Retrospective Analysis of Oxycodone- and Cocaine-Related Deaths in Southwestern Ontario during 2003–2010

Oxycodone hydrochloride is a potent semisynthetic opioid analgesic with a primary role in moderate to severe chronic pain management. It was approved by Health Canada in 1996 for that purpose and added to the Ontario provincial drug formulary in 2000. Increases in oxycodone abuse and oxycodone-related deaths have been noted in both Canada and the USA since oxycodone's introduction to the pharmaceutical market. A retrospective analysis was conducted, reviewing all of the medicolegal autopsies performed at a regional Ontario Forensic Pathology Unit, from 2003–2010. All cases that listed oxycodone and/or cocaine as cause of death were reviewed to ascertain trends in demographic data, preexisting prescription medication use, and concomitant drug use. Cocaine-related deaths were analyzed in order to contextualize oxycodone-related deaths in the setting of drug abuse. Oxycodone-related deaths were observed to increase from 2003–2010 and surpassed cocaine-related deaths in 2010. The proportion of female to male oxycodone-related deaths did not statistically differ during the study years. The proportion of female deaths was constant over the study period, however, male deaths showed a statistically significant increase by 23% from 2009–2010. Females were more likely to die from oxycodone rather than cocaine use, and the converse was seen in males. Among all oxycodone-related deaths over half of the decedents (53%) had a prescription for oxycodone. Oxycodone was also more likely to be reported with polysubstance use. This study illustrates how an abused prescription analgesic can be an ever-increasing burden on society even ten years after its release onto the market.