Opioid deaths among young adults on the rise

Gomes

Rates of opioid overdose in Ontario, Canada, have increased more than 3-fold over the past 2 decades, according to a study online in Addiction. Furthermore, deaths are clustered among younger Ontarians; in 2010, 1 in 8 deaths among those aged 25 to 34 years were related to opioids.

“We have seen in past studies that individuals who die of opioid-related causes in North America are often young-with the mean age in studies often ranging between 40 and 50 years,” said Tara Gomes, MHSc, of St. Michael's Hospital in Toronto. “However, no one has studied how these deaths are clustered in different age groups, and the burden of this early loss of life has not been estimated.”

Gomes and colleagues abstracted all deaths (5,935) in Ontario between January 1991 and December 2010 related to drugs and alcohol from the Office of the Chief Coroner to determine the number and rate of deaths in Ontario related to opioid overdose.

“We investigated the patient characteristics of those who died of an opioid overdose, specifically measuring the burden of premature death due to this early loss of life by calculating the years of potential life lost,” she said.

Furthermore, the substantial impact of this early loss of life was surprising, according to Gomes. In 2010, 21,927 years of life lost were attributable to opioid-related death, which is more than that attributable to alcohol use disorders, pneumonia, or influenza.

“These findings highlight the pervasiveness of the issue of opioid misuse and overdose in Ontario and suggests that this doesn’t seem to be abating,” Gomes said. “Decision-makers should consider what can be done in their facilities to ensure that these drugs are being prescribed in an appropriate manner, to ensure the safety of their patients.”

Several policies have been put in place in Ontario to try to address inappropriate opioid use and to ensure the safety of patients who are prescribed these drugs.

“However, the environment is constantly shifting with new formulations [eg, tamper-deterrent formulations] and generic versions of opioids being released, driving shifts in patterns of opioid misuse and abuse,” Gomes said. “Formulary managers need to continue to work with the various stakeholders involved in this issue-including prescribers, patients, and manufacturers-to develop policies and tools that will address new, emerging issues.”

This study clearly demonstrates that the overuse of opioids is having devastating impacts on young adults and their families across Ontario, according to the researchers.

“It is likely that these findings further extend to other provinces in Canada where we have seen similar patterns of high opioid use,” Gomes said. “Prescribers, pharmacists, policy-makers and patients need to work together to ensure that patients who truly need these drugs to treat severe pain are still able to access them, while others are not put at undue risk of harm.”