HealthDay News — Initiation of oxycodone vs codeine is not associated with an increased risk for persistent opioid use after delivery overall, but increased risk is seen after vaginal delivery, according to a study published online July 31 in CMAJ, the journal of the Canadian Medical Association.

Jonathan S. Zipursky, MD, PhD, from the Sunnybrook Health Sciences Centre in Toronto, and colleagues conducted a population-based cohort study involving people who filled a prescription for codeine or oxycodone within 7 days of hospital discharge after delivery between September 1, 2012, and June 30, 2020. The primary outcome was persistent opioid use, for which the risk was compared for those who initiated oxycodone vs codeine.

A total of 70,607 people who filled an opioid prescription within 7 days of discharge were identified during the 8-year study period: 21,308 and 49,299 (30.2% and 69.8%) received codeine and oxycodone, respectively. Receipt of oxycodone was not associated with persistent opioid use compared with receipt of codeine (relative risk, 1.04; 95% confidence interval, 0.91 to 1.20). After vaginal delivery, there was an association noted between oxycodone and persistent use (relative risk, 1.63; 95% confidence interval, 1.31 to 2.03), but this was not seen after cesarean delivery (relative risk, 0.85; 95% confidence interval, 0.73 to 1.00).

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“Awareness of these factors and others related to persistent use may help clinicians tailor opioid prescribing while ensuring adequate analgesia after delivery,” the authors write.

Several authors disclosed ties to biopharmaceutical companies; several authors receive payment for expert testimony or providing medicolegal opinions relating to analgesics.

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