title: The impact of prescription opioids on all-cause mortality in Canada.
abstract: An influential study from the United States generated considerable discussion and debate. This study documented rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century, with clear linkages of all-cause mortality to increasing rates of poisonings, suicides and chronic liver disease deaths. All of these causes of deaths are strongly related to the use of legal and illegal substances, but the study stressed the importance of prescription opioids. Given the similarities between the United States and Canada in prescription opioid use, the assessment of similar all-cause mortality trends is relevant for Canada. As this commentary highlights, the all-cause mortality shifts seen in the United States cannot be seen in Canada for either sex or age groups. The exact reasons for the differences between the two countries are not clear, but it is important for public health to further explore this question.
authors.affiliation: Institute of Medical Science, University of Toronto, Toronto, Canada. sameer.imtiaz@gmail.com.|Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Canada. sameer.imtiaz@gmail.com.
authors.forename: Sameer
authors.initials: S
authors.lastname: Imtiaz
authors.affiliation: Institute of Medical Science, University of Toronto, Toronto, Canada.|Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Canada.|Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada.|Department of Psychiatry, University of Toronto, Toronto, Canada.|Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.|Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Rehm
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002170:Canada; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D009293:Opioid-Related Disorders / Q000401:mortality*; D011041:Poisoning / Q000401:mortality*; D063487:Prescription Drug Misuse / Q000401:mortality* / Q000639:trends*; D055815:Young Adult
keywords: All-cause mortality; Canada; Drug poisoning mortality; Opioid analgesics