Nicholas Baldwin1, Roger Gray2, Anirudh Goel3, Evan Wood4, Jane A Buxton5, Launette Marie Rieb6. 1. Department of Family Practice, University of British Columbia, St. Paul's Hospital, 1081 Burrard St., Vancouver, B.C., Canada. Electronic address: nicholas.jc.baldwin@gmail.com. 2. Department of Family Practice, University of British Columbia, St. Paul's Hospital, 1081 Burrard St., Vancouver, B.C., Canada. Electronic address: roger.gray@mail.mcgill.ca. 3. Department of Family Practice, University of British Columbia, St. Paul's Hospital, 1081 Burrard St., Vancouver, B.C., Canada. Electronic address: anirudh.goel@medportal.ca. 4. Department of Medicine, University of British Columbia, and B.C. Centre on Substance Use, 2312 Pandosy St., Kelowna, B.C., Canada. Electronic address: bccsu-ew@cfenet.ubc.ca. 5. Department of Family Practice, University of British Columbia, St. Paul's Hospital, 1081 Burrard St., Vancouver, B.C., Canada; School of Population and Public Health, University of British Columbia, and B.C. Centre for Disease Control, 655 W 12th Ave, Vancouver, B.C., Canada. Electronic address: jane.buxton@ubc.ca. 6. Department of Family Practice, University of British Columbia, St. Paul's Hospital, 1081 Burrard St., Vancouver, B.C., Canada. Electronic address: launette.rieb@ubc.ca.
Abstract
BACKGROUND: Due to the alarming rise in opioid-related overdose deaths, a public health emergency was declared in British Columbia (BC). In this study, we examined the relationship between illicit fentanyl and heroin found in seized drugs and illicit overdose deaths in BC. METHODS: An observational cross-sectional survey was conducted using BC data from Health Canada's Drug Analysis Service, which analyzes drug samples seized by law enforcement agencies, and non-intentional illicit overdoses from the BC Coroner's Service, from 2000 to 2016. Initial scatter plots and subsequent multivariate regression analysis were performed to describe the potential relationship between seized illicit fentanyl samples and overdose deaths and to determine if this differed from seized heroin and overdose deaths. Fentanyl samples were analyzed for other drug content. RESULTS: Fentanyl is increasingly being found combined with other opioid and non-opioid illicit drugs. Strong positive relationships were found between the number of seized fentanyl samples and total overdose deaths (R2 = 0.97) as well as between seized fentanyl and fentanyl-detected overdose deaths (R2 = 0.99). A positive association was found between the number of seized heroin samples and total overdose deaths (R2 = 0.78). CONCLUSION: This research contributes to the expanding body of evidence implicating illicit fentanyl use (often combined with heroin or other substances) in overdose deaths in BC. Policy makers and healthcare providers are urged to implement drug treatment and harm reduction strategies for people at risk of overdose associated with current trends in illicit opioid use.
BACKGROUND: Due to the alarming rise in opioid-related overdose deaths, a public health emergency was declared in British Columbia (BC). In this study, we examined the relationship between illicit fentanyl and heroin found in seized drugs and illicit overdose deaths in BC. METHODS: An observational cross-sectional survey was conducted using BC data from Health Canada's Drug Analysis Service, which analyzes drug samples seized by law enforcement agencies, and non-intentional illicit overdoses from the BC Coroner's Service, from 2000 to 2016. Initial scatter plots and subsequent multivariate regression analysis were performed to describe the potential relationship between seized illicit fentanyl samples and overdose deaths and to determine if this differed from seized heroin and overdose deaths. Fentanyl samples were analyzed for other drug content. RESULTS:Fentanyl is increasingly being found combined with other opioid and non-opioid illicit drugs. Strong positive relationships were found between the number of seized fentanyl samples and total overdose deaths (R2 = 0.97) as well as between seized fentanyl and fentanyl-detected overdose deaths (R2 = 0.99). A positive association was found between the number of seized heroin samples and total overdose deaths (R2 = 0.78). CONCLUSION: This research contributes to the expanding body of evidence implicating illicit fentanyl use (often combined with heroin or other substances) in overdose deaths in BC. Policy makers and healthcare providers are urged to implement drug treatment and harm reduction strategies for people at risk of overdose associated with current trends in illicit opioid use.
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