Contributions of prescribed and non-prescribed opioids to opioid related deaths: population based cohort study in Ontario, Canada

AbstractObjectiveTo describe the contributions of prescribed and non-prescribed opioids to opioid related deaths.DesignPopulation based cohort study.SettingOntario, Canada, from 1 January 2013 to 31 December 2016.ParticipantsAll Ontarians who died of an opioid related cause.ExposureActive opioid pre...

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Bibliographic Details
Published in:BMJ (Online) 2018-08, Vol.362, p.k3207
Main Authors: Gomes, Tara, Khuu, Wayne, Martins, Diana, Tadrous, Mina, Mamdani, Muhammad M, Paterson, J Michael, Juurlink, David N
Format: Article
Language:English
Subjects:
Adult
Aged
Analgesics, Opioid - adverse effects
Autopsy
Cause of Death
Cohort analysis
Cohort Studies
Death
Drug overdose
Drug Overdose - mortality
Fatalities
Female
Fentanyl
Health Services Research
Humans
Male
Middle Aged
Mortality
Narcotics
Ontario - epidemiology
Opioid-Related Disorders - mortality
Opioids
Policy Making
Population studies
Population-based studies
Practice Patterns, Physicians' - statistics & numerical data
Prescription drugs
Prescription Drugs - adverse effects
Prevalence
Young Adult
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Summary:AbstractObjectiveTo describe the contributions of prescribed and non-prescribed opioids to opioid related deaths.DesignPopulation based cohort study.SettingOntario, Canada, from 1 January 2013 to 31 December 2016.ParticipantsAll Ontarians who died of an opioid related cause.ExposureActive opioid prescriptions, defined as those with a duration overlapping the date of death, and recent opioid prescriptions, defined as those dispensed in the 30 and 180 days preceding death. Postmortem toxicology results from the Drug and Drug/Alcohol Related Death database were used to characterise deaths on the basis of presence of prescribed and non-prescribed (that is, diverted or illicit) opioids, overall and stratified by year and age.Results2833 opioid related deaths occurred. An active opioid prescription on the date of death was relatively common but declined slightly throughout the study period (38.2% (241/631) in 2013 and 32.5% (278/855) in 2016; P for trend=0.03). Older people and women were relatively more likely to have an active opioid prescription at time of death. In 2016, 46% (169/364) of people aged 45-64 had an active opioid prescription compared with only 12% (8/69) among those aged 24 or younger (P for trend
ISSN:0959-8138
1756-1833
DOI:10.1136/bmj.k3207