Fischer Benedikt, Ialomiteanu Anca, Kurdyak Paul, Mann Robert E, Rehm Jürgen
Centre for Applied Research in Mental Health and Addictions (CARMHA), Faculty of Health Sciences, Simon Fraser University, 2400-515 W Hastings St,, V6B 5K3, Vancouver, BC, Canada.
Subst Abuse Treat Prev Policy. 2013 Feb 14;8:7. doi: 10.1186/1747-597X-8-7.
Non-medical prescription opioid use (NMPOU) and prescription opioid (PO) related harms have become major substance use and public health problems in North America, the region with the world's highest PO use levels. In Ontario, Canada's most populous province, NMPOU rates, PO-related treatment admissions and accidental mortality have risen sharply in recent years. A series of recent policy interventions from governmental and non-governmental entities to stem PO-related problems have been implemented since 2010.
We compared the prevalence of NMPOU in the Ontario general adult population (18 years+) in 2010 and 2011 based on data from the 'Centre for Addiction and Mental Health (CAMH) Monitor' (CM), a long-standing annual telephone interview-based representative population survey of substance use and health indicators. While 'any PO use' (in past year) changed non-significantly from 26.6% to 23.9% (Chi2 = 2.511; df = 1; p = 0.113), NMPOU decreased significantly from 7.7% to 4.0% (Chi2 = 14.786; df = 1; p < 0.001) between 2010 and 2011. Over-time changes varied by age group but not by sex.
The observed substantial decrease in NMPOU in the Ontario adult population could be related to recent policy interventions, alongside extensive media reporting, focusing on NMPOU and PO-related harms, and may mean that these interventions have shown initial effects. However, other casual factors could have been involved. Thus, it is necessary to systematically examine whether the observed changes will be sustained, and whether other key PO-related harm indicators (e.g., treatment admissions, accidental mortality) change correspondingly in order to more systematically assess the impact of the policy measures.
非医疗处方阿片类药物使用（NMPOU）以及与处方阿片类药物（PO）相关的危害已成为北美地区主要的物质使用和公共卫生问题，该地区是世界上处方阿片类药物使用水平最高的地区。在加拿大人口最多的安大略省，近年来NMPOU率、与PO相关的治疗入院率和意外死亡率急剧上升。自2010年以来，政府和非政府实体实施了一系列旨在遏制与PO相关问题的政策干预措施。
我们根据“成瘾与心理健康中心（CAMH）监测”（CM）的数据，比较了2010年和2011年安大略省普通成年人口（18岁及以上）中NMPOU的患病率。CM是一项长期的年度电话访谈式代表性人口调查，涉及物质使用和健康指标。虽然“过去一年中任何PO使用”情况从26.6%略微降至23.9%（卡方=2.511；自由度=1；p=0.113），但2010年至2011年间，NMPOU从7.7%显著降至4.0%（卡方=14.786；自由度=1；p<0.001）。随时间的变化因年龄组而异，但不因性别而异。
安大略省成年人口中NMPOU的显著下降可能与近期的政策干预措施有关，同时媒体也广泛报道了NMPOU及与PO相关的危害，这可能意味着这些干预措施已初见成效。然而，可能还涉及其他偶然因素。因此，有必要系统地研究观察到的变化是否会持续，以及其他与PO相关的关键危害指标（如治疗入院率、意外死亡率）是否会相应变化，以便更系统地评估政策措施的影响。
