Canadian Journal of Public Health

, Volume 105, Issue 2, pp e146–e149 | Cite as

Non-medical prescription opioid use, prescription opioid-related harms and public health in Canada: An update 5 years later

  • Benedikt FischerEmail author
  • Jenna Gooch
  • Brian Goldman
  • Paul Kurdyak
  • Jürgen Rehm


Five years ago, we highlighted Canada’s emerging problem of prescription opioid (PO)-related harms and emphasized the need for targeted surveillance, research and interventions. Overall levels of PO use in the Canadian population have grown by 70% since then, while at the same time levels of non-medical PO use (NMPOU) in general and in key risk populations have continued to be high; furthermore, PO-related harms — specifically morbidity (e.g., treatment admissions) and mortality (e.g., overdose deaths) — have risen substantively. Unfortunately, major knowledge gaps related to systematic monitoring of PO-related harms continue to exist; for example, no national morbidity or mortality statistics are available. Investigator-driven research has generated important insights into the epidemiology and impacts of PO-related harms: high correlations between population-level PO dispensing and/or PO dosing and harms; high rates of co-occurrence of NMPOU and co-morbidities; and distinct NMPOU-related risk dynamics among street drug users. Select policy measures have been implemented only recently at the federal and provincial levels; these interventions remain to be systematically evaluated, especially given preliminary indications of reductions in PO-related harms (e.g., NMPOU) unfolding prior to the interventions. For these purposes, improvements in surveillance tools and research resources devoted to the extensive public health problem of PO-related harms in Canada continue to be urgently needed.


Prescription opioids non-medical use harms public health surveillance policy Canada 


Il y a cinq ans, nous avions souligné l’émergence de méfaits liés aux opioïdes sur ordonnance (OSO) au Canada et le besoin de mener des études et des interventions de surveillance ciblées. Depuis, les niveaux globaux de consommation d’OSO ont augmenté de 70 %, selon des données (provinciales) limitées, tandis que simultanément, les niveaux de consommation d’OSO à des fins non médicales (COSONM) en général et dans les principales populations à risque ont continué d’être élevés, et les méfaits liés aux OSO — spécifiquement la morbidité (les admissions pour traitement) et la mortalité (les décès par surdose) — ont considérablement augmenté. Malheureusement, il existe encore des lacunes majeures dans la surveillance systématique des méfaits liés aux OSO; à titre d’exemple, les statistiques nationales de morbidité ou de mortalité n’existent pas. La recherche menée à l’initiative des chercheurs eux-mêmes a apporté un éclairage utile sur l’épidémiologie et l’impact des méfaits liés aux OSO: corrélations élevées entre la délivrance et/ou le dosage des OSO et leurs méfaits dans la population; taux élevés de concomitance entre la COSONM et les comorbidités; et dynamique du risque distincte liée à la COSONM chez les utilisateurs de drogues de rue. Certaines mesures n’ont été appliquées que récemment aux paliers fédéral et provincial; ces interventions ne sont pas encore systématiquement évaluées mais devraient l’être, surtout que selon les indications préliminaires, la réduction des méfaits liés aux OSO (dont la COSONM) a commencé avant les interventions. Il existe donc toujours un besoin urgent d’améliorer les outils de surveillance et les ressources de recherche consacrés au vaste problème de santé publique des méfaits liés aux OSO au Canada.

Mots clés

opioïdes sur ordonnance usage non médical méfaits santé publique surveillance politique Canada 


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Copyright information

© The Canadian Public Health Association 2014

Authors and Affiliations

  • Benedikt Fischer
    • 1
    • 2
    • 3
    Email author
  • Jenna Gooch
    • 1
  • Brian Goldman
    • 4
  • Paul Kurdyak
    • 2
    • 3
  • Jürgen Rehm
    • 2
    • 3
    • 5
    • 6
  1. 1.Centre for Applied Research in Mental Health and Addiction, Faculty of Health SciencesSimon Fraser UniversityVancouverCanada
  2. 2.Centre for Addiction and Mental HealthTorontoCanada
  3. 3.Department of PsychiatryUniversity of TorontoTorontoCanada
  4. 4.Mount Sinai HospitalTorontoCanada
  5. 5.Dalla Lana School of Population HealthUniversity of TorontoTorontoCanada
  6. 6.Technische UniversitätDresdenGermany

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