Deaths from opioid use in Ontario, Canada, have doubled since 1991 and the addition of long-acting oxycodone to the drug formulary was associated with a 5-fold increase in oxycodone-related deaths, found a new study in CMAJ (Canadian Medical Association Journal). Most of these additional deaths were accidental.
Opioids are among the most commonly prescribed medications in Canada and are often used for patients with chronic non-malignant pain. Other studies have argued that prescribing is not a major contributor to the adverse health effects of opioid abuse, yet this study suggests that increased rates of opioid prescriptions are a significant factor in accidental opioid-related deaths.
The study looked at prescribing data from 1991 to 2007 from IMS Health Canada, which collects information from almost two-thirds of Canadian pharmacies, and deaths attributed to opioid use from records of the Office of the Chief Coroner of Ontario between 1991 and 2004. It also linked the coroner’s data to health care databases to track patients’ medical visits.
Prescriptions for opioid pain medications increased by 29%, with codeine the most frequently prescribed, although the number of prescriptions for that drug declined during the study period. Oxycodone prescriptions rose more than 850%, much more rapidly than any other opioid, and accounted for 32% of the almost 7.2 million prescriptions for opioids dispensed in 2006.