Postpartum prescriptions for oxycodone were not associated with an increased risk of longer-term opioid use compared to codeine prescriptions, according to new research published in CMAJ (Canadian Medical Association Journal)
Over the last 10 years, there has been a shift to fewer codeine prescriptions and an increase in prescriptions for stronger opioids, such as hydrocodone, hydromorphone and oxycodone for patients postpartum.
To understand whether this emphasis on more potent opioid prescribing is linked to persistent opioid use after giving birth, researchers looked at data on 70,607 individuals who filled an opioid prescription after discharge from an Ontario hospital between 2012 and 2020. More than two-thirds, 49,299 (70%), received oxycodone and 21,308 (30%) received codeine. The majority (56,485 [80%]) had cesarean deliveries.
In secondary analyses, the researchers found a 60% increase in the risk of persistent opioid use among people prescribed oxycodone compared with codeine after vaginal delivery, but no such association for those who delivered by cesarean. This finding warrants further research to explore why those who deliver vaginally may be at greater risk of using opioids longer term following oxycodone use after delivery. Higher dosages and longer prescription duration were also associated with an increased risk of persistent opioid use.