Benedikt Fischer1, Thepikaa Varatharajan2, Kevin Shield3, Jürgen Rehm4, Wayne Jones5. 1. Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Institute of Medical Science (IMS), University of Toronto, Toronto, Canada; Centre for Criminology & Sociolegal Studies, University of Toronto, Toronto, Canada; Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil. Electronic address: benedikt.fischer@utoronto.ca. 2. Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada. 3. Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. 4. Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Institute of Medical Science (IMS), University of Toronto, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Dresden, Germany. 5. Centre for Applied Research in Mental Health and Addictions, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada.
Abstract
BACKGROUND: Numerous interventions aimed at addressing the Canadian 'opioid crisis' have been implemented. However, no empirical estimaes of the number of people with problematic prescription opioid (PO) use exist to inform and guide intervention system needs. METHODS: The annual numbers of Canadian adults (≥ 15 years) with PO misuse and/or use disorders ('addiction') were estimated by combining data on the prevalence and associated 95% Confidence Intervals (CIs) of PO use in the Canadian population, obtained from national surveys, with PO misuse and use disorders transition probabilities, obtained from high-quality studies in recent meta-analyses. Uncertainty Intervals (UI) were estimated using Monte Carlo simulations. RESULTS: Population estimates of PO use were highest in 2008, with 5,967,046 (95% CI: 5,635,543-6,326,173) people using POs (representing 21.6% of adults), and lowest in 2015, with 3,941,935 (95% CI: 3,580,842-4,272,937) people using POs (13.1%). Furthermore, PO misuse and use disorders were highest in 2008, with 1,408,223 (95% UI: 878,686-1,951,211; 5.1% of adults) and 525,100 (95% UI 258,288-801,472; 1.9%) people with PO misuse and use disorders respectively. These numbers declined to 930,297 (95% UI: 576,083-1,295,310; 3.1% of adults) and 346,890 (95% UI: 168,310-532,941; 1.2%) people with PO misuse and use disorders, respectively, in 2015. CONCLUSION: While seemingly declining over-time, the crude population estimates for problematic PO use were high, likely outweighing current intervention capacities. Furthermore, these estimates do not account for the delay of onset and duration of PO misuse and disorders. Thus, more rigorous problem population estimates should be generated to guide interventions.
BACKGROUND: Numerous interventions aimed at addressing the Canadian 'opioid crisis' have been implemented. However, no empirical estimaes of the number of people with problematic prescription opioid (PO) use exist to inform and guide intervention system needs. METHODS: The annual numbers of Canadian adults (≥ 15 years) with PO misuse and/or use disorders ('addiction') were estimated by combining data on the prevalence and associated 95% Confidence Intervals (CIs) of PO use in the Canadian population, obtained from national surveys, with PO misuse and use disorders transition probabilities, obtained from high-quality studies in recent meta-analyses. Uncertainty Intervals (UI) were estimated using Monte Carlo simulations. RESULTS: Population estimates of PO use were highest in 2008, with 5,967,046 (95% CI: 5,635,543-6,326,173) people using POs (representing 21.6% of adults), and lowest in 2015, with 3,941,935 (95% CI: 3,580,842-4,272,937) people using POs (13.1%). Furthermore, PO misuse and use disorders were highest in 2008, with 1,408,223 (95% UI: 878,686-1,951,211; 5.1% of adults) and 525,100 (95% UI 258,288-801,472; 1.9%) people with PO misuse and use disorders respectively. These numbers declined to 930,297 (95% UI: 576,083-1,295,310; 3.1% of adults) and 346,890 (95% UI: 168,310-532,941; 1.2%) people with PO misuse and use disorders, respectively, in 2015. CONCLUSION: While seemingly declining over-time, the crude population estimates for problematic PO use were high, likely outweighing current intervention capacities. Furthermore, these estimates do not account for the delay of onset and duration of PO misuse and disorders. Thus, more rigorous problem population estimates should be generated to guide interventions.
Authors: Katherine M Keyes; Caroline Rutherford; Ava Hamilton; Joshua A Barocas; Kitty H Gelberg; Peter P Mueller; Daniel J Feaster; Nabila El-Bassel; Magdalena Cerdá Journal: Drug Alcohol Depend Rep Date: 2022-04-08
Authors: Peter J Mallow; Nila Sathe; Michael Topmiller; Jennifer Chubinski; Dillon Carr; Roni Christopher Journal: J Health Econ Outcomes Res Date: 2019-04-03