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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 universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Socialmedicinsk epidemiologi.
Former Natl Inst Publ Hlth, Gotgatan 83E, SE-17662 Stockholm, Sweden.
Vise andre og tillknytning
2019 (engelsk)Inngår i: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 201, s. 253-259Artikkel i tidsskrift (Fagfellevurdert) 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.

sted, utgiver, år, opplag, sider
ELSEVIER IRELAND LTD , 2019. Vol. 201, s. 253-259
Emneord [en]
Prescription opioids, Fatal poisoning, Mortality, Epidemiology, Opioid dependence
HSV kategori
Identifikatorer
URN: urn:nbn:se:uu:diva-391284DOI: 10.1016/j.drugalcdep.2019.04.022ISI: 000476963200035PubMedID: 31260826OAI: oai:DiVA.org:uu-391284DiVA, id: diva2:1344924
Forskningsfinansiär
Forte, Swedish Research Council for Health, Working Life and Welfare, 2015-00117Tilgjengelig fra: 2019-08-22 Laget: 2019-08-22 Sist oppdatert: 2019-08-22bibliografisk kontrollert

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