Injuries At A Glance Emergency Department (ED) Visits for Prescription Drug Misuse

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1 Injuries At A Glance Emergency Department (ED) Visits for Prescription Drug Misuse Last Updated: August 2016 Highlights Since 2002, the ED visits rates for prescription opioid misuse in Durham Region females and males have increased, almost a 3-fold increase by In 2015, there were 440 ED visits due to prescription opioid misuse in Durham Region residents. In 2015, the ED visit rate for prescription opioid misuse in Durham Region females was higher than the rate in Ontario females while the rate in Durham Region males was lower compared to the rate in Ontario males. Since 2002, the ED visit rates for prescription opioid misuse in Durham Region females were generally lower than the rates in Durham Region males. Since 2002, the ED visits rates for prescription sedative misuse in Durham Region females have decreased while, in recent years, the rates for males have increased. In 2015, there were 209 ED visits due to prescription sedative misuse in Durham Region residents. In 2015, the ED visit rates for prescription sedative misuse in Durham Region females and males were higher than the rates in Ontario. Since 2002, the ED visit rates for prescription sedative misuse in Durham Region females were higher than the rates in Durham Region males. Since 2002, the ED visits rates for prescription drug misuse -total in Durham Region females and males have increased. In 2015, there were 1,008 ED visits due to prescription drug misuse - total in Durham Region residents. In 2015, the ED visit rate for prescription drug misuse - total in Durham Region females was higher than the rate in Ontario females while the rate in Durham Region males was lower compared to the rate in Ontario males. Since 2002, the ED visit rates for prescription drug misuse - total in Durham Region females were generally lower than the rates in Durham Region males. Introduction Charts and tables are provided for the following indicators for prescription drug misuse for Durham Region: Age-Standardized ED Visit Rates for Prescription Drug Misuse Opioids Age-Standardized ED Visit Rates for Prescription Drug Misuse Sedatives Age-Standardized ED Visit Rates for Prescription Drug Misuse - Total 1

2 For more detailed, topic-specific reports on prescription drug misuse, please go to the Health Statistics in Durham Region webpage found at durham.ca under Departments, Health, Statistics & Publications. For more information or if you require this information in an accessible format, please contact Durham Health Connection Line at or

3 Figure 1: Age-Standardized ED Visit Rates for Prescription Drug Misuse Opioids, Durham Region and Ontario, Rate per 100,000 population Durham Females Durham Males Ontario Females Ontario Males Durham Female Rate Durham Male Rate Ontario Female Rate Ontario Male Rate Durham Female Total # Durham Male Total # Data Source: Emergency Department Visits and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO ED visits for prescription drug misuse - opioids are selected using ICD-10-CA codes F11 (.0-.9) (mental and behavioural disorders such intoxication, addiction, withdrawal and psychosis) or T40 (.2-.4,.6) (poisoning) as the main problem for the visit, or ecodes X42, X62, Y12, Y

4 Figure 2: Age-Standardized ED Visit Rates for Prescription Drug Misuse - Sedatives, Durham Region and Ontario, Rate per 100,000 population Durham Females Durham Males Ontario Females Ontario Males Durham Female Rate Durham Male Rate Ontario Female Rate Ontario Male Rate Durham Female Total # Durham Male Total # Data Source: Emergency Department Visits and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO ED visits for prescription drug misuse - sedatives are selected using ICD-10-CA codes F13 (.0-.9) (mental and behavioural disorders such intoxication, addiction, withdrawal and psychosis) or T42 (.4,.7) (poisoning) as the main problem for the visit, or ecodes Y47 (.0-.9). 4

5 Figure 3: Age-Standardized ED Visit Rates for Prescription Drug Misuse - Total, Durham Region and Ontario, Rate per 100,000 population Durham Females Durham Males Ontario Females Ontario Males Durham Female Rate Durham Male Rate Ontario Female Rate Ontario Male Rate Durham Female Total # Durham Male Total # Data Source: Emergency Department Visits and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO ED visits for prescription drug misuse - total are selected using ICD-10-CA codes F11, F13, F15* and F19** (.0-.9) (mental and behavioural disorders such intoxication, addiction, withdrawal and psychosis), T40 (.2 -.4,.6) (poisoning - opioid), T42 (.4,.7)(poisoning - sedatives) as the main problem for the visit, or ecodes X42, X62, Y12, Y45.0, Y47.*Mental and behavioral disorders due to the use of other stimulants, including caffeine. **Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances. 5

6 Data Sources Emergency Department (ED) Visit data are collected by the Canadian Institute for Health Information (CIHI) on a fiscal year basis. A patient may have more than one diagnosis code for each visit. In such cases, one code is deemed the clinically significant reason for the visit or the main problem (MP). A second set of codes, external cause codes (ecodes), are used to classify the environmental events, circumstances and conditions (i.e. falling) that, more often, are used with injury diagnosis codes. Ecodes are not used as MPs and multiple ecodes can exist for one visit. The NACRS key is used to count unique visits. The codes used in this report are prescription drugs classified under the Controlled Drugs and Substances Act. Misuse occurs when prescription drugs are obtained from illegitimate sources or from a risky pattern of use (excluding under use) such as deviating from acceptable practice or using for purposes that are not therapeutic. Co-morbidity, where a patient may have more than one disease or condition, contributes uncertainty to classifying the MP. A person may visit the ED several times for the same injury, or discharged from more than one hospital (when transferred) or ED for the same injury. ED visit data provides only a crude measure of the prevalence of an injury. Data are influenced by factors that are unrelated to health status such as availability and accessibility of care, administrative policies and hospital procedures. For example, the 2003 SARS outbreaks likely reduced admissions in affected hospitals including Durham Region. This may influence comparisons between areas and over time. For all indicators, data are analyzed by the residence of the patient, not where the ED visit occurred. Ontario residents treated outside of the province are excluded, however, less than 0.5% of hospitalizations for Ontario residents are out-of-province. Data are reported by calendar year, based on year of the ED visit. This report includes ED visit indicators with relevance to public health programming, as outlined in the Ontario Public Health Standards (OPHS). The new OPHS were published in 2008 by the Ministry of Health and Long-Term Care, pursuant to Section 7 of the Health Protection and Promotion Act. Age-standardized ED visit rates are supressed when the total number of visits included in the rate is less than 20. Counts of ED visits are supressed when there are less than 5. Definitions Definition: Age-Standardized ED Visit Rate An Age-Standardized ED Visit Rate is the number of ED visits per the population that would occur if the population had the same age distribution as the 1991 Canadian population (per 100,000). This rate provides a single summary number that allows populations with different age compositions to be compared. 6