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\begin{document}

\title{Defining opioid na\selectlanguage{ngerman}ïve and implications for monitoring opioid use: A
population-based study in Alberta, Canada\selectlanguage{english}}



\author[1]{Dean Eurich}%
\author[1]{Cerina Lee}%
\author[1]{Ming Ye}%
\author[1]{Olivia Weaver}%
\author[2]{Ed Jess}%
\author[2]{Fizza Gilani}%
\author[3]{Salim Samanani}%
\affil[1]{University of Alberta School of Public Health}%
\affil[2]{College of Physicians and Surgeons of Alberta}%
\affil[3]{OKAKI Health Intelligence Inc Calgary}%


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  \date{June 16, 2024}


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\selectlanguage{english}
\begin{abstract}
\textbf{Purpose:} Reducing initial exposure of ``opioid na\selectlanguage{ngerman}ïve'' patients
to opioids is a public health priority. Identifying opioid naïve
patients is difficult, as numerous definitions are used. The objective
is to summarize current definitions and evaluate their impact on opioid
naïve measures in Alberta. \textbf{Methods:} Using dispense data
(2017-2021) and definitions guided by a scoping review, we determined
the number of ``opioid naïve'' patients using descriptive analyses.
Three definitions were identified: 1) no opioid use within the previous
30 days/6 months/1 year, based on dispensation date; 2) definition 1,
based on dispensation date plus days of supply; 3) exclusion of codeine
from definitions 1 and 2. \textbf{Results:} Of over a dozen definitions
of opioid naïve identified in the scoping review, most used an `opioid
free' period (commonly 30 days/6 months/1 year). Other definitions
included ``availability of drug'' based on days of supply and/or
excluded certain opioid products. Approximately 36.4\% of Albertans
(n=1,551,075) had an opioid dispensation in 2017-2021. The average age
was 46.6±18.8 and 52.8\% were female. Results were most affected by the
``opioid free'' period, with 97.4\%, 83.2\% and 65.6\% being classified
as opioid naïve using time windows from definition 1. Definitions 2 and
3 did not materially change the results. \textbf{Conclusions:} The most
convenient definition for ``opioid naïve'' was definition 1 using a
1-year window, which aligns with the Canadian Institutes for Health
Information definition. Irrespective of definition used, a large
proportion of opioid users would be considered opioid naïve despite
initiatives to curb opioid prescription in Alberta.%
\end{abstract}\selectlanguage{ngerman}%



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