Opioid Dispensing Remains Common After Hip Fracture in Older Ontario Adults

A retrospective cohort study published in the Journal of the American Geriatrics Society examined opioid and benzodiazepine dispensing among 114,055 Ontario residents aged 66 years or older admitted for acute hip fracture between April 2008 and March 2024. Researchers used linked ICES administrative data and included patients who survived at least 275 days in the following year. The primary outcome was at least one opioid or benzodiazepine prescription dispensed within 365 days after discharge; secondary outcomes included prehospitalization dispensing, concurrent dispensing, and morphine-equivalent dose.

Benzodiazepine dispensing declined from 33.7% in 2008 to 13.3% in 2024. Opioid dispensing peaked at 55.8% in 2015 before declining to 44.6% in 2024. Concurrent opioid and benzodiazepine dispensing after hip fracture decreased from 3.7% to 1.0% over the study period. Among patients with 90 days of continuous opioid dispensing, most received an average daily dose below 50 mg morphine equivalents.

The findings highlight continued opioid exposure during post-fracture care despite declining benzodiazepine and concurrent dispensing. The authors call for research on initiatives to reduce opioid use while recognizing its role in effective pain control. Dispensing records do not establish medication consumption or prescribing appropriateness, and the survival requirement limits applicability to patients who die earlier. Only the abstract was available; it does not report whether these trends were associated with changes in pain, falls, dependence, or mortality.