Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Jan;55(1):68-9, 69.e1-5.

Changing patterns in opioid addiction: characterizing users of oxycodone and other opioids

Beth Sproule  1 , Bruna Brands, Selina Li, Laura Catz-Biro
Affiliations

Changing patterns in opioid addiction: characterizing users of oxycodone and other opioids

Beth Sproule et al. Can Fam Physician. 2009 Jan.

Abstract
in English, French

Objective: To evaluate the clinical observation that the number of individuals seeking opioid detoxification from oxycodone was increasing at the Centre for Addiction and Mental Health (CAMH) in Toronto, Ont; and to identify the characteristics of individuals seeking opioid detoxification at CAMH.

Design: Retrospective analysis of patient health records.

Setting: Medical Withdrawal Management Service at CAMH.

Participants: All patients admitted for opioid detoxification between January 2000 and December 2004.

Main outcome measures: Number of opioid detoxification admissions each year; type, dose, and source of opioids; comorbid problems and symptoms.

Results: There were 571 opioid detoxification admissions during the 5-year study period. The number of admissions increased steadily over the 5 years; in particular, the number of admissions related to controlled-release oxycodone increased substantially (3.8%, 8.3%, 20.8%, 30.6%, and 55.4% of the total opioid admissions in 2000 to 2004, respectively; chi(4)2= 105.5, P < .001). The rates of admissions involving heroin remained low and stable. Use of controlled-release oxycodone was associated with considerably higher doses than use of other prescription opioids was. Physician prescriptions were the source of the prescription opioids for a large percentage of patients, particularly for older patients. Prescription opioid users reported considerable comorbid substance use problems, pain, and psychiatric symptoms.

Conclusion: This study has demonstrated a significant rise in the number of individuals seeking treatment at CAMH for controlled-release oxycodone addiction. The substantial comorbid pain, psychiatric symptoms, and other psychoactive substance use problems in these patients, coupled with the finding that prescriptions were an important source of opioids, highlight the clinical complexities encountered in the treatment of these individuals. Further research examining these complexities and the many possible pathways leading to prescription opioid addiction is required in order to develop effective prevention and treatment strategies.

OBJECTIF: Vérifier l’observation clinique qui indique que le nombre de personnes venues au Center for Addiction and Mental Health (CAMH) de Toronto, en Ontario, pour sevrage de l’oxycodone a augmenté; et déterminer les caractéristiques des personnes qui se présentent au CAMH pour sevrage des opiacés.

TYPE D’ÉTUDE: Analyse rétrospective à partir des dossiers médicaux des patients.

CONTEXTE: Le Medical Withdrawal Management Service du CAMH.

PARTICIPANTS: Tous les patients admis pour sevrage des opiacés entre janvier 2000 et décembre 2004.

PRINCIPAUX PARAMÈTRES À L’ÉTUDE: Nombre annuel d’admissions pour sevrage des opiacés; type, dose et source des opiacés; comorbidité associée et symptômes.

RÉSULTATS: Il y a eu 571 admissions pour sevrage des opiacés au cours des 5 années de l’étude. Le nombre d’admissions a augmenté régulièrement d’une année à l’autre; en particulier, celui des admissions en lien avec l’oxycodone à libération contrôlée a augmenté de façon substantielle (3,8%, 8,3%, 20,8%, 30,6% et 55,4% de toutes les admissions, respectivement, pour chacune des années entre 2000 et 2004; χ4= 105,5, P < 0,001). Le taux d’admission pour l’héroïne est demeuré stable à un bas niveau. Par rapport aux autres opiacés sur ordonnance, l’’oxycodone à libération contrôlée était associée à des doses beaucoup plus élevées. Pour un fort pourcentage de patients, notamment les plus âgés, les opiacés sur ordonnance provenaient de prescriptions médicales. Les utilisateurs d’opiacés sur ordonnance ont avoué avoir d’importants problèmes associés de toxicomanie, de douleur et de symptômes psychiatriques.

CONCLUSION: Cette étude a montré une augmentation significative du nombre de personnes venues au CAMH pour sevrage de l’oxycodone à libération contrôlée . L’importance des douleurs, symptômes psychiatriques et autres problèmes d’abus de psychotropes chez ces patients fait ressortir la nature complexe du traitement clinique de ces patients. D’autres études devront examiner ces difficultés et les multiples voies conduisant à la dépendance aux opiacés sur ordonnance si on veut développer des stratégies de prévention et de traitement efficaces.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Admissions to the Medical Withdrawal Management Service for opioid detoxification, 2000–2004
The number of admissions increased over the 5 years (2000, n = 78; 2001, n = 96; 2002, n = 120; 2003, n = 111; and 2004, n = 166). Of the 571 admissions, 295 involved 1 opioid, 204 involved 2 opioids, 68 involved 3 opioids, and 4 involved 4 opioids.
Figure 2
Figure 2
Prescription opioid source by age group
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Fischer B, Rehm J, Patra J, Cruz MF. Changes in illicit opioid use across Canada. CMAJ. 2006;175(11):1385. - PMC - PubMed
    1. Brands B, Blake J, Sproule BA, Gourlay D, Busto U. Prescription opioid abuse in patients presenting for methadone maintenance treatment. Drug Alcohol Depend. 2004;73(2):199–207. - PubMed
    1. Gutstein HB, Akil H. Opioid analgesics. In: Brunton LL, Lazo JS, Parker KL, editors. Goodman & Gilman’s the pharmacological basis of therapeutics. 11th ed. New York, NY: McGraw-Hill; 2005.
    1. Ball J, Lehder Roberts D. Oxycodone, hydrocodone, and polydrug use, 2002. DAWN Rep. 2004. Jul [Accessed 2008 Nov 25]. pp. 1–4. Available from: http://dawninfo.samhsa.gov/old_dawn/pubs_94_02/shortreports/files/DAWN_t....
    1. Substance Abuse and Mental Health Services Administration. Treatment admissions involving narcotic painkillers: 2002 update. DASIS Rep. 2004 Jul;:1–3. [Accessed 2008 Nov 25]; Available from: www.oas.samhsa.gov/2k4/painTX/painTX.htm.

Publication types