@article{ref1,
title="Correlations between changes in medical opioid dispensing and contributions of fentanyl to opioid-related overdose fatalities: exploratory analyses from Canada",
journal="International journal of environmental research and public health",
year="2021",
author="Jones, Wayne and Lee, Min-Hye Angelica and Kaoser, Ridhwana and Fischer, Benedikt",
volume="18",
number="14",
pages="e7507-e7507",
abstract="Canada is experiencing an epidemic of opioid-related mortality, with increasing yet heterogeneous fatality patterns from illicit/synthetic (e.g., fentanyl) opioids. The present study examined whether differential provincial reductions in medical opioid dispensing following restrictive regulations (post-2010) were associated with differential contributions of fentanyl to opioid mortality. Annual provincial opioid dispensing totals in defined daily doses/1000 population/day, and change rates in opioid dispensing for the 10 provinces for (1) 2011-2018 and (2) &quot;peak-year&quot; to 2018 were derived from a pan-Canadian pharmacy-based dispensing panel. Provincial contribution rates of fentanyl to opioid-related mortality (2016-2019) were averaged. Correlation values (Pearson's R) between provincial changes in opioid dispensing and the relative fentanyl contributions to mortality were computed for the two scenarios. The correlation between province-based changes in opioid dispensing (2011-2018) and the relative contribution of fentanyl to total opioid deaths (2016-2019) was -0.70 (t = 2.75; df = 8; p = 0.03); the corresponding correlation for opioid dispensing changes (&quot;peak-year&quot; to 2018) was -0.59 (t = -2.06; df = 8; p = 0.07). Provincial reductions in medical opioid dispensing indicated (near-)significant correlations with fentanyl contribution rates to opioid-related death totals. Differential reductions in pharmaceutical opioid availability may have created supply voids for nonmedical use, substituted with synthetic/toxic (e.g., fentanyl) opioids and leading to accelerated opioid mortality. Implications of these possible unintended adverse consequences warrant consideration for public health policy.<p /> <p>Language: en</p>",
language="en",
issn="1661-7827",
doi="10.3390/ijerph18147507",
url="http://dx.doi.org/10.3390/ijerph18147507"
}