Home > 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?

Do, Uyen and Perron, Paul-André and Bruneau, Julie and Larney, Sarah (2024) 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? Drug and Alcohol Review, 43, (6), pp. 1613-1624. https://doi.org/10.1111/dar.13918.

External website: https://onlinelibrary.wiley.com/doi/10.1111/dar.13...

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.


Item Type
Article
Publication Type
International, Open Access, Article
Drug Type
Substances (not alcohol/tobacco), CNS stimulants, Opioid
Intervention Type
Prevention, Harm reduction
Date
2024
Identification #
https://doi.org/10.1111/dar.13918
Page Range
pp. 1613-1624
Publisher
Wiley
Volume
43
Number
6
EndNote

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