(P-461) Prescription Opioid Use in Australian Women of Reproductive Age from 2013 to 2020

Background: Opioid use increased almost four-fold between 1990 and 2014 in Australia. Understanding patterns of opioid use among women of reproductive age is important given these increasing rates and emerging data questioning the safety of opioids during pregnancy.

Objectives: To estimate the prevalence and incidence of prescription opioid use in women of reproductive age (15-44 years) in Australia.

Methods: We conducted a retrospective cross-sectional study using the nationally representative 10% sample of pharmaceutical claims data to identify Australian women aged 15 to 44 years who were dispensed at least one opioid analgesic between January 2013 and July 2012 through the Pharmaceutical Benefits Scheme (PBS). Opioids indicated for the treatment of opioid use disorder are not captured in the 10% PBS sample. We measured annual prevalence (≥1 opioid dispensed) and incidence (≥1 opioid dispensed with no opioid dispensing for prior 12 months) per 100 (%) population overall and by opioid strength, type and age group.

Results: The annual prevalence of opioid dispensing in Australian women aged 15 to 44 years remained relatively unchanged (12.8%-13.2%) between 2013 and 2020. Codeine combination (50.3% of total opioid use), oxycodone (25.4%), and tramadol (13.4%) were the most common opioids dispensed. Weaker opioids and strong opioids accounted for 59.0% and 41.0%, respectively, of opioids dispensed. The prevalence of weaker opioids dispensed decreased across the study period (10.7%-9.6%) whereas dispensing of strong opioids increased (3.7%-5.0%). The prevalence of opioid use increased with women’s age: 7.5% among women aged 15-19 years and 15.9% among those aged 40-44 years. In 2014, the incidence of opioid use was 10.3%, decreasing to 8.1% in 2020. The decrease in incidence was driven by a decrease in the initiation of weaker opioids.

Conclusions: The prevalence of opioid use in Australia among women of reproductive age remained unchanged in 2012 to 2020, while the incidence decreased slightly decreased. This may reflect the strong tightened prescribing restrictions introduced for analgesic opioids Australia during the this period. Although there was a decrease in the dispensing of weaker opioids, the use of strong opioids is increasing.