OBJECTIVE: To evaluate the clinical observation that the number of individuals seeking opioid detoxification from oxycodone was increasing at the Centre for Addiction and Mental Health (CAMH) in Toronto, Ont; and to identify the characteristics of individuals seeking opioid detoxification at CAMH. DESIGN: Retrospective analysis of patient health records. SETTING: Medical Withdrawal Management Service at CAMH. PARTICIPANTS: All patients admitted for opioid detoxification between January 2000 and December 2004. MAIN OUTCOME MEASURES: Number of opioid detoxification admissions each year; type, dose, and source of opioids; comorbid problems and symptoms. RESULTS: There were 571 opioid detoxification admissions during the 5-year study period. The number of admissions increased steadily over the 5 years; in particular, the number of admissions related to controlled-release oxycodone increased substantially (3.8%, 8.3%, 20.8%, 30.6%, and 55.4% of the total opioid admissions in 2000 to 2004, respectively; chi(4)2= 105.5, P < .001). The rates of admissions involving heroin remained low and stable. Use of controlled-release oxycodone was associated with considerably higher doses than use of other prescription opioids was. Physician prescriptions were the source of the prescription opioids for a large percentage of patients, particularly for older patients. Prescription opioid users reported considerable comorbid substance use problems, pain, and psychiatric symptoms. CONCLUSION: This study has demonstrated a significant rise in the number of individuals seeking treatment at CAMH for controlled-release oxycodone addiction. The substantial comorbid pain, psychiatric symptoms, and other psychoactive substance use problems in these patients, coupled with the finding that prescriptions were an important source of opioids, highlight the clinical complexities encountered in the treatment of these individuals. Further research examining these complexities and the many possible pathways leading to prescription opioid addiction is required in order to develop effective prevention and treatment strategies.
OBJECTIVE: To evaluate the clinical observation that the number of individuals seeking opioid detoxification from oxycodone was increasing at the Centre for Addiction and Mental Health (CAMH) in Toronto, Ont; and to identify the characteristics of individuals seeking opioid detoxification at CAMH. DESIGN: Retrospective analysis of patient health records. SETTING: Medical Withdrawal Management Service at CAMH. PARTICIPANTS: All patients admitted for opioid detoxification between January 2000 and December 2004. MAIN OUTCOME MEASURES: Number of opioid detoxification admissions each year; type, dose, and source of opioids; comorbid problems and symptoms. RESULTS: There were 571 opioid detoxification admissions during the 5-year study period. The number of admissions increased steadily over the 5 years; in particular, the number of admissions related to controlled-release oxycodone increased substantially (3.8%, 8.3%, 20.8%, 30.6%, and 55.4% of the total opioid admissions in 2000 to 2004, respectively; chi(4)2= 105.5, P < .001). The rates of admissions involving heroin remained low and stable. Use of controlled-release oxycodone was associated with considerably higher doses than use of other prescription opioids was. Physician prescriptions were the source of the prescription opioids for a large percentage of patients, particularly for older patients. Prescription opioid users reported considerable comorbid substance use problems, pain, and psychiatric symptoms. CONCLUSION: This study has demonstrated a significant rise in the number of individuals seeking treatment at CAMH for controlled-release oxycodone addiction. The substantial comorbid pain, psychiatric symptoms, and other psychoactive substance use problems in these patients, coupled with the finding that prescriptions were an important source of opioids, highlight the clinical complexities encountered in the treatment of these individuals. Further research examining these complexities and the many possible pathways leading to prescription opioid addiction is required in order to develop effective prevention and treatment strategies.
Authors: Jennifer Sharpe Potter; Grace Hennessy; Jennifer A Borrow; Shelly F Greenfield; Roger D Weiss Journal: Drug Alcohol Depend Date: 2004-11-11 Impact factor: 4.492
Authors: Theodore J Cicero; Steven P Kurtz; Hilary L Surratt; Gladys E Ibanez; Matthew S Ellis; Maria A Levi-Minzi; James A Inciardi Journal: J Drug Issues Date: 2011
Authors: James M Thompson; Roland Chiasson; Patrick Loisel; Lt Col Markus Besemann; Tina Pranger Journal: Can Fam Physician Date: 2009-11 Impact factor: 3.275
Authors: James M Thompson; Roland Chiasson; Patrick Loisel; Lt Col Markus Besemann; Tina Pranger Journal: Can Fam Physician Date: 2009-11 Impact factor: 3.275
Authors: Suzanne D Turner; Tara Gomes; Ximena Camacho; Zhan Yao; Astrid Guttmann; Muhammad M Mamdani; David N Juurlink; Irfan A Dhalla Journal: CMAJ Open Date: 2015-01-13