Impact of the COVID-19 pandemic on opioid toxicity mortality rates in Nova Scotia: An interrupted time series analysis (2009-2023).

IF 2.6 4区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Canadian Journal of Public Health-Revue Canadienne De Sante Publique Pub Date : 2025-08-06 DOI:10.17269/s41997-025-01092-8

Cindy Feng, Mark Asbridge, Amy Grant, Lihui Liu, Guanjie Lyu, Fahima Hassan

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引用次数: 0

Abstract

Objectives: To examine trends in opioid toxicity mortality in Nova Scotia and its health zones from 2009 to 2023, focusing on differences between pharmaceutical and non-pharmaceutical opioid-related deaths.

Methods: We conducted a population-based study using data on annual opioid toxicity mortality rates from 2009 to 2023, stratified by health zone and opioid type. An interrupted time series (ITS) analysis was applied to assess changes in mortality trends across three pandemic-related periods. Comparisons were made between pharmaceutical and non-pharmaceutical opioid mortality to assess evolving patterns of opioid-related harm.

Results: Opioid toxicity mortality in Nova Scotia declined during the peri-pandemic period (2019-2021) but increased significantly post-pandemic, particularly in non-pharmaceutical opioid-related deaths, which steadily rose after 2021. Pharmaceutical opioid-related deaths remained higher than non-pharmaceutical deaths. Health zone analysis revealed geographic variation: the Central Zone experienced stable pharmaceutical mortality with rising non-pharmaceutical deaths post-pandemic; the Eastern Zone saw higher pharmaceutical mortality pre-pandemic, which declined during the peri-pandemic period, while non-pharmaceutical deaths remained low; the Northern Zone had stable pharmaceutical mortality but rising non-pharmaceutical deaths post-pandemic; and the Western Zone exhibited consistently lower mortality rates across both opioid types.

Conclusion: This study reveals significant shifts in opioid-related mortality trends in Nova Scotia, with a rise in non-pharmaceutical opioid deaths post-pandemic, while pharmaceutical opioids remain a major contributor. Geographic variations across health zones highlight the need for region-specific public health strategies. Ongoing efforts to reduce both pharmaceutical and illicit opioid misuse through harm reduction and improved prescribing practices are crucial.

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2019冠状病毒病大流行对新斯科舍省阿片类药物毒性死亡率的影响：中断时间序列分析（2009-2023）。

目的：研究2009年至2023年新斯科舍省及其卫生区阿片类药物毒性死亡率的趋势，重点研究药物和非药物阿片类药物相关死亡之间的差异。方法：我们进行了一项基于人群的研究，使用2009年至2023年阿片类药物毒性死亡率的数据，按卫生区和阿片类药物类型分层。采用中断时间序列（ITS）分析来评估三个大流行相关时期死亡率趋势的变化。比较了药物和非药物阿片类药物死亡率，以评估阿片类药物相关危害的演变模式。结果：新斯科舍省阿片类药物毒性死亡率在大流行期间（2019-2021年）下降，但在大流行后显著上升，特别是与非药物阿片类药物相关的死亡，在2021年之后稳步上升。与药物类阿片有关的死亡人数仍然高于非药物类死亡人数。卫生区域分析揭示了地理差异：大流行后，中心区药物死亡率稳定，非药物死亡率上升；东部地区在大流行前的药物死亡率较高，在大流行期间有所下降，而非药物死亡率仍然很低；北区的药物死亡率稳定，但大流行后非药物死亡率上升；西部地区两种阿片类药物的死亡率均较低。结论：本研究揭示了新斯科舍省阿片类药物相关死亡率趋势的重大变化，大流行后非药物阿片类药物死亡人数上升，而药物阿片类药物仍然是主要原因。卫生区域之间的地理差异突出表明需要制定针对特定区域的公共卫生战略。通过减少危害和改进处方做法减少药物和非法阿片类药物滥用的持续努力至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Canadian Journal of Public Health-Revue Canadienne De Sante Publique PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

6.10

自引率

4.70%

发文量

128

期刊介绍： The Canadian Journal of Public Health is dedicated to fostering excellence in public health research, scholarship, policy and practice. The aim of the Journal is to advance public health research and practice in Canada and around the world, thus contributing to the improvement of the health of populations and the reduction of health inequalities. CJPH publishes original research and scholarly articles submitted in either English or French that are relevant to population and public health. CJPH is an independent, peer-reviewed journal owned by the Canadian Public Health Association and published by Springer. Énoncé de mission La Revue canadienne de santé publique se consacre à promouvoir l’excellence dans la recherche, les travaux d’érudition, les politiques et les pratiques de santé publique. Son but est de faire progresser la recherche et les pratiques de santé publique au Canada et dans le monde, contribuant ainsi à l’amélioration de la santé des populations et à la réduction des inégalités de santé. La RCSP publie des articles savants et des travaux inédits, soumis en anglais ou en français, qui sont d’intérêt pour la santé publique et des populations. La RCSP est une revue indépendante avec comité de lecture, propriété de l’Association canadienne de santé publique et publiée par Springer.