Characteristics of Opioid-Users Whose Death Was Related to Opioid-Toxicity: A Population-Based Study in Ontario, Canada
Open Access
- 5 April 2013
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 8 (4), e60600
- https://doi.org/10.1371/journal.pone.0060600
Abstract
The impact of the prescription opioid public health crisis has been illustrated by the dramatic increase in opioid-related deaths in North America. We aimed to identify patterns and characteristics amongst opioid-users whose cause of death was related to opioid toxicity. This was a population-based study of Ontarians between the years 2006 and 2008. All drug-related deaths which occurred during this time frame were reviewed at the Office of the Chief Coroner of Ontario, and opioid-related deaths were identified. Medical, toxicology, pathology, and police reports were comprehensively reviewed. Narratives, semi-quantitative, and quantitative variables were extracted, tabulated, and analyzed. Out of 2330 drug-related deaths in Ontario, 58% were attributed either in whole or in part, to opioids (n = 1359). Oxycodone was involved in approximately one-third of all opioid-related deaths. At least 7% of the entire cohort used opioids that were prescribed for friends and/or family, 19% inappropriately self-administered opioids (injection, inhalation, chewed patch), 3% were recently released from jail, and 5% had been switched from one opioid to another near the time of death. Accidental deaths were significantly associated with personal history of substance abuse, enrollment in methadone maintenance programs, cirrhosis, hepatitis, and cocaine use. Suicides were significantly associated with mental illness, previous suicide attempts, chronic pain, and a history of cancer. These results identify novel, susceptible groups of opioid-users whose cause of death was related to opioids in Ontario and provide the first evidence to assist in quantifying the contribution of opioid misuse and diversion amongst opioid-related mortality in Canada. Multifaceted prevention strategies need to be developed based on subpopulations of opioid users.Keywords
This publication has 26 references indexed in Scilit:
- Medically induced opioid addiction reaching alarming levelsCMAJ : Canadian Medical Association Journal, 2012
- Use of other opioids during methadone therapy: a population‐based studyAddiction, 2011
- Medicine and the Epidemic of Incarceration in the United StatesNew England Journal of Medicine, 2011
- Long-term opioid management for chronic noncancer painCochrane Database of Systematic Reviews, 2010
- Deaths related to the use of prescription opioidsCMAJ : Canadian Medical Association Journal, 2009
- Prescribing of opioid analgesics and related mortality before and after the introduction of long-acting oxycodoneCMAJ : Canadian Medical Association Journal, 2009
- Oral Abuse of Fentanyl Patches (Duragesic®): Seven Case ReportsJournal of Forensic Sciences, 2008
- Long-term opioid management for chronic noncancer painPublished by Wiley ,2007
- Release from Prison — A High Risk of Death for Former InmatesNew England Journal of Medicine, 2007
- Predicting Aberrant Behaviors in Opioid-Treated Patients: Preliminary Validation of the Opioid Risk ToolPain Medicine, 2005