3. Changes in primary cause of overdose deaths following liberalisations in opioid prescription practices and differences in overdose death correlates.
Previous studies have found an association between opioid prescription practices and overdose deaths. There has been changes in opioid prescription practices in Norway. This study examine trend 2010-2018 in heroin and pharmaceutical opioid (PO) overdose deaths and examine and compare overdose death correlates.
Accidental PO and heroin overdose deaths identified through the Norwegian Cause of Death Registry (n=1267) and cross-linked with population and patient registries. Overdose death correlates examined using multivariable logistic regression.
The likelihood of PO overdose death increased by 13% each year. Those dying in public spaces (Adjusted Odds Ratios (aOR)=0.5 95% Confidence Intervals (CI)=0.4-0.7)), living in urban areas (aOR=0.5 95% CI=0.4-0.6), having recent specialised drug treatment encounters (aOR=0.7 95% CI 0.5-0.9), or criminal charge(s) (aOR=0.6 95% CI=0.4-0.8) were less likely to have died from a PO overdose, while those ≥50 years (aOR=1.6 95% CI=1.0-2.5), receiving a disability pension (aOR=1.6 95% CI=1.2-2.2) or having the highest net wealth (aOR=2.3 95% CI=1.3-4.0) were more likely to have died from a PO overdose. The likelihood of a PO overdose death increased by 90% for those with back problems and 60% for accidents and injuries, while it was reduced by 40% for those with a substance use disorder among primary health care attendants.
Following liberalisations of opioid prescription practices in Norway there has been a shift from heroin to PO being the main cause of overdose death. Those dying from PO and heroin overdoses differ greatly in sociodemographic characteristics, primary and secondary health care encounters, and criminal charges.