Pharmaceutical opioid misuse is an increasing problem globally. One of the difficulties in examining the extent of pharmaceutical misuse in Australia is the lack of indicator data on prevalence or harms. As such the extent of morbidity associated with pharmaceutical opioids is poorly understood. One potential population based indicator of harm is ambulance attendances. A retrospective analysis was undertaken of a unique database of non-fatal ambulance attendances available in Melbourne, Australia from 1998 to 2006. Presentations relating to methadone, buprenorphine, buprenorphine-naloxone, morphine and oxycodone were examined, including presenting characteristics and outcomes. There presentations were compared to heroin related attendances over the same time period.
There were 1567 attendances identified relating to the five pharmaceutical opioids examined. The annual rate of presentations related to buprenorphine and morphine were relatively stable since 2001 while the number of presentations related to oxycodone appeared to be increasing. Only two cases implicated the buprenorphine-naloxone product in the two years of availability examined. The majority of cases where oxycodone or methadone were involved also stated use of alcohol, benzodiazepine or both. Buprenorphine cases differed with over 70% of cases not stating use of benzodiazepine or alcohol. The majority of attendances resulted in transport to hospital. In comparison to the rate of heroin related ambulance attendances there were relatively few ambulance attendances in which pharmaceutical opioids were implicated. The number of cases related to oxycodone appears to be increasing with the increasing use of oxycodone in this jurisdiction. Ambulance attendance data appears to be a useful indicator of harm related to pharmaceutical opioids.