Prescriptions led to 1 in 3 opioid deaths in Ontario in 2016, study says

About a third of deaths caused by opioids in Ontario in 2016 were among people who had been prescribed the drugs, a study published Wednesday shows.

It’s a trend researchers expect will continue to decline — but not disappear — as the scourge of illicitly obtained fentanyl overdoses continues.

In the mid-1990s, Canadian doctors expanded their prescribing of opioids to people with moderate-to-severe pain rather than only people with terminal cancer. Those drugs could be diverted by people sharing or giving away medication, as well as being stolen and then sold illicitly on the street.

As opioid-related deaths climb in North America, researchers and policy makers have been searching for information on the role of prescribed versus non-prescribed opioids in the deaths.

The federal government says that as of June, a total of 3,987 apparent opioid-related deaths were reported in Canada in 2017. Of these, 92 per cent were accidental and mainly involved fentanyl or analogues such as carfentanil.

In a study published in Wednesday’s issue ot the British medical journal BMJ, researchers spell out the role of prescribed, diverted and illicit opioids to opioid-related deaths in Ontario.

They conducted the analysis by reviewing medical coroners’ charts for all deaths determined to be opioid-related in Ontario from 2013 to 2016. The study’s authors also reviewed billing records for physician services and information from the province’s narcotic monitoring database for drugs sold at community pharmacies.

Among the 2,833 opioid-related deaths in the study, one third, or 997, were among people who had an active opioid prescription at the time of their death.

“To me, given the conversation right now and how much of a focus there is on [illicit] fentanyl, I think some people might be surprised that one third of deaths still are occurring among people who are actively receiving prescription from their physician,” said study author Tara Gomes, a scientist at St. Michael’s Hospital in Toronto.