Comparing the contribution of prescribed opioids to opioid-related hospitalizations across Canada: A multi-jurisdictional cross-sectional study

Abstract

There remains an important ongoing contribution of prescribed opioids to overdoses across Canada, but non-prescribed opioids play a growing role, particularly in BC. These findings underscore the importance of more judicious opioid prescribing, harm reduction programs, and improved access to addiction care for people with an opioid use disorder.

Examining correlations between opioid dispensing and opioid-related hospitalizations in Canada, 2007 - 2016

“…In this context, we note that signi cant (including borderline) correlations between opioid dispensing and hospitalizations were found speci cally in four of the ve Canadian provinces (PEI, NS, QC, NB, SK) reporting the lowest levels of contribution (<25%) of (mostly illicit) fentanyl or fentanylanalogue product involvement among opioid-related mortality in 2017 (i.e., 'low contamination' provinces); conversely, no correlations were observed in the provinces (MN, ON, AB, BC) with fentanyl products identi ed as a contributor to mortality in the majority (>50%) of fatalities in 2017 (i.e., 'high contamination' provinces; [7,8,41]). Similarly differential -but consistent with our results -patterns of illicit opioid involvement in opioid-related hospitalizations have been shown in individual-based analyses in select provinces [45]. These -rather consistent -differentiation patterns in our ecological study results allow to plausibly speculate that, in the absence of illicit opioid-related 'contamination' effects, the strength of province-based correlation signals between opioid dispensing and hospitalizations likely would have been more pronounced.…”

Examining correlations between opioid dispensing and opioid-related hospitalizations in Canada, 2007–2016

“…In this context, we note that significant (including borderline) correlations between opioid dispensing and hospitalizations were found specifically in four of the five Canadian provinces (PEI, NS, QC, NB, SK) reporting the lowest levels of contributions (< 25%) of (mostly illicit) fentanyl or fentanyl-analogue product involvement among opioid-related mortality in 2017 (i.e., ‘low contamination’ provinces); conversely, no correlations were observed in the provinces (MN, ON, AB, BC) with fentanyl products identified as a contributor to mortality in the majority (> 50%) of fatalities in 2017 (i.e., ‘high contamination’ provinces [ 7 , 8 , 41 ];). Similarly differential – but consistent with our results – patterns of illicit opioid involvement in opioid-related hospitalizations have been shown in analyses for select individual provinces [ 45 ]. These – rather consistent – differentiation patterns in our ecological study results allow to plausibly speculate that, in the absence of illicit opioid-related ‘contamination’ effects, the strength of province-based correlation signals between opioid dispensing and hospitalizations likely would have been more pronounced.…”

Examining correlations between opioid dispensing and opioid-related hospitalizations in Canada, 2007 - 2016

“…In this context, we note that significant (including borderline) correlations between opioid dispensing and hospitalizations were found specifically in four of the five Canadian provinces (PEI, NS, QC, NB, SK) reporting the lowest levels of contribution (<25%) of (mostly illicit) fentanyl or fentanyl-analogue product involvement among opioid-related mortality in 2017 (i.e., 'low contamination' provinces); conversely, no correlations were observed in the provinces (MN, ON, AB, BC) with fentanyl products identified as a contributor to mortality in the majority (>50%) of fatalities in 2017 (i.e., 'high contamination' provinces; [7,8,41]). Similarly differential -but consistent with our results -patterns of illicit opioid involvement in opioid-related hospitalizations have been shown in individual-based analyses in select provinces [45]. These -rather consistent -differentiation patterns in our ecological study results allow to plausibly speculate that, in the absence of illicit opioid-related 'contamination' effects, the strength of province-based correlation signals between opioid dispensing and hospitalizations likely would have been more pronounced.…”