Significant factors associated with problematic use of opioid pain relief medications among the household population, Canada, 2018.

Background: Reliance on the use of opioids to manage pain has increased over time, as have opioid-related morbidity and deaths. In 2018, 12.7% of Canadians reported having used opioid pain relief medications (OPRMs) in the previous year. Among these people, 9.6% had engaged in problematic use that could cause harm to their health. Though socioeconomic characteristics associated with opioid-related harms have previously been reported, population-level evidence based on administrative health data lacks important behavioural and psychosocial information. This analysis extends previous research by using modelling to report factors related to the problematic use of OPRMs for the household population aged 15 and older in Canada.

Data and methods: This analysis uses responses to the 2018 Canadian Community Health Survey to identify factors that are significantly associated, after adjustment using multivariate logistic regression models, with elevated odds of problematic use of OPRMs.

Results: The fully adjusted model confirmed that being male, being younger (ages 20 to 24), having fair or poor mental health, having unmet needs for help with mental or emotional health or substance problems, being a smoker, or being unattached and living with others were significantly related to problematic OPRM use.

Interpretation: Subjective perceptions significantly related to problematic OPRM use, independent of socioeconomic circumstances, were examined in this study. While previous research based on administrative health data has contributed much to knowledge about factors associated with opioid harms, modelled results revealed that self-reported experiential factors also warrant consideration as they are significantly associated with problematic use. Having fair or poor mental health, having unmet perceived needs for help, and being unattached in terms of household arrangement relationship were related to problematic use of OPRMs, even after adjustment for socioeconomic and other health covariates. This study suggests risk profiles that could be used to inform health care providers, and strategies to support safe pain management.