Trends in Rates of Opioid Agonist Treatment and Opioid-Related Deaths for Youths in Ontario, Canada, 2013-2021

Abstract

ImportanceData suggest that the opioid crisis in North America has recently been reflected in opioid-related mortality among youths. Despite recommendation for its use, youths encounter barriers to accessing OAT, including stigma, burden of witnessed dosing, and lack of availability of youth-oriented services and prescribers comfortable treating this population.ObjectiveTo compare rates of opioid agonist treatment (OAT) and opioid-related mortality between youths aged 15 to 24 years and adults aged 25 to 44 years in Ontario, Canada, over time.Design, Setting, and ParticipantsThis cross-sectional analysis of rates of OAT and opioid-related deaths between 2013 and 2021 used data obtained from the Ontario Drug Policy Research Network, Public Health Ontario, and Statistics Canada. Individuals included in the analysis were aged 15 to 44 years and residing in Ontario, the most populous province in Canada.ExposuresYouths aged 15 to 24 years compared with adults aged 25 to 44 years.Main Outcomes and MeasuresOAT (methadone, buprenorphine, and slow-release oral morphine) per 1000 population and opioid-related deaths per 100 000 population.ResultsBetween 2013 and 2021, 1021 youths aged 15 to 24 years died from opioid toxicity; 710 were male (69.5%). In the final year of the study period, 225 youths (146 male [64.9%]) died from opioid toxicity, and 2717 (1494 male [55.0%]) were dispensed OAT. Over the study period, the rate of opioid-related deaths among youths in Ontario increased 369.2% from 2.6 to 12.2 per 100 000 population (48 to 225 total deaths) and the rate of OAT use decreased 55.9% from 3.4 to 1.5 per 1000 (6236 to 2717 individuals). For adults aged 25 to 44 years, the rate of opioid-related deaths increased 371.8% from 7.8 to 36.8 per 100 000 (283 to 1502 deaths), and the rate of OAT increased 27.8% from 7.9 to 10.1 per 1000 population (28 667 to 41 200 individuals). Trends for youths and adults persisted across both sexes.Conclusions and RelevanceThe findings of this study suggest that opioid-related deaths are increasing among youths while OAT use is paradoxically declining. The reasons for these observed trends require further investigation, including a consideration of changing trends in opioid use and opioid use disorder among youths, barriers to OAT, and opportunities to optimize care and reduce harms for youths who use substances.

Improving Substance Use Disorder Treatment Training in Medical School

“…Many physicians and medical students are not aware that there are effective treatments for SUD and that the patients are not a "lost cause". It is mind-boggling that less than 25% of individuals with OUD are enrolled in evidence-based opiate agonist therapy (OAT) [4].…”

Lower Opioid Prescription Quantity Does Not Negatively Impact Pain Control or Patient Satisfaction After ACL Reconstruction

“…Orthopaedic surgeons frequently overprescribe opioid medications, even in the adolescent and young adult population, which can be saved by patients and thus can be at high risk for later misuse or diversion 2-7 . A cross-sectional analysis of public health data from Ontario, Canada, found that a youth population <25 years of age experienced a 369.2% increase in opioid-related deaths from 2013 to 2021 8 and male patients of this age were at especially high risk for opioid use disorder and overdose 9 . Despite these risks, recent reports have suggested that surgeons are biased toward providing patients of this demographic group with a higher-quantity postoperative prescription 10 .…”