{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:22:36Z","timestamp":1788870156376,"version":"build-2803163510"},"reference-count":44,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,11,21]],"date-time":"2013-11-21T00:00:00Z","timestamp":1384992000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Canadian Institutes of Health Research (CIHR)","award":["SAF-94814"],"award-info":[{"award-number":["SAF-94814"]}]},{"name":"Canadian Institutes of Health Research (CIHR)","award":["GIR-109852"],"award-info":[{"award-number":["GIR-109852"]}]},{"name":"CIHR\/PHAC Applied Public Health Research Chair"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2014,1]]},"abstract":"Abstract<\/jats:title>\n \n Introduction and Aims<\/jats:title>\n \n Prescription opioid analgesic (\n POA<\/jats:styled-content>\n )\u2010related harms constitute a major public health problem in\n N<\/jats:styled-content>\n orth\n A<\/jats:styled-content>\n merica.\n O<\/jats:styled-content>\n ntario features above\u2010average\n POA<\/jats:styled-content>\n use levels in\n C<\/jats:styled-content>\n anada and has seen consistent increases in related mortality and morbidity. Recent studies documented strong correlations between\n POA<\/jats:styled-content>\n dispensing levels and related harm outcomes on population levels. We examined correlations between\n POA<\/jats:styled-content>\n dispensing and key\n POA<\/jats:styled-content>\n \u2010related mortality and morbidity indicators in\n O<\/jats:styled-content>\n ntario, 2005\u20132011.\n <\/jats:p>\n <\/jats:sec>\n \n Design and Methods<\/jats:title>\n \n Correlations between (i) annual dispensing levels of four strong\n POA<\/jats:styled-content>\n formulations (fentanyl, hydromorphone, morphine and oxycodone; from\n IMS<\/jats:styled-content>\n Brogan's Compuscript converted to defined daily doses) and\n POA<\/jats:styled-content>\n \u2010related mortality (based on provincial coroner's data) and (ii) annual total\n POA<\/jats:styled-content>\n dispensing and\n POA<\/jats:styled-content>\n \u2010related treatment caseload (from the Drug and Alcohol Treatment Information System) were examined for the study context.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Strong and significant correlations were observed between\n POA<\/jats:styled-content>\n dispensing and mortality for three formulations, namely hydromorphone: 0.98 [95% confidence interval (\n CI<\/jats:styled-content>\n ) 0.89\u20131.00;\n P<\/jats:italic>\n \u2009\n <<\/jats:italic>\n \u20090.001], fentanyl: 0.93 (95%\n CI<\/jats:styled-content>\n 0.58\u20130.99;\n P<\/jats:italic>\n \u2009\n =<\/jats:italic>\n \u20090.003) and oxycodone: 0.93 (95%\n CI<\/jats:styled-content>\n 0.57\u20130.99;\n P<\/jats:italic>\n \u2009\n =<\/jats:italic>\n \u20090.003), but not morphine (\u22120.29; 95%\n CI<\/jats:styled-content>\n \u22120.86\u20130.59;\n P<\/jats:italic>\n \u2009\n =<\/jats:italic>\n \u20090.523), as well as for treatment when examining congruent years [0.99 (95%\n CI<\/jats:styled-content>\n 0.92\u20131.00);\n P<\/jats:italic>\n \u2009\n <<\/jats:italic>\n \u20090.001] and when using a 1\u2010year offset (1.00; 95%\n CI<\/jats:styled-content>\n 0.96\u20131.00;\n P<\/jats:italic>\n \u2009\n <<\/jats:italic>\n \u20090.001).\n <\/jats:p>\n <\/jats:sec>\n \n Discussion and Conclusions<\/jats:title>\n \n POA<\/jats:styled-content>\n dispensing levels were found to be strongly correlated with mortality and morbidity (treatment) indicators. Targeted and sensible reductions of\n POA<\/jats:styled-content>\n use level would likely constitute a primary measure to reduce\n POA<\/jats:styled-content>\n \u2010related harms on a population level, especially in a jurisdiction with high\n POA<\/jats:styled-content>\n consumption levels.\n [Fischer B, Jones W, Urbanoski K, Skinner R, Rehm J. Correlations between prescription opioid analgesic dispensing levels and related mortality and morbidity in Ontario, Canada, 2005\u20132011.<\/jats:italic>\n Drug Alcohol Rev\n 2014;33:19\u201326]<\/jats:italic>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/dar.12089","type":"journal-article","created":{"date-parts":[[2013,11,21]],"date-time":"2013-11-21T22:30:55Z","timestamp":1385073055000},"page":"19-26","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":76,"title":["Correlations between prescription opioid analgesic dispensing levels and related mortality and morbidity in\n O<\/scp>\n ntario,\n C<\/scp>\n anada, 2005\u20132011"],"prefix":"10.1111","volume":"33","author":[{"given":"Benedikt","family":"Fischer","sequence":"first","affiliation":[{"name":"Centre for Applied Research in Mental Health and Addiction Faculty of Health Sciences Simon Fraser University Vancouver Canada"},{"name":"Social and Epidemiological Research Centre for Addiction and Mental Health Toronto Canada"},{"name":"Department of Psychiatry University of Toronto Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wayne","family":"Jones","sequence":"additional","affiliation":[{"name":"Centre for Applied Research in Mental Health and Addiction Faculty of Health Sciences Simon Fraser University Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Urbanoski","sequence":"additional","affiliation":[{"name":"Social and Epidemiological Research Centre for Addiction and Mental Health Toronto Canada"},{"name":"Dalla Lana School of Population Health University of Toronto Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Skinner","sequence":"additional","affiliation":[{"name":"Office of the Chief Coroner of Ontario Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Rehm","sequence":"additional","affiliation":[{"name":"Social and Epidemiological Research Centre for Addiction and Mental Health Toronto Canada"},{"name":"Department of Psychiatry University of Toronto Toronto Canada"},{"name":"Dalla Lana School of Population Health University of Toronto Toronto Canada"},{"name":"Technische Universit\u00e4t Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,11,21]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2012\/15\/ES191"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2012\/15\/ES9"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.272"},{"key":"e_1_2_6_5_1","volume-title":"Treatment Episode Data Set (TEDS) 2000\u20132010 national admissions for substance abuse treatment services. 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