Substance Use
Venous thromboembolism among people with opioid use disorder: a retrospective data linkage study Myanca Rodrigues* Myanca Rodrigues Keerat Grewal Glenda Babe Tea Rosic Brittany B. Dennis Richard Perez Lehana Thabane Claire de Oliveira Zainab Samaan Kerstin de Wit Sameer Parpia
Background:
Research in other jurisdictions has demonstrated a higher incidence of venous thromboembolism (VTE) in people with opioid use disorder (OUD) compared to controls. Other studies have found that more males than females are at risk of thrombosis. However, there is a paucity of evidence in examining VTE among people with OUD in Canada, with no study conducted in Ontario to date.
Objective:
Our primary aim was to determine the prevalence of VTE among people receiving treatment for OUD over an eight-year period in Ontario, Canada. We also assessed whether there were sex-specific differences in VTE.
Methods:
We linked observational cohort data collected from 3,430 people receiving treatment for OUD between 2011 and 2021 in Ontario, Canada to health administrative databases for individuals enrolled in Ontario’s public health insurance program. Commencing on the day of cohort enrolment, we included health records five years prior to study entry, and three years post-recruitment. Our primary outcome was overall prevalence of VTE over the eight-year period, which we identified using ICD-10-CA diagnostic codes and the diagnostic codes of physician billing claims. A Poisson regression model with VTE as the dependent variable was used to explore the association between sex and thrombosis.
Results:
The prevalence of VTE over the eight-year period was 4.8% (n=166, 95% confidence interval (CI)=4.1,5.6%). We did not find an association between sex and VTE (Prevalence Ratio=0.85, 95%CI-0.63,1.14), with a similar prevalence of thrombosis among both males (n=86/1916, 4.5%) and females (n=80/1514, 5.3%).
Limitations:
Since we lack a control group, we are unable to infer the incidence of VTE among this clinical population.
Conclusions:
The prevalence of VTE is high among people with OUD in Ontario, with both males and females susceptible to thrombosis. Clinicians responsible for the care of people with OUD should consider the impact of VTE on treatment course.