The Poison Review

PRESCRIBING OF OPIOID ANALGESICS AND RELATED MORTALITY BEFORE AND AFTER THE INTRODUCTION OF LONG-ACTING OXYCODONE Dhalla IA et al. Canad Med Assoc J Dec 8 2009;181:891-896.

Article

The authors surveyed trends in the number of prescriptions written for opiate analgesics in the province of Ontario for the years 1991 to 2007, as well as deaths attributed to opiate overdose from 1991 to 2004.  At a point during that time period (specifically January 2000) long-acting oxycodone became available on the province’s formulary.  They found that between 1999 and 2004 opiate-related deaths increased 41% and deaths related to oxycodone increased 5-fold.  The authors note that the number of opiate-related deaths in 2004 were over twice the number from HIV infection.  They suggest that deceptive marketing when the drug was introduced might have contributed to it being used widely and sometimes inappropriately. It is interesting to note that they also found that in the overwhelming majority of opiate-related deaths (91.6%) another non-opiate central nervous system depressant was involved; these included benzodiazepines, alcohol, and cyclic antidepressants.