Trends in toxicological findings in unintentional opioid or stimulant toxicity deaths in Québec, Canada, 2012-2021: Has Québec entered a new era of drug-related deaths?

Autor: Do U; Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Canada., Perron PA; Bureau du coroner, Montréal, Canada., Bruneau J; Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Canada.; Department of Family Medicine and Emergency Medicine, Faculty of Medicine, University of Montréal, Montréal, Canada., Larney S; Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Canada.; Department of Family Medicine and Emergency Medicine, Faculty of Medicine, University of Montréal, Montréal, Canada.
Jazyk: angličtina
Zdroj: Drug and alcohol review [Drug Alcohol Rev] 2024 Sep; Vol. 43 (6), pp. 1613-1624. Date of Electronic Publication: 2024 Aug 06.
DOI: 10.1111/dar.13918
Abstrakt: Introduction: We aimed to describe rates and toxicological findings of unintentional opioid and stimulant toxicity deaths, 2012-2021.
Methods: The dataset included accidental deaths determined by the Coroner to be due to opioids or stimulants. We calculated annual crude mortality rates and described combinations of drugs identified in toxicological examinations of these deaths. We described temporal trends in the detection of specific opioids, stimulants, benzodiazepines (including novel benzodiazepines), gabapentinoids and z-drugs in deaths due to opioids and stimulants.
Results: Mortality rates increased over time, reaching their peak in 2020 and remaining high in 2021. In deaths due to opioids, there was a decline in the proportion of deaths involving pharmaceutical opioids after 2019, and a corresponding increase in the proportion of deaths with fentanyl detected. Benzodiazepines were often present in deaths due to opioids, with novel benzodiazepines increasing rapidly from 2019 onwards. Cocaine was the most frequently detected drug in deaths due to stimulants, but amphetamine/methamphetamine was detected in around half of all stimulant deaths from 2016 onwards.
Discussion and Conclusions: Despite availability of a multitude of overdose prevention interventions, mortality rates due to drug toxicity have increased in Québec. Toxicological findings of these deaths suggest concerning shifts in the illicit drug market, with Québec potentially having entered a new era of elevated overdose mortality. Intervention scale-up is essential, but unlikely to be sufficient, to reduce drug-related mortality. Policy reform to address the root causes of drug toxicity deaths, including an unpredictable drug supply, strained health systems and socio-economic precarity, is essential.
(© 2024 The Author(s). Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.)
Databáze: MEDLINE
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