Wynne William, Iacono Anita, Yang Joanna, Hamzat Bisola, Leece Pamela, Kolla Gillian, Boyd Rob, Bozinoff Nikki, Franklyn Mike, Shearer Dana, Smoke Ashley, Wu Fangyun, Newcombe Paul, Gomes Tara
Li Ka Shing Knowledge Institute of St. Michael's Hospital, 30 Bond St, Toronto, ON M5B 1W8, Canada.
Department of Health Studies, University of Toronto, 25 King's College Circle, Toronto, ON M5S 1A1, Canada.
Alcohol Alcohol. 2025 Jul 16;60(5). doi: 10.1093/alcalc/agaf055.
Despite a high prevalence of alcohol use disorder (AUD) in Canada, access to medication-based treatment remains poor. Therefore, our aim was to explore patterns of alcohol toxicity deaths in Ontario, Canada, circumstances surrounding death, prior healthcare interactions, and pharmacotherapy for AUD.
We conducted a population-based repeated cross-sectional study of alcohol toxicity deaths occurring between 1 January 2018 and 30 June 2022 in Ontario, Canada. We reported trends in deaths over time and determined demographic characteristics of decedents, circumstances surrounding death, and prior healthcare interactions. Among a subset of the cohort with an AUD diagnosis eligible for public drug benefits, we reported receipt of medications used to treat AUD before death.
We identified 1346 alcohol toxicity deaths over the study period, at a median age of 42 years, with 73.8% occurring among men. The majority of alcohol toxicity deaths involved other substances, including opioids (75.2%), benzodiazepines (10.8%), and/or stimulants (45.2%). Half had an AUD (50.4%) and 62.7% had an opioid, benzodiazepine or stimulant use disorder. Among decedents who were public drug beneficiaries with an AUD (N = 361), only 3.6% were actively prescribed first-line AUD pharmacotherapies (naltrexone and/or acamprosate) at time of death.
We found that the majority of alcohol toxicity deaths in Ontario involved other non-alcohol substances. We also detected a high prevalence of prior healthcare encounters for substance use disorders (SUDs) and low prevalence of evidence-based AUD pharmacotherapy. This suggests a need for integrated treatment across concurrent SUDs and improved access to pharmacotherapies for AUD across Ontario.
尽管加拿大酒精使用障碍（AUD）的患病率很高，但基于药物的治疗方法的可及性仍然很差。因此，我们的目的是探讨加拿大安大略省酒精中毒死亡的模式、死亡情况、先前的医疗保健接触以及AUD的药物治疗。
我们对2018年1月1日至2022年6月30日在加拿大安大略省发生的酒精中毒死亡进行了基于人群的重复横断面研究。我们报告了随时间推移的死亡趋势，并确定了死者的人口统计学特征、死亡情况以及先前的医疗保健接触。在符合公共药物福利资格的AUD诊断队列子集中，我们报告了在死亡前接受用于治疗AUD的药物的情况。
在研究期间，我们确定了1346例酒精中毒死亡病例，中位年龄为42岁，其中73.8%发生在男性中。大多数酒精中毒死亡涉及其他物质，包括阿片类药物（75.2%）、苯二氮䓬类药物（10.8%）和/或兴奋剂（45.2%）。一半的人患有AUD（50.4%），62.7%的人患有阿片类药物、苯二氮䓬类药物或兴奋剂使用障碍。在患有AUD的公共药物受益死者中（N = 361），只有3.6%在死亡时被积极开具一线AUD药物治疗（纳曲酮和/或阿坎酸）。
我们发现安大略省大多数酒精中毒死亡涉及其他非酒精物质。我们还发现物质使用障碍（SUDs）先前的医疗保健接触患病率很高，而基于证据的AUD药物治疗患病率很低。这表明需要对并发的SUDs进行综合治疗，并改善安大略省AUD药物治疗的可及性。
