{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:35:31Z","timestamp":1774917331655,"version":"3.50.1"},"reference-count":43,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,1,13]],"date-time":"2020-01-13T00:00:00Z","timestamp":1578873600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1163961"],"award-info":[{"award-number":["1163961"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aims<\/jats:title><jats:p>Despite increases in opioid prescribing and related morbidity and mortality, few studies have comprehensively documented harms across opioid types. We examined a population\u2010wide indicator of extramedical pharmaceutical opioid\u2010related harm to determine if the supply\u2010adjusted rates of ambulance presentations, the severity of presentations or other attendance characteristics differed by opioid type.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective observational study of coded ambulance patient care records related to extramedical pharmaceutical opioid use, January 2013 to September 2018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Australia<\/jats:p><\/jats:sec><jats:sec><jats:title>Cases<\/jats:title><jats:p>Primary analyses used Victorian data (<jats:italic>n<\/jats:italic>\u00a0=\u00a09823), with available data from other Australian jurisdictions (<jats:italic>n<\/jats:italic>\u00a0=\u00a04338) used to determine generalizability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>We calculated supply\u2010adjusted rates of attendances using Poisson regression, and used multinomial logistic regression to compare demographic, presentation severity, mental health, substance use and other characteristics of attendances associated with seven pharmaceutical opioids.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>In Victoria, the highest rates of attendance [per 100\u2009000 oral morphine equivalent mg (OME)] were for codeine (0.273\/100\u2009000) and oxycodone (0.113\/100\u2009000). The lowest rates were for fentanyl (0.019\/100\u2009000) and tapentadol (0.005\/100\u2009000). Oxycodone\u2013naloxone rates (0.031\/100 000) were lower than for oxycodone as a single ingredient (0.113\/100\u2009000). Fentanyl\u2010related attendances were associated with the most severe characteristics, most likely to be an accidental overdose, most likely to have naloxone administered and least likely to be transferred to hospital. In contrast, codeine\u2010related attendances were more likely to involve suicidal thoughts\/behaviours, younger females and be transported to hospital. Supply\u2010adjusted attendance rates for individual opioids were stable over time. Victorian states were broadly consistent with non\u2010Victorian states.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In Australia, rates and characteristics of opioid\u2010related harm vary by opioid type. Supply\u2010adjusted ambulance attendance rates appear to be both stable over time and unaffected by large changes in supply.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.14896","type":"journal-article","created":{"date-parts":[[2019,11,19]],"date-time":"2019-11-19T01:00:55Z","timestamp":1574125255000},"page":"1075-1087","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Comparing rates and characteristics of ambulance attendances related to extramedical use of pharmaceutical opioids in Victoria, Australia from 2013 to 2018"],"prefix":"10.1111","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5341-1055","authenticated-orcid":false,"given":"Suzanne","family":"Nielsen","sequence":"first","affiliation":[{"name":"Monash Addiction Research Centre, Eastern Health Clinical School Monash University  Frankston Victoria 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