Chronic disease diagnoses and health service use among people who died of illicit drug toxicity in British Columbia, Canada.
Heather Palis, Kevin Hu, Andrew Tu, Frank Scheuermeyer, John A Staples, Jessica Moe, Beth Haywood, Roshni Desai, Chloé G Xavier, Jessica C Xavier, Alexis Crabtree, Amanda Slaunwhite
Author Information
Heather Palis: BC Centre for Disease Control, UBC School of Population and Public Health, Vancouver, Canada. heather.palis@bccdc.ca.
Kevin Hu: BC Centre for Disease Control, Vancouver, Canada.
Andrew Tu: BC Coroners Service, Burnaby, Canada.
Frank Scheuermeyer: Department of Emergency Medicine, Center for Advancing Health Outcomes, St Paul's Hospitaland the, University of British Columbia, Vancouver, Canada.
John A Staples: Division of General Internal Medicine, Department of Medicine, Centre for Clinical Epidemiology & Evaluation (C2E2), University of British Columbia, Vancouver, Canada.
Jessica Moe: Department of Emergency Medicine, UBC, BC Centre for Disease Control, Vancouver, Canada.
Beth Haywood: BC Centre for Disease Control, Vancouver, Canada.
Roshni Desai: BC Centre for Disease Control, Vancouver, Canada.
Chloé G Xavier: BC Centre for Disease Control, Vancouver, Canada.
Jessica C Xavier: BC Centre for Disease Control, Vancouver, Canada.
Alexis Crabtree: BC Centre for Disease Control, UBC School of Population and Public Health, Vancouver, Canada.
Amanda Slaunwhite: BC Centre for Disease Control, UBC School of Population and Public Health, Vancouver, Canada.
BACKGROUND: Illicit drug toxicity (i.e., overdose) is the leading cause of death in British Columbia (BC) for people aged 10-59. Stimulants are increasingly detected among drug toxicity deaths. As stimulant use and detection in deaths rises, it is important to understand how people who die of stimulant toxicity differ from people who die of opioid toxicity. METHODS: BC Coroners Service records were retrieved for all people who died of unintentional illicit drug toxicity (accidental or undetermined) between January 1, 2015, and December 31, 2019, whose coroner investigation had concluded and who had an opioid and/or stimulant detected in post-mortem toxicology and identified by the coroner as relevant to the death (N = 3788). BC Chronic Disease Registry definitions were used to identify people with chronic disease. Multinomial regression models were used to examine the relationship between chronic disease diagnoses and drug toxicity death type. RESULTS: Of the 3788 deaths, 11.1% (N = 422) had stimulants but not opioids deemed relevant to the cause of death (stimulant group), 26.8% (N = 1014) had opioids but not stimulants deemed relevant (opioid group), and 62.1% (N = 2352) had both opioids and stimulants deemed relevant (opioid/stimulant group). People with ischemic heart disease (1.80 (1.14-2.85)) and people with heart failure (2.29 (1.25-4.20)) had approximately twice the odds of being in the stimulant group as compared to the opioid group. CONCLUSIONS: Findings suggest that people with heart disease who use illicit stimulants face an elevated risk of drug toxicity death. Future research should explore this association and should identify opportunities for targeted interventions to reduce drug toxicity deaths among people with medical comorbidities.
