners

Dentists# of Prescriptions # of Practitioners

Nurse Practitioners# of Prescriptions # of Practitioners

Medical Residents# of Prescriptions # of Practitioners

Pharmacists# of Prescriptions # of Practitioners

DESCRIPTION: Total number of practitioners by profession prescribing monitored drugs and the total number of prescriptions written.

ANALYSIS: Physicians, as the lead prescribing healthcare provider, prescribe the majority of monitored drugs.

NOTE: Pharmacists are allowed to prescribe and dispense Tylenol #1.

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10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000

100,000

110,000

0

Monitored Drugs - Overall Stats by Calendar Year

# of Prescriptions - Total - Monitored Drugs

110,142

102,298

104,683

98,752 99,000

103,676

107,743

111,071

35,91935,142 35,785 34,974 34,556 35,14835,956 36,239

# of Individuals - Total - Monitored Drugs

20182011 2012 2013 2014 2015 2016 2017

# o

f In

div

idu

als

/ # o

f P

resc

rip

tio

ns

3.07Script/PHN

2.91Script/PHN

2.93Script/PHN

2.82Script/PHN

2.86Script/PHN

2.95Script/PHN

3.00Script/PHN

3.06Script/PHN

DESCRIPTION: Yearly comparison of the total number of prescriptions written for monitored drugs and the number of people prescribed monitored drugs.

ANALYSIS: After a decline in 2013, there has been a steady increase in the number of prescriptions written for monitored drugs while the number of patients being prescribed monitored drugs has remained relatively constant.

NOTE: The increase in prescriptions is directly related to the methadone program.

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5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

45,000

50,000

55,000

0

60,000

65,000

70,000

2014

# o

f In

div

idu

als

/ # o

f P

resc

rip

tio

ns

2015 2016 2017

Narcotics Targeted Controlled Other

Monitored Drug Trends 2014-2018Drug Utilization Stats

63,3

41 S

crip

ts

58,4

61 S

crip

ts

62,1

63 S

crip

ts

64,1

71 S

crip

ts

29,8

65 S

crip

ts

29,3

51 S

crip

ts

28,7

96 S

crip

ts

29,1

68 S

crip

ts

3,75

8 P

HN

s •

13,6

36 S

crip

ts

2,07

4 P

HN

s •

3,30

0 S

crip

ts

11,7

31 P

HN

s

18,3

56 P

HN

s

2,64

2 P

HN

s •

8,59

8 S

crip

ts

1,47

3 P

HN

s •

2,59

0 S

crip

ts

2,93

7 P

HN

s •

10,0

74 S

crip

ts

1,48

8 P

HN

s •

2,64

3 S

crip

ts

3,16

5 P

HN

s •

11,0

06 S

crip

ts

1,89

4 P

HN

s •

3,39

8 S

crip

ts

11,4

70 P

HN

s

18,9

71 P

HN

s

11,4

74 P

HN

s

19,2

49 P

HN

s

11,6

54 P

HN

s

19,2

43 P

HN

s

2018

65,5

67 S

crip

ts

30,1

67 S

crip

ts

3,49

5 P

HN

s •

11,9

49 S

crip

ts

1,97

4 P

HN

s •

3,38

8 S

crip

ts

11,9

49 P

HN

s

18,8

21 P

HN

s3

.48

Scrip

t/PH

N

2.5

2 Sc

ript/

PHN

3.4

2 Sc

ript/

PHN

1.7

2 Sc

ript/

PHN

3.3

3 Sc

ript/

PHN

2.5

0 Sc

ript/

PHN

3.4

8 Sc

ript/

PHN

1.7

9 Sc

ript/

PHN

3.2

3 Sc

ript/

PHN

2.5

1 Sc

ript/

PHN

3.4

3 Sc

ript/

PHN

1.7

8 Sc

ript/

PHN

3.0

8 Sc

ript/

PHN

2.5

6 Sc

ript/

PHN

3.2

5 Sc

ript/

PHN

1.7

6 Sc

ript/

PHN

3.4

5 Sc

ript/

PHN

2.5

5 Sc

ript/

PHN

3.6

3 Sc

ript/

PHN

1.5

9 Sc

ript/

PHN

DESCRIPTION: Yearly comparison of total prescriptions written for monitored drugs and the number of people prescribed monitored drugs.

ANALYSIS: Number of prescriptions written for each category of monitored drug and the number of people prescribed monitored drugs has been steady since 2014.

NOTE: N/A

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200

400

600

800

1,000

1,200

1,400

1,600

02010 2011 2012 2013

MM

E p

er c

apit

a

MME (including methadone and Suboxone®)

MME (excluding methadone and Suboxone®)

Opioid Prescription Dispenses, morphine milligram equivalents (MME) per person,PEI, fiscal years 2010 to 2018

2014 2015 2016 2017

1,800

2018

DESCRIPTION: Opioid prescription dispenses expressed as morphine milligram equivalents per person for fiscal years 2010 to 2018.

ANALYSIS: When methadone and suboxone prescriptions are excluded, opioid prescribing based on morphine milligram equivalents has been steady since 2010.

NOTE: Morphine milligram equivalents is a value assigned to opioids to represent their relative potencies.

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5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

45,000

50,000

55,000

0

Summary of Top 5 Narcotics (Opioid) Category

# of Prescriptions - Total - Summary of Select Narcotics

50,386

48,320

49,558

52,584

46,791

56,564

52,757

53,688

17,689

20,405 20,657

21,701

18,603

20,817

18,99318,355

# of Individuals - Total - Summary of Select Narcotics

2011 2012 2013 2014 2015 2016 2017 2018

# o

f In

div

idu

als

/ # o

f P

resc

rip

tio

ns

2.85Script/PHN2.37

Script/PHN

2.40Script/PHN

2.42Script/PHN

2.52Script/PHN

2.72Script/PHN

2.78Script/PHN

2.92Script/PHN

60,000

Note: Codeine (Tylenol 1,2,3,4), Oxycodone (Percocet), Methadone, Hydromorphone (Dilaudid), Morphine

DESCRIPTION: Yearly comparison of the top 5 most prescribed monitored drugs with the number of prescriptions and the number of individuals prescribed for.

ANALYSIS: There was a slight decrease in prescribing of the top 5 monitored drugs in 2014. The Province expanded coverage of methadone in 2013 which may have led to a decrease in prescriptions for monitored drugs. The rise in prescribing in 2015 is the result of more methadone prescriptions.

NOTE: Methadone maintenance treatment is the use of methadone, administered over a prolonged period of time, as treatment for someone who is addicted to opioids such as heroin, where detoxification has been unsuccessful and/or admittance to a substance abuse treatment facility requires complete abstinence.

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2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

20,000

02014 2015 2016 2017

# o

f P

resc

rip

tio

ns

Acetaminophen/Codeine/Caffeine

Methadone

Morphine

Oxycodone/Acetaminophen

Hydromorphone

Monitored Drug Trends 2014-2018Top 5 Opioid Category

11,973

5,862

9,603

9,740

13,208

6,626

4,802

8,437

11,641

15,285

11,174

5,302

8,251

14,494

17,343

12,456

5,699

9,246

11,192

14,164

2018

14,528

10,387

9,750

12,559

6,464

DESCRIPTION: Number of prescriptions written for the top 5 prescribed opioids from 2014 to 2018.

ANALYSIS: Methadone prescribing has increased since 2014 related to expanded access to the medication through Pharmacare drug programs.

NOTE: N/A

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2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

20,000

02014

# o

f In

div

idu

als

/ # o

f P

resc

rip

tio

ns

2015 2016 2017 2018

14,5

28

8,5

06

1.71

Scr

ipt/

PHN

10,3

87

3,7

26

2.7

9 Sc

ript/

PHN

9,7

50

3,2

25

3.0

2 Sc

ript/

PHN

6,4

64

1,9

56

3.3

0 Sc

ript/

PHN

12,5

59

94

213

.33

Scrip

t/PH

N

14,1

64

9,0

181.

57

Scrip

t/PH

N

11,1

92

4,1

95

2.6

7 Sc

ript/

PHN

9,2

46

3,0

193

.06

Scrip

t/PH

N

5,6

99

1,81

03

.15

Scrip

t/PH

N

12,4

56

951

13.1

0 Sc

ript/

PHN

17,3

43

10,5

94

1.6

4 Sc

ript/

PHN

14,4

94

5,0

82

2.8

5 Sc

ript/

PHN

8,2

512

,53

33

.26

Scrip

t/PH

N

5,3

02

1,7

02

3.1

2 Sc

ript/

PHN

11,1

749

06

12.3

3 Sc

ript/

PHN

15,2

85

9,5

161.

61 S

crip

t/PH

N

11,6

414

,613

2.5

2 Sc

ript/

PHN

63

7 /

6,6

26

10.4

0 Sc

ript/

PHN

8,4

37

2,3

79

3.5

5 Sc

ript/

PHN

4,8

02

1,4

58

3.2

9 Sc

ript/

PHN

13,2

08

7,9

711.

66

Scrip

t/PH

N

9,7

40

3,3

83

2.8

8 Sc

ript/

PHN

9,6

03

3,5

752

.69

Scrip

t/PH

N

5,8

62

1,81

53

.23

Scrip

t/PH

N

Codeine (Tylenol 1,2,3,4) Methadone Morphine


Summary of Select Narcotics (Opioid) Category

11,9

73

94

512

.67

Scrip

t/PH

N

13


DESCRIPTION: Number of prescriptions written for the top 5 prescribed opioids from 2014 to 2018 with additional information.

ANALYSIS: Methadone prescribing has increased since 2014 related to expanded access to the medication through Pharmacare drug programs.

NOTE: This chart contains same data as previous chart with additional information added (# individuals and prescriptions per PHN).

prince edward island prescription monitoring report narcotics · monitored drug trends 2014-2018...

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