{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T18:24:37Z","timestamp":1790447077056,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T00:00:00Z","timestamp":1722902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>We aimed to describe rates and toxicological findings of unintentional opioid and stimulant toxicity deaths, 2012\u20132021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The dataset included accidental deaths determined by the Coroner to be due to opioids or stimulants. We calculated annual crude mortality rates and described combinations of drugs identified in toxicological examinations of these deaths. We described temporal trends in the detection of specific opioids, stimulants, benzodiazepines (including novel benzodiazepines), gabapentinoids and z\u2010drugs in deaths due to opioids and stimulants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mortality rates increased over time, reaching their peak in 2020 and remaining high in 2021. In deaths due to opioids, there was a decline in the proportion of deaths involving pharmaceutical opioids after 2019, and a corresponding increase in the proportion of deaths with fentanyl detected. Benzodiazepines were often present in deaths due to opioids, with novel benzodiazepines increasing rapidly from 2019 onwards. Cocaine was the most frequently detected drug in deaths due to stimulants, but amphetamine\/methamphetamine was detected in around half of all stimulant deaths from 2016 onwards.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Conclusions<\/jats:title>\n                    <jats:p>Despite availability of a multitude of overdose prevention interventions, mortality rates due to drug toxicity have increased in Qu\u00e9bec. Toxicological findings of these deaths suggest concerning shifts in the illicit drug market, with Qu\u00e9bec potentially having entered a new era of elevated overdose mortality. Intervention scale\u2010up is essential, but unlikely to be sufficient, to reduce drug\u2010related mortality. Policy reform to address the root causes of drug toxicity deaths, including an unpredictable drug supply, strained health systems and socio\u2010economic precarity, is essential.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dar.13918","type":"journal-article","created":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T23:34:38Z","timestamp":1722987278000},"page":"1613-1624","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Trends in toxicological findings in unintentional opioid or stimulant toxicity deaths in Qu\u00e9bec, Canada, 2012\u20132021: Has Qu\u00e9bec entered a new era of drug\u2010related deaths?"],"prefix":"10.1111","volume":"43","author":[{"given":"Uyen","family":"Do","sequence":"first","affiliation":[{"name":"Centre de recherche du Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al  Montr\u00e9al Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul\u2010Andr\u00e9","family":"Perron","sequence":"additional","affiliation":[{"name":"Bureau du coroner  Montr\u00e9al Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3484-6456","authenticated-orcid":false,"given":"Julie","family":"Bruneau","sequence":"additional","affiliation":[{"name":"Centre de recherche du Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al  Montr\u00e9al Canada"},{"name":"Department of Family Medicine and Emergency Medicine, Faculty of Medicine University of Montr\u00e9al  Montr\u00e9al Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5602-4963","authenticated-orcid":false,"given":"Sarah","family":"Larney","sequence":"additional","affiliation":[{"name":"Centre de recherche du Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al  Montr\u00e9al Canada"},{"name":"Department of Family Medicine and Emergency Medicine, Faculty of Medicine University of Montr\u00e9al  Montr\u00e9al Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,6]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Opioid\u2010 and stimulant\u2010related harms in Canada [Internet]. 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