Opioid‐related overdose deaths among people experiencing homelessness, 2017 to 2021: A population‐based analysis using coroner and health administrative data from Ontario, Canada.

Aims: To measure the change in proportion of opioid‐related overdose deaths attributed to people experiencing homelessness and to compare the opioid‐related fatalities between individuals experiencing homelessness and not experiencing homelessness at time of death. Design, setting and participants:...

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Publicado en:Addiction Vol. 119; no. 2; pp. 334 - 345
Autores principales: Booth, Richard G., Shariff, Salimah Z., Carter, Brooke, Hwang, Stephen W., Orkin, Aaron M., Forchuk, Cheryl, Gomes, Tara
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Feb2024
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Opioid‐related overdose deaths among people experiencing homelessness, 2017 to 2021: A population‐based analysis using coroner and health administrative data from Ontario, Canada.
      aug:
        au:
          Booth, Richard G.
          Shariff, Salimah Z.
          Carter, Brooke
          Hwang, Stephen W.
          Orkin, Aaron M.
          Forchuk, Cheryl
          Gomes, Tara
        affil: Arthur Labatt Family School of Nursing, Western University, London, Canada
      sug:
        subj:
          Opiate Overdose Mortality
          Homelessness
          Human
          Ontario
          Time Series
          Comparative Studies
          Secondary Analysis
          Homeless Persons Psychosocial Factors
          Sociodemographic Factors
          Adult
          Middle Age
          Age Factors
          Aged
          Mental Disorders
          Substance Use Disorders
          Health Resource Utilization
          Methadone Poisoning
          Resuscitation
          Naloxone Therapeutic Use
          Descriptive Statistics
          Female
          Male
          Funding Source
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Female
          Male
      ab: Aims: To measure the change in proportion of opioid‐related overdose deaths attributed to people experiencing homelessness and to compare the opioid‐related fatalities between individuals experiencing homelessness and not experiencing homelessness at time of death. Design, setting and participants: Population‐based, time‐trend analysis using coroner and health administrative databases from Ontario, Canada from 1 July 2017 and 30 June 2021. Measurements: Quarterly proportion of opioid‐related overdose deaths attributed to people experiencing homelessness. We also obtained socio‐demographic and health characteristics of decedents, health‐care encounters preceding death, substances directly contributing to death and circumstances surrounding deaths. Findings A total of 6644 individuals (median age = 40 years, interquartile range = 31–51; 74.1% male) experienced an accidental opioid‐related overdose death, among whom 884 (13.3%) were identified as experiencing homelessness at the time of death. The quarterly proportion of opioid‐related overdose deaths attributed to people experiencing homelessness increased from 7.2% (26/359) in July–September 2017 to 16.8% (97/578) by April–June 2021 (trend test P < 0.01). Compared with housed decedents, those experiencing homelessness were younger (61.3 versus 53.1% aged 25–44), had higher prevalence of mental health or substance use disorders (77.1 versus 67.1%) and more often visited hospitals (32.1 versus 24.5%) and emergency departments (82.6 versus 68.5%) in the year prior to death. Fentanyl and its analogues more often directly contributed to death among people experiencing homelessness (94.0 versus 81.4%), as did stimulants (67.4 versus 51.6%); in contrast, methadone was less often present (7.8 versus 12.4%). Individuals experiencing homelessness were more often in the presence of a bystander during the acute toxicity event that led to death (55.8 versus 49.7%); and where another individual was present, more often had a resuscitation attempted (61.7 versus 55.1%) or naloxone administered (41.2 versus 28.9%). Conclusions: People experiencing homelessness account for an increasing proportion of fatal opioid‐related overdoses in Ontario, Canada, reaching nearly one in six such deaths in 2021.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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