However, since the ODPRN’s initial launch of this tool in 2018, the landscape of the overdose crisis in Ontario has shifted, with an increasing recognition that the majority of opioid-related harms have been associated with the unregulated opioid supply, which is predominantly made up of fentanyl. [...] To better meet the needs of the current crisis, the tool was updated in August 2022 with new indicators that focus less on the dispensing of opioids for pain, and more on opioids used for the treatment of opioid use disorder, complications arising from opioid-related harms, and harm reduction. [...] We used data from the NMS to present trends in the number and rate of people dispensed opioid prescriptions, the number and rate of people receiving high daily dose opioid prescriptions, the volume of opioid prescriptions dispensed, the number and rate of people with opioid agonist therapy (OAT) use, and the number and rate of prescribers for OAT. [...] We restricted to hospitalizations among individuals with a history of opioid use disorder, which was defined as an emergency department visit or hospitalization for opioid use disorder or a prescription for OAT in the 1 year prior to or on the date of hospitalization. [...] We then use the following formula to calculate the fentanyl dose in milligrams of morphine equivalents: 𝑑𝑑𝑑𝑑𝑑𝑑𝑑𝑑 = 𝑞𝑞𝑞𝑞𝑞𝑞𝑞𝑞𝑞𝑞𝑞𝑞𝑞𝑞𝑞𝑞 ∗ 𝑑𝑑𝑞𝑞𝑞𝑞𝑑𝑑 𝑑𝑑𝑓𝑓 𝑝𝑝𝑞𝑞𝑞𝑞𝑐𝑐ℎ 𝑞𝑞𝑑𝑑𝑑𝑑 ∗ 𝑐𝑐𝑑𝑑𝑞𝑞𝑐𝑐𝑑𝑑𝑠𝑠𝑑𝑑𝑞𝑞𝑑𝑑𝑞𝑞 𝑓𝑓𝑞𝑞𝑐𝑐𝑞𝑞𝑑𝑑𝑠𝑠 Once the total dose of the dispensed opioid prescription is calculated, the average daily dose (i.e., the amount of t.
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Table of Contents
- Background 3
- Indicators 4
- Opioids for Pain 4
- Individuals dispensed an opioid for pain 4
- Volume of opioids dispensed for pain 5
- Opioids for Opioid Agonist Therapy 6
- Individuals dispensed an opioid for OAT 6
- Individuals newly dispensed an opioid for OAT 6
- Prescribers for OAT 7
- Opioid-Related Harm 8
- Incident healthcare encounters for opioid-related infective endocarditis 8
- Incident healthcare encounters for opioid-related serious infections 8
- Opioid toxicity incidents resulting in serious complications 8
- Harm Reduction 9
- Naloxone doses provided 9
- Community-provided naloxone doses 9
- Pharmacy-provided naloxone doses 9
- Straight stems provided 10
- Bowl pipes provided 10
- Foils provided 10
- Paper straws provided 10
- EMS Opioid Response 11
- Suspected opioid toxicities treated by emergency medical services 11
- Data Sources 11
- ICES Data 11
- Dispensed Opioid Prescriptions 11
- Pharmacy-provided Naloxone 11
- Drug Information Database 12
- Opioid-related Harms 12
- Other Health Services 12
- Demographics 12
- Ontario Ministry of Health Data 12
- Methodological Notes 13
- List of opioids by drug and formulation 15
- Milligrams of morphine equivalents 17
- List of healthcare encounters and associated diagnosis codes 19
- Small cell censoring and suppression 20
- Acknowledgements 20
- Suggested Citation 20