Table 2.
Opioid use context and associated characteristics
| Category ID | Category | Sub-Categories | Count (%) [95% CI] |
% Male | Median age in years [IQR] | Five most common opioids (%)* | % Involving substances other than opioids |
|---|---|---|---|---|---|---|---|
| I | Non-prescribed opioid use, without intention to cause harm |
1. An opioid was used due to dependence (opioid use disorder), for euphoric effect (such as recreational use) or stress relief. The opioid can be a drug or medication not used for the prescribed purpose. 2. Opioid drugs (not prescribed medication) were used to manage pain, insomnia, withdrawal symptoms from other substances, or other health conditions. 3. Rehabilitation-related methadone/suboxone was used concomitantly with other drugs. |
4,120 (50.8%) [49.7 – 51.9%] |
68.9% | 33.6 [15.9] |
1. 53.8% - Fentanyl 2. 22.6% - Heroin 3. 3.2% - Oxycodone 4. 1.7% - Codeine 5. 1.7% - Morphine |
34.3% |
| II | Medication error |
1. A prescribed opioid medication was used and doctors’ instructions were unintentionally broken by self or caregiver, such as using wrong medication, expired medication, wrong dosage, interval, or administration route. 2. Opioid medication was occasionally used to treat pain without doctors’ instructions. |
215 (2.7%) [2.3 – 3.0%] |
50.7% | 51.6 [45.7] |
1. 24.2% - Hydromorphone 2. 23.3% - Morphine 3. 18.1% - Oxycodone 4. 14.0% - Codeine 5. 11.2% - Methadone |
39.1% |
| III | Children’s exposure |
1. Children ingested or absorbed adults’ opioid medication or drug. 2. Children were suspected of ingesting or absorbing adults’ opioid medication or drug. |
295 (3.6%) [3.3 – 4.1%] |
53.6% | 2.1 [1.4] |
1. 23.1% - Oxycodone 2. 20.0% - Codeine 3. 13.9% - Hydromorphone 4. 11.9% - Buprenorphine 5. 8.1% - Morphine |
38.0% |
| IV | Mother’s opioid use | Mother used opioids (medication or drugs) during pregnancy or breast-feeding period. |
10 (0.1%) [0.1 – 0.2%] |
60% | 0.1 [0.2] |
1. 50.0% - Methadone 2. 20.0% - Codeine 3. 10.0% - Oxycodone 4. 10.0% - Fentanyl 5. 10.0% - Hydromorphone |
40.0% |
| V | Medical treatment |
1. Opioid medication was prescribed for managing pain. 2. Opioid medication was prescribed for rehabilitation. |
53 (0.7%) [0.5 – 0.9%] |
66% | 41.6 [24.5] |
1. 22.6% - Hydromorphone 2. 20.8% - Methadone 3. 13.2% - Buprenorphine 4. 13.2% - Morphine 5. 11.3% - Oxycodone |
20.8% |
| VI | Other context, without intention to cause harm |
1. Drug concealing in organs (ex. gastrointestinal tract). 2. Second hand exposure on job duty. 3. Taking opioids due to instructions from auditory hallucinations caused by mental illnesses. |
32 (0.4%) [0.3 – 0.6%] |
62.5% | 28.4 [12.0] |
1. 31.3% - Heroin 2. 21.9% - Fentanyl 3. 18.8% - Morphine 4. 9.4% - Methadone 5. 9.4% - Hydromorphone |
28.1% |
| VII | Unclear context, without intention to cause harm |
1. It was hard to differentiate between opioid misuse, medication error and medical treatment. 2. The context was not clear, but it was sure that there was no intention to cause harm. |
1,720 (21.2%) [20.3 – 22.1%] |
67.9% | 35.3 [15.7] |
1. 38.5% - Fentanyl 2. 16.8% - Heroin 3. 3.6% - Oxycodone 4. 3.1% - Methadone 5. 2.0% - Codeine |
23.0% |
| VIII | Self-poisoning |
1. Suicide attempt. 2. Self-poisoning without suicidal intent, such as grabbing attention. |
930 (11.5%) [10.8 – 12.2%] |
38.7% | 18.1 [23.3] |
1. 29.3% - Codeine 2. 18.0% - Oxycodone 3. 13.0% - Hydromorphone 4. 11.9% - Morphine 5. 10.8% - Fentanyl |
73.0% |
| IX | Poisoned by others | Opioids were used by other people to deliberately cause harm to a patient. |
18 (0.2%) [0.1 – 0.4%] |
11.1% | 17.4 [13.0] |
1. 66.7% - Fentanyl 2. 11.1% - Heroin 3. 5.6% - Methadone 4. all the others - unspecified opioids |
38.9% |
| X | Unclear context, undetermined intent to cause harm |
1. It was hard to differentiate between unintended poisoning, self-poisoning and poisoned by others. 2. The context was not clear and the intention was not clear. |
719 (8.9%) [8.3 – 9.5%] |
72.8% | 37.1 [16.6] |
1. 53.9% - Fentanyl 2. 7.4% - Heroin 3. 3.1% - Oxycodone 4. 2.8% - Hydromorphone 5. 2.5% - Methadone |
19.7% |
| Total | 8,112 (100.0%) |
Note: (1) * Some patients were associated with multiple opioids. (2) The distributions of sex, age group, opioid type, and other substance were tested between Category I (reference) and each of the other categories:
sex — P < 0.05 for all pairs except for (I, IV), (I, V), (I, VI), and (I, VII);
age group — P < 0.05 for all pairs except for (I, VI);
fentanyl — P < 0.05 for all pairs except for (I, IX) and (I, X);
heroin — P < 0.05 for all pairs except for (I, IV), (I, VI), and (I, IX);
oxycodone — P < 0.05 for all pairs except for (I, IV), (I, VI), (I, VII), (I, IX) and (I, X);
codeine — P < 0.05 for all pairs except for (I, V), (I, VI), (I, VII), (I, IX) and (I, X);
morphine — P < 0.05 for all pairs except for (I, IV), (I, VII), (I, IX) and (I, X);
hydromorphone — P < 0.05 for all pairs except for (I, IV), (I, VII), (I, IX) and (I, X);
methadone — P < 0.05 for all pairs except for (I, VIII) and (I, IX);
buprenorphine — P < 0.05 for all pairs except for (I, II), (I, IV), (I, VI), (I, VII), (I, VIII), (I, IX) and (I, X);
other substance — P < 0.05 for all pairs except for (I, IV), (I, VI) and (I, IX);