Correlations between prescription opioid analgesic dispensing levels and related mortality and morbidity in Ontario, Canada, 2005-2011

Introduction and Aims Prescription opioid analgesic (POA)‐related harms constitute a major public health problem in North America. Ontario features above‐average POA use levels in Canada and has seen consistent increases in related mortality and morbidity. Recent studies documented strong correlatio...

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Bibliographic Details
Published in:Drug and alcohol review 2014-01, Vol.33 (1), p.19-26
Main Authors: Fischer, Benedikt, Jones, Wayne, Urbanoski, Karen, Skinner, Roger, Rehm, Jürgen
Format: Article
Language:English
Subjects:
Analgesics, Opioid - adverse effects
Canada
Caseloads
Consumption
Dosage
Drug abuse
Drug Overdose - mortality
Drug Utilization - statistics & numerical data
Drug Utilization - trends
Health problems
Humans
Hydromorphone
Jurisdiction
Morbidity
Morphine
Mortality
Narcotics
Ontario - epidemiology
Opioid-Related Disorders - epidemiology
Opioid-Related Disorders - mortality
Opioids
population health
Prescription Drugs - adverse effects
Prescription Drugs - supply & distribution
prescription opioid
Public health
Substance abuse
Substance abuse treatment
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Summary:Introduction and Aims Prescription opioid analgesic (POA)‐related harms constitute a major public health problem in North America. Ontario features above‐average POA use levels in Canada and has seen consistent increases in related mortality and morbidity. Recent studies documented strong correlations between POA dispensing levels and related harm outcomes on population levels. We examined correlations between POA dispensing and key POA‐related mortality and morbidity indicators in Ontario, 2005–2011. Design and Methods Correlations between (i) annual dispensing levels of four strong POA formulations (fentanyl, hydromorphone, morphine and oxycodone; from IMS Brogan's Compuscript converted to defined daily doses) and POA‐related mortality (based on provincial coroner's data) and (ii) annual total POA dispensing and POA‐related treatment caseload (from the Drug and Alcohol Treatment Information System) were examined for the study context. Results Strong and significant correlations were observed between POA dispensing and mortality for three formulations, namely hydromorphone: 0.98 [95% confidence interval (CI) 0.89–1.00; P 
ISSN:0959-5236
1465-3362
DOI:10.1111/dar.12089