Assessing the prevalence of non-medical prescription opioid use in the Canadian general adult population: evidence of large variation depending on survey questions used

BMC Psychiatry

Research Article

Anca Ialomiteanu¹  Benedikt Fischer²  Kevin D Shield³  Jürgen Rehm⁴ 

[1] Centre for Addiction and Mental Health (CAMH), 33 Russell Street, M5S 2S1, Toronto, Ontario, Canada;Centre for Addiction and Mental Health (CAMH), 33 Russell Street, M5S 2S1, Toronto, Ontario, Canada;Centre for Applied Research in Mental Health and Addiction, Simon Fraser University, Faculty of Health Sciences, Vancouver, British Columbia, Canada;Centre for Addiction and Mental Health (CAMH), 33 Russell Street, M5S 2S1, Toronto, Ontario, Canada;Institute of Medical Sciences (IMS), University of Toronto, Toronto, Ontario, Canada;Centre for Addiction and Mental Health (CAMH), 33 Russell Street, M5S 2S1, Toronto, Ontario, Canada;Institute of Medical Sciences (IMS), University of Toronto, Toronto, Ontario, Canada;Dalla Lana School of Public Health (DLSPH), University of Toronto, Toronto, Ontario, Canada;Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, Dresden, Germany;

关键词: Prescription Opioids;    Non-medical use;    Surveillance;    General population;    Morbidity;   

DOI  :  10.1186/1471-244X-13-6

 received in 2012-03-08, accepted in 2012-12-27,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundMorbidity and mortality related to Prescription Opioid Analgesics (POAs) have been rising sharply in North America. Non-Medical Prescription Opioid Use (NMPOU) in the general population is a key indicator of POA-related harm, yet the role of question item design for best NMPOU prevalence estimates in general population surveys is unclear, and existing NMPOU survey data for Canada are limited.MethodsWe tested the impact of different NMPOU question items by comparing an item in the 2008 and 2009 (N = 2,017) samples of the CAMH Monitor surveys – an Ontario adult general population survey – with a newly developed item used in the 2010 (N = 2,015) samples of the Centre for Addiction and Mental Health (CAMH) Monitor surveys. To control for a potential difference in the population demographics between surveys, we adjusted for gender, age, region, income, prescription opioid use, cigarette smoking, weekly binge drinking, cannabis use in the past three months, and psychological distress in our analyses.ResultsThe prevalence of NMPOU as measured by the 2008 and 2009 CAMH monitor (2.0% [95% CI: 1.2% to 2.8%]) was significantly different when compared to the prevalence of NMPOU as measured by the 2010 CAMH monitor (7.7% [95% CI: 6.3% to 9.2%]) (p < 0.001). This difference was also found when stratifying our analysis by sex (p < 0.001) and when adjusting for all potential confounding covariates.ConclusionIt is highly unlikely that the extensive NMPOU prevalence differences observed from the different survey items reflect an actual increase of NMPOU or changes in NMPOU determinants, but rather point to measurement effects. It appears that we currently do not have accurate estimates of NMPOU in the Canadian general population, even though these estimates are needed to guide and implement targeted interventions. Given the current substantial morbidity and mortality impact of NMPOU, there is an urgent need to systematically develop, validate and standardize NMPOU items for future general population surveys in Canada.

【 授权许可】

CC BY   
© Shield et al.; licensee BioMed Central Ltd. 2013