1 40 1 Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Citation List Month Backlog URL Address <a href="http://doi.org/10.1503/cmaj.090784" target="_blank" rel="noreferrer">http://doi.org/10.1503/cmaj.090784</a> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Prescribing of opioid analgesics and related mortality before and after the introduction of long-acting oxycodone Publisher An entity responsible for making the resource available Canadian Medical Association Journal Date A point or period of time associated with an event in the lifecycle of the resource 2009 Subject The topic of the resource Humans; Analgesics; Ontario/epidemiology; Oxycodone/therapeutic use; Delivery of Health Care/utilization; Mortality/trends; Opioid/poisoning/therapeutic use; Poisoning/mortality/prevention & control; Prescription Drugs/poisoning/therapeutic use Creator An entity primarily responsible for making the resource Dhalla IA; Mamdani M; Sivilotti ML; Kopp A; Qureshi O; Juurlink DN Description An account of the resource INTRODUCTION: Opioid-related mortality appears to be increasing in Canada. We examined the true extent of the problem and the impact of the introduction of long-acting oxycodone. METHODS: We examined trends in the prescribing of opioid analgesics in the province of Ontario from 1991 to 2007. We reviewed all deaths related to opioid use between 1991 and 2004. We linked 3271 of these deaths to administrative data to examine the patients' use of health care services before death. Using time-series analysis, we determined whether the addition of long-acting oxycodone to the provincial drug formulary in January 2000 was associated with an increase in opioid-related mortality. RESULTS: From 1991 to 2007, annual prescriptions for opioids increased from 458 to 591 per 1000 individuals. Opioid-related deaths doubled, from 13.7 per million in 1991 to 27.2 per million in 2004. Prescriptions of oxycodone increased by 850% between 1991 and 2007. The addition of long-acting oxycodone to the drug formulary was associated with a 5-fold increase in oxycodone-related mortality (p<0.01) and a 41% increase in overall opioid-related mortality (p=0.02). The manner of death was deemed unintentional by the coroner in 54.2% and undetermined in 21.9% of cases. Use of health care services in the month before death was common: for example, of the 3066 patients for whom data on physician visits were available, 66.4% had visited a physician in the month before death; of the 1095 patients for whom individual-level prescribing data were available, 56.1% had filled a prescription for an opioid in the month before death. INTERPRETATION: Opioid-related deaths in Ontario have increased markedly since 1991. A significant portion of the increase was associated with the addition of long-acting oxycodone to the provincial drug formulary. Most of the deaths were deemed unintentional. The frequency of visits to a physician and prescriptions for opioids in the month before death suggests a missed opportunity for prevention. 2009 Identifier An unambiguous reference to the resource within a given context <a href="http://doi.org/10.1503/cmaj.090784" target="_blank" rel="noreferrer">10.1503/cmaj.090784</a> Rights Information about rights held in and over the resource Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s). Type The nature or genre of the resource Journal Article 2009 Analgesics Backlog Canadian Medical Association Journal Delivery of Health Care/utilization Dhalla IA Humans Journal Article Juurlink DN Kopp A Mamdani M Mortality/trends Ontario/epidemiology Opioid/poisoning/therapeutic use Oxycodone/therapeutic use Poisoning/mortality/prevention & control Prescription Drugs/poisoning/therapeutic use Qureshi O Sivilotti ML