{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T12:20:17Z","timestamp":1781094017133,"version":"3.54.1"},"reference-count":52,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,12,2]],"date-time":"2019-12-02T00:00:00Z","timestamp":1575244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,12,2]],"date-time":"2019-12-02T00:00:00Z","timestamp":1575244800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000991","name":"Faculty of Medicine, Nursing and Health Sciences, Monash University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000991","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To characterize the trajectory in the years leading up to 2018 in pharmaceutical opioid and heroin morbidity in Victoria, Australia, and to assess the effect on that trajectory of reformulation of oxycodone to a form that could not be easily snorted or injected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Interrupted time\u2013series analyses of population\u2010level data before versus after reformulation of oxycodone, stratified by sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Victoria, Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The population of Victoria aged 12+ years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Ambulance patient care and emergency department (ED) records were examined using both fixed\u2010code and free\u2010text fields, with each record manually cleaned and checked by trained coders. These were used to derive the output variables providing an index of harm: rates of opioid\u2010related ambulance attendances and ED attendances for pharmaceutical opioids and heroin. The input variable was pre\u2010 versus post\u2010oxycodone reformulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>There were 30\u2009045 opioid\u2010related ambulance attendances from January 2012 to October 2018 (54% heroin\u2010related), and 10\u2009113 ED attendances from July 2008 to June 2018 (39% heroin\u2010related). There was an increase in the rate (events per 100\u2009000 people per year) of all opioid ED attendances from 2008 to 2018 [increase\u00a0=\u00a00.063; 95% confidence interval (CI)\u00a0=\u00a00.049, 0.078]. Pharmaceutical opioid ED attendances decreased from 2014 onwards (slope change\u00a0=\u00a0\u20130.083; 95% CI\u00a0=\u00a0\u20130.108, \u20130.059). Heroin\u2010related ED attendances increased from 2014 to 2018; 11\u2009324 heroin\u2010related ambulance attendances and 1980 ED attendances were observed from April 2014 to June 2018, compared with the respective estimates of 8176, and 1661 had the pre\u2010April 2014 trend continued (ambulance slope change\u00a0=\u00a00.296, 95% CI\u00a0=\u00a00.104, 0.489; ED slope change\u00a0=\u00a00.026, 95% CI\u00a0=\u00a00.005, 0.046). The inflection point of 2014 coincided with the re\u2010formulation of oxycodone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In Victoria, Australia, there appears to have been a trend starting around mid\u20102014 of increasing heroin\u2010related harm, and a flattening of the increase or a decrease of harms relating to pharmaceutical opioids. These changes may, in part, reflect reformulation of oxycodone to reduce the extent to which it can be injected or snorted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.14784","type":"journal-article","created":{"date-parts":[[2019,8,29]],"date-time":"2019-08-29T11:48:59Z","timestamp":1567079339000},"page":"261-269","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Recent trends in heroin and pharmaceutical opioid\u2010related harms in Victoria, Australia up to 2018"],"prefix":"10.1111","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4902-7293","authenticated-orcid":false,"given":"Tina","family":"Lam","sequence":"first","affiliation":[{"name":"Monash Addiction Research Centre, Eastern Health Clinical School Monash University  Frankston Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2421-2003","authenticated-orcid":false,"given":"Lisa","family":"Kuhn","sequence":"additional","affiliation":[{"name":"Monash Addiction Research Centre, Eastern Health Clinical School Monash University  Frankston Victoria Australia"},{"name":"Monash Nursing and Midwifery Monash University  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Hayman","sequence":"additional","affiliation":[{"name":"Monash Addiction Research Centre, Eastern Health Clinical School Monash University  Frankston Victoria Australia"},{"name":"Victorian Injury Surveillance Unit, Monash University Accident Research Centre Monash University  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Middleton","sequence":"additional","affiliation":[{"name":"Monash Addiction Research Centre, Eastern Health Clinical School Monash University  Frankston Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Wilson","sequence":"additional","affiliation":[{"name":"Turning Point, Eastern Health &amp; Eastern Health Clinical School Monash University  Richmond Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debbie","family":"Scott","sequence":"additional","affiliation":[{"name":"Monash Addiction Research Centre, Eastern Health Clinical School Monash University  Frankston Victoria Australia"},{"name":"Turning Point, Eastern Health &amp; Eastern Health Clinical School Monash University  Richmond Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6747-1937","authenticated-orcid":false,"given":"Dan I.","family":"Lubman","sequence":"additional","affiliation":[{"name":"Monash Addiction Research Centre, Eastern Health Clinical School Monash University  Frankston Victoria Australia"},{"name":"Turning Point, Eastern Health &amp; Eastern Health Clinical School Monash University  Richmond Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Smith","sequence":"additional","affiliation":[{"name":"Monash Addiction Research Centre, Eastern Health Clinical School Monash University  Frankston Victoria Australia"},{"name":"Department of Epidemiology and Preventive Medicine Monash University  Melbourne Victoria Australia"},{"name":"Ambulance Victoria  Victoria Australia"},{"name":"Department of Community Emergency Health and Paramedic Practice Monash University  Frankston Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5341-1055","authenticated-orcid":false,"given":"Suzanne","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Monash Addiction Research Centre, Eastern Health Clinical School Monash University  Frankston Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,2]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Drug\u2010related Deaths in Sweden","author":"Leifman H.","year":"2016"},{"key":"e_1_2_8_3_1","volume-title":"Drug\u2010related Deaths in Scotland in 2016","author":"National Records of Scotland","year":"2017"},{"key":"e_1_2_8_4_1","unstructured":"British Columbia Coroners Service.Illicit Drug Overdose Deaths in BC. Burnaby BC: Office of the Chief Coroner;2017."},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14905"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00161-6"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050324518767445"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(18)30337-7"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6626a4"},{"key":"e_1_2_8_10_1","volume-title":"Australia's Annual Overdose Report 2018","author":"Pennington Institute","year":"2018"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2017.07.018"},{"key":"e_1_2_8_12_1","first-page":"2018","volume-title":"Opioid\u2010, amphetamine\u2010, and cocaine\u2010induced deaths in Australia: August 2018","author":"Roxburgh A."},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2019.01.010"},{"key":"e_1_2_8_14_1","first-page":"1419","article-title":"Drug and opioid\u2010involved overdose deaths\u2014United States, 2013\u20132017","volume":"67","author":"Scholl L. S. P.","year":"2019","journal-title":"Morbid Mortal Wkly Rep (MMWR)"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3404"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.12446"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.12916"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/0959523021000002778"},{"key":"e_1_2_8_19_1","volume-title":"The Causes, Course and Consequences of the Heroin Shortage in Australia","author":"Degenhardt L.","year":"2004"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.12937"},{"key":"e_1_2_8_21_1","unstructured":"Australian Institute for Health and Welfare (AIHW).Opioid Harm in Australia and Comparisons Between Australia and Canada. Canberra: AIHW;2018."},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/1753-6405.12568"},{"key":"e_1_2_8_23_1","unstructured":"Australian Bureau of Statistics.Population Projections Australia 2017 (base)\u20142066 2018. Available at:https:\/\/www.abs.gov.au\/ausstats\/abs@.nsf\/mf\/3222.0(accessed 20 February 2019)."},{"key":"e_1_2_8_24_1","volume-title":"Australian Drug Trends 2018: Key Findings from the National Illicit Drug Reporting System (IDRS) Interviews","author":"Peacock A.","year":"2018"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753-6405.2010.00499.x"},{"key":"e_1_2_8_26_1","volume-title":"National Drug Strategy Household Survey 2016: detailed findings","author":"Australian Institute of Health and Welfare (AIHW)","year":"2017"},{"key":"e_1_2_8_27_1","unstructured":"Australian Bureau of Statistics.Causes of Death Australia 2016: Drug Induced Deaths in Australia. Canberra: Australian Bureau of Statistics; 2018[updated 25 September 2018. Available at:https:\/\/www.abs.gov.au\/AUSSTATS\/abs@.nsf\/Lookup\/3303.0Main+Features62016?OpenDocument(accessed 01 October 2018)."},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-008-0349-6"},{"key":"e_1_2_8_29_1","unstructured":"Australian Bureau of Statistics.Australian Demographic Statistics June 2018. 2018. Available at:http:\/\/www.abs.gov.au\/ausstats\/abs@.nsf\/0\/D56C4A3E41586764CA2581A70015893E?Opendocument(accessed 4 February 2019)."},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.12028"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.12036"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.33151\/ajp.15.2.584"},{"key":"e_1_2_8_33_1","unstructured":"Department of Health and Human Services Australia.Victorian Emergency Minimum Dataset (VEMD) 2019 [cited 2019 18 Feb]. Available at:https:\/\/www2.health.vic.gov.au\/hospitals\u2010and\u2010health\u2010services\/data\u2010reporting\/health\u2010data\u2010standards\u2010systems\/data\u2010collections\/vemd."},{"key":"e_1_2_8_34_1","unstructured":"Australian Bureau of Statistics.Quarterly Population Estimates (ERP) by State\/Territory Sex and Age 2018. Available at:http:\/\/stat.data.abs.gov.au\/OECDStat_Metadata\/ShowMetadata.ashx?Dataset=ERP_QUARTERLY&ShowOnWeb=true&Lang=en (accessed 28 February 2019)."},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2017.11.025"},{"key":"e_1_2_8_36_1","unstructured":"Australian Institute for Health and Welfare AIHW).National Opioid Pharmacotherapy Statistics Annual Data collection (NOPSAD) 2018. Canberra: AIHW;2019."},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.12812"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(18)30003-8"},{"key":"e_1_2_8_39_1","first-page":"348","article-title":"Interrupted time series regression for the evaluation of public health interventions: a tutorial","volume":"46","author":"Lopez Bernal J.","year":"2016","journal-title":"Int J Epidemiol"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyy135"},{"key":"e_1_2_8_41_1","first-page":"348","article-title":"Interrupted time series regression for the evaluation of public health interventions: a tutorial","volume":"46","author":"Gasparrini A.","year":"2016","journal-title":"Int J Epidemiol"},{"key":"e_1_2_8_42_1","unstructured":"Australian Criminal Intelligence Commission.National Wastewater Drug Monitoring Program report 7. Canberra: Australian Criminal Intelligence Commission;2019."},{"key":"e_1_2_8_43_1","unstructured":"Australian Criminal Intelligence Commission.Illicit Drug Data Report 2016\u201317. Australian Criminal Intelligence Commission: Canberra: Australian Criminal Intelligence Commission;2018."},{"key":"e_1_2_8_44_1","volume-title":"Australian Needle Syringe Program Survey National Data Report 2013\u20132017: prevalence of HIV, HCV and injecting and sexual behaviour among NSP attendees","author":"Heard S.","year":"2018"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.12746"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/pme.12295"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1204141"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1257\/pol.20170082"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2018.05232"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.18773\/austprescr.2019.007"},{"key":"e_1_2_8_51_1","unstructured":"Drugs Poisons and Controlled Substances Amendment (Real\u2010time Prescription Monitoring) Act 2017. Victoria: Chief Parliamentary Counsel;2017."},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/bkx013"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja15.01181"}],"container-title":["Addiction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.14784","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/add.14784","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.14784","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T05:55:18Z","timestamp":1780984518000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/add.14784"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,2]]},"references-count":52,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2020,2]]}},"alternative-id":["10.1111\/add.14784"],"URL":"https:\/\/doi.org\/10.1111\/add.14784","archive":["Portico"],"relation":{},"ISSN":["0965-2140","1360-0443"],"issn-type":[{"value":"0965-2140","type":"print"},{"value":"1360-0443","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,2]]},"assertion":[{"value":"2019-03-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-08-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-12-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}