A recent study analyzing Fraser Health Emergency Department visits is offering new insights into the relationship between opioid overdoses following a post-injury prescription.
Dr. Aamir Bharmal, study co-author and medical health officer at Fraser Health, says much of the information available on the relationship between injury and risk of overdose was in individual anecdotes or stories.
“What we really wanted to try and understand is OK, well what is that relationship? And can we understand more, rather than just the individual stories? What happens at a population level?” he said.
Individuals with no previous history of opioid use who were prescribed opioids for an injury following a hospital visit were 27 per cent more likely to suffer a non-medical drug poisoning than those who were not prescribed opioids or opioid agonist therapy. However, this risk is lower than other contributing factors such as age, being male, and having lower income.
In addition, results of the study debunked the previously thought stereotype that there is a higher risk of overdose for those who received opioids for workplace-associated injuries.
In fact, those who were injured on the job are 18 per cent less likely to be prescribed opioids and 38 per cent less likely to suffer from a drug-poisoning event than someone who is injured outside of the workplace. Bharmal said that this was one of the most surprising results they came across.
In 2016, B.C. declared a public health emergency in response to the rapid increase in opioid-related death. According to the study, 70 per cent of the 300,000 emergency department visits between 2012 and 2018 were not prescribed opioids. The biggest predictor for whether someone will receive them as a treatment is dependent on whether they have been prescribed them before for pain management.
Results also confirmed that men under 35 in lower income brackets have the highest risk of overdose.
“This is consistent with data from the BC Coroners Service indicating that men between 30 and 39 years of age suffer the most overdose deaths, with decreasing rates for older age groups,” according to a media statement.
Bharmal says that the next steps are now to understand further how workplace injuries affect the likelihood of a drug poisoning event, such as analyzing different occupational groups.
“I think another piece is also just in terms of helping, kind of, solidify some of the guidelines that we have for opioid prescribing,” he said. “This also reinforces that it does show that there is a risk, but, we might just need to think about it in terms of that individual person and what are their individual risk factors to determine whether they might be at higher opioid overdose risk or not.”