Polysubstance use poisoning deaths in Canada: an analysis of trends from 2014 to 2017 using mortality data.
Intentional poisoning
Opioid poisoning
Polysubstance mortality
Polysubstance use
Stimulants
Unintentional poisoning
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
10 02 2022
10 02 2022
Historique:
received:
26
08
2021
accepted:
13
01
2022
entrez:
11
2
2022
pubmed:
12
2
2022
medline:
20
4
2022
Statut:
epublish
Résumé
Over the past decade, rates of drug poisoning deaths have increased dramatically in Canada. Current evidence suggests that the non-medical use of synthetic opioids, stimulants and patterns of polysubstance use are major factors contributing to this increase. Counts of substance poisoning deaths involving alcohol, opioids, other central nervous system (CNS) depressants, cocaine, and CNS stimulants excluding cocaine, were acquired from the Canadian Vital Statistics Death Database (CVSD) for the years 2014 to 2017. We used joinpoint regression analysis and the Cochrane-Armitage trend test for proportions to examine changes over time in crude mortality rates and proportions of poisoning deaths involving more than one substance. Between 2014 and 2017, the rate of substance poisoning deaths in Canada almost doubled from 6.4 to 11.5 deaths per 100,000 population (Average Annual Percent Change, AAPC: 23%, p < 0.05). Our analysis shows this was due to increased unintentional poisoning deaths (AAPC: 26.6%, p < 0.05) and polysubstance deaths (AAPC: 23.0%, p < 0.05). The proportion of unintentional poisoning deaths involving polysubstance use increased significantly from 38% to 58% among males (p < 0.0001) and 40% to 55% among females (p < 0.0001). Polysubstance use poisonings involving opioids and CNS stimulants (excluding cocaine) increased substantially during the study period (males AAPC: 133.1%, p < 0.01; females AAPC: 118.1%, p < 0.05). Increases in substance-related poisoning deaths between 2014 and 2017 were associated with polysubstance use. Increased co-use of stimulants with opioids is a key factor contributing to the epidemic of opioid deaths in Canada.
Sections du résumé
BACKGROUND
Over the past decade, rates of drug poisoning deaths have increased dramatically in Canada. Current evidence suggests that the non-medical use of synthetic opioids, stimulants and patterns of polysubstance use are major factors contributing to this increase.
METHODS
Counts of substance poisoning deaths involving alcohol, opioids, other central nervous system (CNS) depressants, cocaine, and CNS stimulants excluding cocaine, were acquired from the Canadian Vital Statistics Death Database (CVSD) for the years 2014 to 2017. We used joinpoint regression analysis and the Cochrane-Armitage trend test for proportions to examine changes over time in crude mortality rates and proportions of poisoning deaths involving more than one substance.
RESULTS
Between 2014 and 2017, the rate of substance poisoning deaths in Canada almost doubled from 6.4 to 11.5 deaths per 100,000 population (Average Annual Percent Change, AAPC: 23%, p < 0.05). Our analysis shows this was due to increased unintentional poisoning deaths (AAPC: 26.6%, p < 0.05) and polysubstance deaths (AAPC: 23.0%, p < 0.05). The proportion of unintentional poisoning deaths involving polysubstance use increased significantly from 38% to 58% among males (p < 0.0001) and 40% to 55% among females (p < 0.0001). Polysubstance use poisonings involving opioids and CNS stimulants (excluding cocaine) increased substantially during the study period (males AAPC: 133.1%, p < 0.01; females AAPC: 118.1%, p < 0.05).
CONCLUSIONS
Increases in substance-related poisoning deaths between 2014 and 2017 were associated with polysubstance use. Increased co-use of stimulants with opioids is a key factor contributing to the epidemic of opioid deaths in Canada.
Identifiants
pubmed: 35144586
doi: 10.1186/s12889-022-12678-z
pii: 10.1186/s12889-022-12678-z
pmc: PMC8830122
doi:
Substances chimiques
Analgesics, Opioid
0
Central Nervous System Stimulants
0
Cocaine
I5Y540LHVR
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
269Informations de copyright
© 2022. The Author(s).
Références
Drug Alcohol Depend. 2019 Nov 1;204:107556
pubmed: 31546120
Hum Psychopharmacol. 2017 Sep;32(5):
pubmed: 28750478
Addict Behav. 2018 Nov;86:66-72
pubmed: 29198490
Am J Public Health. 2017 Mar;107(3):430-432
pubmed: 28177817
MMWR Morb Mortal Wkly Rep. 2019 May 03;68(17):388-395
pubmed: 31048676
Harm Reduct J. 2018 Jul 5;15(1):34
pubmed: 29976195
PLoS One. 2014 Aug 11;9(8):e101604
pubmed: 25111292
Int J Drug Policy. 2021 Dec;98:103400
pubmed: 34469781
Int J Drug Policy. 2013 Mar;24(2):142-9
pubmed: 23182550
Int J Drug Policy. 2020 Sep;83:102864
pubmed: 32702611
Drug Alcohol Depend. 2019 May 1;198:28-33
pubmed: 30877954
Ann Epidemiol. 2020 Jan;41:43-48.e1
pubmed: 31928897
Natl Vital Stat Rep. 2018 Dec;67(9):1-14
pubmed: 30707673
Drug Alcohol Depend. 2018 Dec 1;193:14-20
pubmed: 30326396
Subst Use Misuse. 2017 Jul 3;52(8):1051-1058
pubmed: 28323507
Int J Drug Policy. 2020 Mar;77:102665
pubmed: 31962283
Int J Drug Policy. 2019 Apr;66:64-72
pubmed: 30708237
Drug Alcohol Depend. 2020 Sep 1;214:108148
pubmed: 32702620
MMWR Morb Mortal Wkly Rep. 2019 Aug 30;68(34):737-744
pubmed: 31465320
Addict Behav. 2020 Aug;107:106400
pubmed: 32222564
Harm Reduct J. 2020 Jan 10;17(1):6
pubmed: 31924209
Subst Abus. 2018;39(3):266-270
pubmed: 28991520
Can J Public Health. 2019 Apr;110(2):210-215
pubmed: 30725386
Epidemiol Rev. 2020 Jan 31;42(1):154-166
pubmed: 33511987
Stat Med. 2000 Feb 15;19(3):335-51
pubmed: 10649300
Psychother Psychosom. 2017;86(5):268-282
pubmed: 28903117
Clin Toxicol (Phila). 2020 Jun;58(6):460-465
pubmed: 31475588
Health Promot Chronic Dis Prev Can. 2018 Jun;38(6):224-233
pubmed: 29911818
SSM Popul Health. 2017 Jan 31;3:219-226
pubmed: 29349219
Am J Public Health. 2020 Feb;110(2):244-250
pubmed: 31855487
Inj Prev. 2021 Apr;27(2):194-200
pubmed: 32220934
Drug Alcohol Depend. 2019 Dec 1;205:107671
pubmed: 31706248
Drug Alcohol Depend. 2019 Dec 1;205:107656
pubmed: 31706247
Curr Opin Psychiatry. 2014 Jul;27(4):269-75
pubmed: 24852056
Drug Alcohol Depend. 2019 Jul 1;200:59-63
pubmed: 31100636
Clin Toxicol (Phila). 2015;53(10):962-1147
pubmed: 26624241
Mol Psychiatry. 2021 Jan;26(1):41-50
pubmed: 33188253
Harm Reduct J. 2020 May 12;17(1):29
pubmed: 32398090
MMWR Morb Mortal Wkly Rep. 2015 Jan 9;63(53):1238-42
pubmed: 25577989
Drug Alcohol Depend. 2020 Jul 1;212:108028
pubmed: 32370933
Am J Public Health. 2014 Aug;104(8):e32-42
pubmed: 24922138
Natl Vital Stat Rep. 2016 Dec;65(10):1-15
pubmed: 27996932
Subst Use Misuse. 2005;40(9-10):1525-37
pubmed: 16048831