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Opioid-related deaths and previous care for drug use and pain relief in Sweden
Karolinska Inst, Dept Clin Neurosci, Gotgatan 83E, SE-I1662 Stockholm, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Forensic Medicine.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
Former Natl Inst Publ Hlth, Gotgatan 83E, SE-17662 Stockholm, Sweden.
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2019 (English)In: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 201, p. 253-259Article in journal (Refereed) Published
Abstract [en]

Aim: In 2006-2014, the rate of drug-related deaths, typically opioid poisonings, more than doubled in Sweden. Opioid prescriptions for pain control or opioid agonist therapy also increased. In this retrospective study, we compared death rates between individuals whose first recorded contact with prescribed opioids was for pain control and individuals that had received substance use disorder (SUD) treatment before their first recorded opioid prescription.

Methods: We included 2834 forensically examined individuals (ages 15-64 years) that died of poisoning in Sweden in 2006-2014. For each death we acquired data on previous opioid prescriptions and SUD treatments. We compared three study groups: pain control (n = 788); a SUD treatment group (n = 1629); and a group with no prescription for pain control or SUD treatment (n = 417).

Results: Overall fatal poisonings increased from 2.77 to 7.79 (per 100,000 individuals) from 2006 to 2014 (relative 181% increase). Fatal poisoning increased from 2006 to 2014 by 269% in the pain control group (0.64 to 2.36 per 100,000) and by 238% in the SUD treatment group (1.35 to 4.57 per 100,000). Heroin-related deaths remained constant; consequently, the increase was likely attributable to prescription opioids.

Conclusion: A rapid increase in deaths attributable mainly to prescription opioids for pain control, was reported previously in the United States. Our study indicated that increased access to prescription opioids might contribute to higher death rates also in Sweden among patients seeking pain control and individuals with an established SUD; however, deaths related to prescription opioids mainly occurred among those with SUDs.

Place, publisher, year, edition, pages
ELSEVIER IRELAND LTD , 2019. Vol. 201, p. 253-259
Keywords [en]
Prescription opioids, Fatal poisoning, Mortality, Epidemiology, Opioid dependence
National Category
Substance Abuse
Identifiers
URN: urn:nbn:se:uu:diva-391284DOI: 10.1016/j.drugalcdep.2019.04.022ISI: 000476963200035PubMedID: 31260826OAI: oai:DiVA.org:uu-391284DiVA, id: diva2:1344924
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2015-00117Available from: 2019-08-22 Created: 2019-08-22 Last updated: 2019-08-22Bibliographically approved

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