Cayley Russell1, Michelle Firestone2, Len Kelly3, Christopher Mushquash4, Benedikt Fischer5. 1. Centre for Addiction and Mental Health,Toronto, Ontario, Canada. cayley.russell@camh.ca. 2. Centre for Research on Inner City Health,Toronto, Ontario,Canada. FirestoneM@smh.ca. 3. Sioux Lookout Meno Ya Win Health Centre, Sioux Lookout, Ontario, Canada. lkelly@mcmaster.ca. 4. Department of Pyschology and Northern Ontario School of Medicine, Lakehead University, Thunder Bay, Ontario, Canada. cjmushqu@lakeheadu.ca. 5. Centre for Addiction and Mental Health, Toronto, Ontario, Canada. bfischer@sfu.ca.
Abstract
INTRODUCTION: Prescription opioid (PO) misuse and related harms are high in Canada, and a major public health challenge. In Canada, 1.4 million individuals (4.3% of the total population) self-identify as Aboriginal, among whom substance use and related harms are elevated. While there are reports of PO use and associated problems among Aboriginal groups, no comprehensive data review currently exists. METHODS: A review of available data sources (ie journal publications, public reports and 'grey' literature) was conducted following principles of a scoping review. Information and data were identified, extracted, and organized into major indicator categories: <i>PO prescribing/dispensing</i>, <i>use/abuse</i>, <i>morbidity/mortality harms and treatment</i>, and narratively reported. RESULTS: Data suggest that PO dispensing, use and misuse levels among Aboriginal populations are high and/or rising in select settings when compared to the general Canadian population. High levels of PO-related dependence and pregnancy harms exist (mainly in Northern Ontario); there is some indication of elevated opioid mortality among Aboriginals. Vast discrepancies in availability and access to interventions exist; some recent pilot studies suggest improved care. CONCLUSIONS: Data regarding PO use and harms among Aboriginal people are limited, even though elevated problem levels are indicated; improved monitoring, and more effective yet culturally and contextually appropriate interventions for this acute problem are needed.
INTRODUCTION: Prescription opioid (PO) misuse and related harms are high in Canada, and a major public health challenge. In Canada, 1.4 million individuals (4.3% of the total population) self-identify as Aboriginal, among whom substance use and related harms are elevated. While there are reports of PO use and associated problems among Aboriginal groups, no comprehensive data review currently exists. METHODS: A review of available data sources (ie journal publications, public reports and 'grey' literature) was conducted following principles of a scoping review. Information and data were identified, extracted, and organized into major indicator categories: <i>PO prescribing/dispensing</i>, <i>use/abuse</i>, <i>morbidity/mortality harms and treatment</i>, and narratively reported. RESULTS: Data suggest that PO dispensing, use and misuse levels among Aboriginal populations are high and/or rising in select settings when compared to the general Canadian population. High levels of PO-related dependence and pregnancy harms exist (mainly in Northern Ontario); there is some indication of elevated opioid mortality among Aboriginals. Vast discrepancies in availability and access to interventions exist; some recent pilot studies suggest improved care. CONCLUSIONS: Data regarding PO use and harms among Aboriginal people are limited, even though elevated problem levels are indicated; improved monitoring, and more effective yet culturally and contextually appropriate interventions for this acute problem are needed.
Entities:
Keywords:
Alcohol and Drug; Epidemiology; Health Promotion; North America; Pharmacology/Drugs; Public Health
Authors: Nathan C Nickel; Jennifer E Enns; Julianne Sanguins; Carrie O'Conaill; Dan Chateau; S Michelle Driedger; Carole Taylor; Gilles Detillieux; Miyosha Tso Deh; Emily Brownell; A Frances Chartrand; Alan Katz Journal: CMAJ Open Date: 2022-03-29