Recent trends in heroin and pharmaceutical opioid-related harms in Victoria, Australia up to 2018.
Abuse-Deterrent Formulations
Adolescent
Adult
Aged
Analgesics, Opioid
/ poisoning
Child
Emergency Medical Services
/ trends
Female
Heroin
/ poisoning
Humans
Interrupted Time Series Analysis
Male
Middle Aged
Morbidity
/ trends
Opiate Overdose
/ epidemiology
Oxycodone
/ administration & dosage
Prescription Drug Misuse
/ trends
Victoria
/ epidemiology
Young Adult
abuse deterrent formulations
heroin
opioid
opioid trends
oxycodone
oxycodone re-formulation
Journal
Addiction (Abingdon, England)
ISSN: 1360-0443
Titre abrégé: Addiction
Pays: England
ID NLM: 9304118
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
received:
18
03
2019
revised:
20
06
2019
accepted:
08
08
2019
pubmed:
30
8
2019
medline:
20
1
2021
entrez:
30
8
2019
Statut:
ppublish
Résumé
To characterize the trajectory in the years leading up to 2018 in pharmaceutical opioid and heroin morbidity in Victoria, Australia, and to assess the effect on that trajectory of reformulation of oxycodone to a form that could not be easily snorted or injected. Interrupted time-series analyses of population-level data before versus after reformulation of oxycodone, stratified by sex. Victoria, Australia. The population of Victoria aged 12+ years. Ambulance patient care and emergency department (ED) records were examined using both fixed-code and free-text fields, with each record manually cleaned and checked by trained coders. These were used to derive the output variables providing an index of harm: rates of opioid-related ambulance attendances and ED attendances for pharmaceutical opioids and heroin. The input variable was pre- versus post-oxycodone reformulation. There were 30 045 opioid-related ambulance attendances from January 2012 to October 2018 (54% heroin-related), and 10 113 ED attendances from July 2008 to June 2018 (39% heroin-related). There was an increase in the rate (events per 100 000 people per year) of all opioid ED attendances from 2008 to 2018 [increase = 0.063; 95% confidence interval (CI) = 0.049, 0.078]. Pharmaceutical opioid ED attendances decreased from 2014 onwards (slope change = -0.083; 95% CI = -0.108, -0.059). Heroin-related ED attendances increased from 2014 to 2018; 11 324 heroin-related ambulance attendances and 1980 ED attendances were observed from April 2014 to June 2018, compared with the respective estimates of 8176, and 1661 had the pre-April 2014 trend continued (ambulance slope change = 0.296, 95% CI = 0.104, 0.489; ED slope change = 0.026, 95% CI = 0.005, 0.046). The inflection point of 2014 coincided with the re-formulation of oxycodone. In Victoria, Australia, there appears to have been a trend starting around mid-2014 of increasing heroin-related harm, and a flattening of the increase or a decrease of harms relating to pharmaceutical opioids. These changes may, in part, reflect reformulation of oxycodone to reduce the extent to which it can be injected or snorted.
Substances chimiques
Abuse-Deterrent Formulations
0
Analgesics, Opioid
0
Heroin
70D95007SX
Oxycodone
CD35PMG570
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
261-269Subventions
Organisme : Faculty of Medicine, Nursing and Health Sciences, Monash University
Pays : International
Informations de copyright
© 2019 Society for the Study of Addiction.
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