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How Many People in Canada Use Prescription Opioids Nonmedically in General and Street Drug Using Populations?

  • Quantitative Research
  • Published:
Canadian Journal of Public Health Aims and scope Submit manuscript

Abstract

Objective

Medical prescriptions for opioids as well as their non-medical use have increased in Canada in recent years. This study aimed to estimate the number of non-medical prescription opioid (PO) users in the general and street drug using populations in Canada.

Methods

The number of non-medical PO users among the general population and the number of non-medical PO users, heroin users, or both among the street drug using population was estimated for Canada and for the most populous Canadian provinces. Different estimation methods were used: 1) the number of non-medical PO users in the Canadian general population was estimated based on Canadian availability data, and the ratio of US availability to non-medical PO use from US survey data; 2) numbers within the street drug using population were indirectly estimated based on overdose death data, and a key informants survey. Distribution and trends by usage of opioids were determined by using the multi-site Canadian OPICAN cohort data.

Results

Between 321,000 to 914,000 non-medical PO users were estimated to exist among the general population in Canada in 2003. The estimated number of non-medical PO users, heroin users, or both among the street drug using population was about 72,000, with more individuals using nonmedical PO than heroin in 2003. Based on data from the OPICAN survey, in 2005 the majority of the street drug using population in main Canadian cities was non-medical PO users, with the exception of Vancouver and Montreal. A relative increase of 24% was observed from 2002 to 2005 in the proportion of the street drug using population who used non-medical POs only.

Discussion

There is an urgent need to further assess the extent and patterns of non-medical prescription opioid use, related problems and drug distribution channels in Canada.

Résumé

Objectif

Les prescriptions médicales pour les opiacés ainsi que leur utilisation non médicinale ont augmenté au Canada au cours des dernières années. Cette étude vise à évaluer le nombre d’utilisateurs d’opiacés d’ordonnance (OO) non médicinaux au sein de la population générale et de la population utilisant des drogues illicites au Canada.

Méthode

Le nombre d’utilisateurs d’OO non médicinaux parmi la population générale et le nombre d’utilisateurs d’OO non médicinaux, d’utilisateurs d’héroïne ou les deux parmi la population faisant usage de drogues illicites ont été évalués au Canada et dans les provinces canadiennes les plus populeuses. Différentes méthodes d’évaluation ont été utilisées: 1) le nombre d’utilisateurs d’OO non médicinaux au sein de la population générale du Canada a été évalué selon les données sur la disponibilité canadienne et le ratio de la disponibilité américaine pour l’utilisation d’OO non médicinaux à partir des données des études américaines; 2) le nombre au sein de la population faisant usage de drogues illicites était indirectement évalué selon les données sur le décès par surdose et une étude auprès de répondants clés. La distribution et les tendances selon l’usage d’opiacés ont été déterminées à l’aide des données de cohorte de l’étude OPICAN effectuée dans plusieurs villes canadiennes.

Résultats

On a évalué qu’il y avait entre 321 000 et 914 000 utilisateurs d’OO non médicinaux au sein de la population canadienne en 2003. Le nombre évalué d’utilisateurs d’OO non médicinaux, d’utilisateurs d’héroïne ou les deux parmi la population faisant usage de drogues illicites était de 72 000, avec davantage de personnes utilisant des OO non médicinaux que l’héroïne en 2003. Selon les données de l’étude OPICAN, en 2005, la majorité de la population faisant usage de drogues illicites dans les principales villes canadiennes était des utilisateurs d’OO non médicinaux, à l’exception de Montréal et de Vancouver. Un accroissement relatif de 24 % a été observé de 2002 à 2005 selon la proportion de la population faisant usage de drogues illicites qui utilisait des OO non médicinaux seulement.

Discussion

Il existe un besoin urgent d’évaluer davantage la portée et les modèles de l’utilisation d’OO non médicinaux, les problèmes connexes et les réseaux de distribution de drogues au Canada.

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Authors and Affiliations

  1. Centre for Addiction and Mental Health, 33 Russell Street, Room T510, Toronto, ON, M5S 2S1, Canada

    Svetlana Popova MD, PhD, Jayadeep Patra PhD, Satya Mohapatra PhD, Benedikt Fischer PhD & Jürgen Rehm PhD

  2. Department of Public Health Sciences, University of Toronto, Toronto, ON, Canada

    Svetlana Popova MD, PhD, Benedikt Fischer PhD & Jürgen Rehm PhD

  3. Faculty of Social Work, University of Toronto, Toronto, ON, Canada

    Svetlana Popova MD, PhD

  4. Department of Human Development and Applied Psychology, University of Toronto, Toronto, ON, Canada

    Jayadeep Patra PhD

  5. Centre for Addictions Research of British Columbia, University of Victoria, Victoria, BC, Canada

    Benedikt Fischer PhD

  6. Addiction Research Institute, Zurich, Switzerland

    Jürgen Rehm PhD

  7. Epidemiological Research Unit, Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany

    Jürgen Rehm PhD

Authors
  1. Svetlana Popova MD, PhD
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  2. Jayadeep Patra PhD
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  3. Satya Mohapatra PhD
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  4. Benedikt Fischer PhD
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  5. Jürgen Rehm PhD
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Corresponding author

Correspondence to Svetlana Popova MD, PhD.

Additional information

Acknowledgements: This study was supported in part by funding from the Canadian Institutes of Health Research. This contribution was also based on research within the framework of the Second Canadian Study on Social Costs of Substance Abuse, which has received funding from the Canadian Centre on Substance Abuse. In addition, the current study was also in part financially supported by a contract of Schering-Plough Canada to the Centre for Addiction and Mental Health. The authors would also like to thank Sandy Maksimowska and Dolly Baliunas for their thorough review of an earlier version of this manuscrip.

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Popova, S., Patra, J., Mohapatra, S. et al. How Many People in Canada Use Prescription Opioids Nonmedically in General and Street Drug Using Populations?. Can J Public Health 100, 104–108 (2009). https://doi.org/10.1007/BF03405516

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  • DOI: https://doi.org/10.1007/BF03405516

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