Characteristics of Opioid-Users Whose Death Was Related to Opioid-Toxicity

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Background

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.

Results

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.

Non-medical use of prescription opioids has culminated in a public health crisis in many North American jurisdictions. The impact of this crisis has been powerfully illustrated by the dramatic increase in opioid-related deaths [1]–[6]: in 2008, prescription opioids were involved in 14,800 accidental deaths in the United States [4]. That there has been a parallel increase in the consumption of prescription opioids and deaths related to opioid drugs is not in dispute......