Prescribing of Opioids and Opioid-Related Mortality in Ontario: 2004–2006

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Authors: Tara Gomes, David N. Juurlink, Rahim Moineddin, Piotr Gozdyra, Irfan Dhalla, J. Michael Paterson, Muhammad M. Mamdani
July 2012

Originally reported in:
Gomes T, Juurlink DN, Moineddin R, Gozdyra P, Dhalla I, Paterson JM, Mamdani MM. Geographical Variation in Opioid Prescribing and Opioid-Related Mortality in Ontario. Healthcare Quarterly. 2011. 14 (1); 22-24.
Sections reprinted with permission


In 2011, we reported rates of opioid prescribing and related mortality in Ontario in Healthcare Quarterly.
The map included in the original publication is replicated below with permission from the publisher, along with the County-level prescribing rates and opioid-related mortality rates that underlie the map (Table 1).
Additionally, annualized rates of opioid-related mortality between 2004 and 2006 have been generated at the level of the Public Health Unit in Table 2. There are 36 Public Health Units that administer health promotion and disease prevention programs in Ontario.

Methodological Notes:

  • All rates were averaged over three years (between 2004 and 2006), and therefore represent an average annual rate over this period.
  • In all analyses, rates are among people aged 15 to 64. Both crude and age/sex-standardized opioid-related mortality rates are presented.
  • Due to the small number of opioid-related deaths in some areas, their corresponding mortality rate estimates are quite unstable, as evidenced by wide confidence intervals in Tables 1 and 2.
  • For more details on the methods, please refer to the original publication in Healthcare Quarterly.

Please contact Tara Gomes ( with any questions relating to this report.

Figure: Opioid Prescription Rate and Opioid-Related Death Rates > 1 Standard Deviation above the mean in Ontario, by county, 2004-2006.
Map of Ontario

Table 1: Rates of Opioid Prescribing and Opioid-Related Deaths, by County in Ontario. Ages 15 to 64, 2004-2006.

CountyAnnual Opioid Prescription Rate*Annual Opioid-related Deaths
  Crude RateAdjusted Rate**95% Confidence Interval
Algoma District4,9955.45.32.9 to 8.9
Brant County6,6033.73.71.8 to 6.8
Bruce County3,3494.44.21.5 to 9.1
Cochrane District4,7435.15.12.4 to 9.4
Dufferin County3,6192.52.30.5 to 6.9
Durham Regional Municipality8,6223.73.82.8 to 5.1
Elgin County3,1442.22.10.6 to 5.5
Essex County4,2385.95.94.4 to 7.8
Frontenac County10,3555.86.23.7 to 9.7
Grey County7,0107.48.04.4 to 13.4
Haldimand-Norfolk Regional Municipality3,5767.17.04.1 to 11.1
Haliburton County4,7996.04.60.5 to 16.6
Halton Regional Municipality3,6452.42.51.6 to 3.7
Hamilton-Wentworth Regional Municipality6,0105.95.84.5 to 7.4
Hastings County7,0135.05.22.8 to 8.7
Huron County2,5493.33.30.9 to 8.5
City of Kawartha Lakes8,3513.33.21.0 to 7.5
Kenora District5,2333.43.31.1 to 7.8
Kent County3,2594.84.82.4 to 8.5
Lambton County5,3025.35.73.2 to 9.4
Lanark County3,4622.22.10.4 to 6.2
Leeds and Grenville United Counties2,7842.42.40.8 to 5.7
Lennox and Addington County9,3848.28.53.4 to 17.5
Manitoulin District5,50210.811.92.4 to 34.8
Middlesex County7,3997.37.25.6 to 9.2
Muskoka District Municipality4,2565.04.91.8 to 10.6
Niagara Regional Municipality9,1206.05.94.5 to 7.7
Nipissing District8,6667.98.24.6 to 13.6
Northumberland County5,0663.02.90.9 to 6.9
Ottawa-Carleton Regional Municipality3,8132.42.31.7 to 3.1
Oxford County5,0323.73.81.6 to 7.5
Parry Sound District4,9961.11.40.0 to 7.5
Peel Regional Municipality3,6832.42.41.8 to 3.1
Perth County4,1483.23.41.1 to 7.9
Peterborough County10,7137.67.74.8 to 11.9
Prescott and Russell United Counties1,8542.22.10.6 to 5.3
Prince Edward County3,1563.83.50.4 to 12.7
Rainy River District3,8380.00.00.0 to 0.0
Renfrew County3,2655.05.02.4 to 9.1
Simcoe County7,5734.44.43.1 to 6.0
Stormont, Dundas and Glengarry United Counties3,0946.06.33.5 to 10.4
Sudbury District4,5966.26.41.3 to 19.0
Sudbury Regional Municipality8,9069.19.16.2 to 12.9
Thunder Bay District12,6359.39.36.4 to 13.2
Timiskaming District4,4225.46.21.7 to 16.1
Toronto Metropolitan Municipality5,9893.73.73.2 to 4.2
Waterloo Regional Municipality4,9232.82.71.8 to 3.9
Wellington County7,4254.14.22.5 to 6.6
York Regional Municipality4,4971.61.61.1 to 2.3
* Per 1000 population eligible for drug coverage under the Ontario Drug Benefit Program. Prescribing rates averaged between 2004 and 2006
**Age- and Sex-adjusted, per 100,000 population. Rates averaged between 2004 and 2006

Source: Gomes T, Juurlink DN, Moineddin R, Gozdyra P, Dhalla I, Paterson JM, Mamdani MM. Geographical Variation in Opioid Prescribing and Opioid-Related Mortality in Ontario. Healthcare Quarterly. 2011. 14 (1); 22-24County

Table 2: Rates of Opioid-Related Deaths, by Public Health Unit in Ontario. All ages, 2004-2006.

Public Health UnitCrude RateAdjusted Rate*95% Confidence Interval
Algoma Public Health Unit6.26.23.4 to 10.3
Brant Public Health Unit5.15.22.8 to 8.7
City of Toronto Public Health Unit4.24.43.8 to 5.0
Durham Public Health Unit3.93.92.9 to 5.3
Elgin-St Thomas Public Health Unit2.32.30.6 to 5.8
Bruce-Grey-Owen Sound Public Health Unit6.26.74.1 to 10.4
Haldimand-Norfolk Public Health Unit6.77.24.0 to 11.9
Haliburton-Kawartha-Pine Ridge PHU3.83.82.0 to 6.6
Halton Public Health Unit2.52.61.6 to 3.9
Hamilton-Wentworth Public Health Unit6.06.04.6 to 7.7
Hastings and Prince Edward Public Health Unit4.74.52.5 to 7.4
Huron Public Health Unit3.43.30.9 to 8.4
Kent-Chatham Public Health Unit4.94.92.4 to 8.8
Kingston-Frontenac-Lennox and Addington PHU6.66.84.5 to 10.0
Lambton Public Health Unit5.35.73.1 to 9.7
Leeds-Grenville-Lanark Public Health Unit2.42.41.0 to 4.7
Middlesex-London Public Health Unit7.57.55.8 to 9.5
Niagara Public Health Unit6.36.24.7 to 8.1
North Bay Public Health Unit7.07.44.3 to 11.7
Northwestern Public Health Unit3.03.01.0 to 7.1
Ottawa Carleton Public Health Unit2.62.72.0 to 3.5
Oxford Public Health Unit3.83.91.7 to 7.7
Peel Public Health Unit2.62.72.1 to 3.4
Perth Public Health Unit2.62.80.8 to 7.1
Peterborough Public Health Unit7.77.94.9 to 12.1
Porcupine Public Health Unit5.45.32.6 to 9.9
Renfrew Public Health Unit4.94.92.4 to 9.1
Eastern Ontario Public Health Unit4.54.62.7 to 7.3
Simcoe Public Health Unit4.64.63.3 to 6.1
Sudbury Public Health Unit9.09.16.4 to 12.6
Thunder Bay Public Health Unit9.49.66.5 to 13.7
Timiskaming Public Health Unit5.66.31.7 to 16.3
Waterloo Public Health Unit3.03.02.0 to 4.2
Wellington-Dufferin-Guelph Public Health Unit4.14.12.6 to 6.2
Windsor-Essex Public Health Unit6.46.54.9 to 8.5
York Public Health Unit1.81.81.2 to 2.5
*Age- and Sex-adjusted, per 100,000 population. Rates averaged between 2004 and 2006
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