Evidence map›Paper›PMID 40408455›Full record

ArticlePloS one2025

The changing role of substances: trends, characteristics of individuals and prior healthcare utilization among individuals with accidental substance-related toxicity deaths in Ontario Canada.

Shaleesa Ledlie, Alice Holton, Pamela Leece, Bisola Hamzat, Joanna Yang, Gillian Kolla, Nikki Bozinoff, Rob Boyd, Mike Franklyn, Ashley Smoke and 2 more

Abstract read
In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Shaleesa LedlieLi Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.
Alice HoltonLi Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.
Pamela LeecePublic Health Ontario, Toronto, Ontario, Canada.
Bisola HamzatLi Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.
Joanna YangICES, Toronto, Ontario, Canada.
Gillian KollaFaculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada.
Nikki BozinoffDepartment of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
Rob BoydOttawa Inner City Health Inc, Ottawa, Ontario, Canada.
Mike FranklynNorthern Ontario School of Medicine, Sudbury, Ontario, Canada.
Ashley SmokeOntario Drug Policy Research Network Lived Experience Advisory Group, Toronto, Ontario, Canada.
Paul NewcombeOntario Drug Policy Research Network Lived Experience Advisory Group, Toronto, Ontario, Canada.
Tara GomesLi Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0002-1468-1965

Funding

Mentoring the next generation of addiction clinician scientists while responding to the opioid epidemicR25DA037756 · NIDA · UNIVERSITY OF BRITISH COLUMBIA · PI FAIRBAIRN, NADIA · 2014 to 2023
$3.6M
NIDA NIH HHS R25 DA037756
6 · The paper itself

Abstract

objectiveTo investigate trends and the circumstances surrounding fatal substance-related toxicities directly attributed to alcohol, stimulants, benzodiazepines or opioids and combinations of substances in Ontario, Canada.

methodsWe conducted a population-based cross-sectional study of all accidental substance-related toxicity deaths in Ontario, Canada from January 1, 2018 to June 30, 2022. We reported monthly rates of substance-related toxicity deaths and investigated the combination of substances most commonly involved in deaths. Demographic characteristics, location of incident, and prior healthcare encounters for non-fatal toxicities and substance use disorders were examined.

resultsOverall, 10,022 accidental substance-related toxicity deaths occurred, with the annual number of deaths nearly doubling between the first and last 12 months of the study period (N = 1,570-2,702). Opioids were directly involved in the majority of deaths (84.1%; N = 8,431), followed by stimulants (60.9%; N = 6,108), alcohol (13.4%; N = 1,346) and benzodiazepines (7.8%; N = 782). In total, 56.9% (N = 5,698) of deaths involved combinations of substances. Approximately one-fifth of individuals were treated in a hospital setting for a substance-related toxicity in the past year, with the majority being opioid-related (17.4%; N = 1,748). Finally, 60.9% (N = 6,098) of people had a substance use disorder diagnosis at time of death.

conclusionsOur study shows not only the enormous loss of life from substance-related toxicities but also the growing importance of combinations of substances in these deaths. A large proportion of people had previously interacted within an hospital setting for prior substance-related toxicity events or related to a substance use disorder, representing important missed intervention points in providing appropriate care.

Indexed as

Patient Acceptance of Health CareSubstance-Related DisordersAccidentsAdolescentAdultAgedAnalgesics, OpioidBenzodiazepinesCentral Nervous System StimulantsChildCross-Sectional StudiesDrug OverdoseFemaleHumansMaleMiddle AgedAnalgesics, OpioidBenzodiazepinesCentral Nervous System Stimulants

Identifiers

PMID40408455
PMCPMC12101627

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.