Evidence map›Paper›PMID 40768024›Full record

ArticleCanadian journal of public health = Revue canadienne de sante publique2026

Impact of the COVID-19 pandemic on opioid toxicity mortality rates in Nova Scotia: An interrupted time series analysis (2009-2023).

Cindy Feng, Mark Asbridge, Amy Grant, Lihui Liu, Guanjie Lyu, Fahima Hassan

Abstract read
In one paragraph

Article in Canadian journal of public health = Revue canadienne de sante publique, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

6 authors.

Cindy FengDepartment of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, 5790 University Ave, Halifax, NS, Canada. cindy.feng@dal.ca.ORCID http://orcid.org/0000-0003-4030-7413
Mark AsbridgeDepartment of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, 5790 University Ave, Halifax, NS, Canada.
Amy GrantMaritime SPOR SUPPORT Unit (MSSU), Halifax, NS, Canada.
Lihui LiuDepartment of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, 5790 University Ave, Halifax, NS, Canada.
Guanjie LyuDepartment of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, 5790 University Ave, Halifax, NS, Canada.
Fahima HassanDepartment of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, 5790 University Ave, Halifax, NS, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo examine trends in opioid toxicity mortality in Nova Scotia and its health zones from 2009 to 2023, focusing on differences between pharmaceutical and non-pharmaceutical opioid-related deaths.

methodsWe conducted a population-based study using data on annual opioid toxicity mortality rates from 2009 to 2023, stratified by health zone and opioid type. An interrupted time series (ITS) analysis was applied to assess changes in mortality trends across three pandemic-related periods. Comparisons were made between pharmaceutical and non-pharmaceutical opioid mortality to assess evolving patterns of opioid-related harm.

resultsOpioid toxicity mortality in Nova Scotia declined during the peri-pandemic period (2019-2021) but increased significantly post-pandemic, particularly in non-pharmaceutical opioid-related deaths, which steadily rose after 2021. Pharmaceutical opioid-related deaths remained higher than non-pharmaceutical deaths. Health zone analysis revealed geographic variation: the Central Zone experienced stable pharmaceutical mortality with rising non-pharmaceutical deaths post-pandemic; the Eastern Zone saw higher pharmaceutical mortality pre-pandemic, which declined during the peri-pandemic period, while non-pharmaceutical deaths remained low; the Northern Zone had stable pharmaceutical mortality but rising non-pharmaceutical deaths post-pandemic; and the Western Zone exhibited consistently lower mortality rates across both opioid types.

conclusionThis study reveals significant shifts in opioid-related mortality trends in Nova Scotia, with a rise in non-pharmaceutical opioid deaths post-pandemic, while pharmaceutical opioids remain a major contributor. Geographic variations across health zones highlight the need for region-specific public health strategies. Ongoing efforts to reduce both pharmaceutical and illicit opioid misuse through harm reduction and improved prescribing practices are crucial.

Indexed as

Analgesics, OpioidCOVID-19Drug OverdoseOpioid-Related DisordersHumansInterrupted Time Series AnalysisNova ScotiaPandemicsAnalgesics, OpioidCOVID-19 pandemicInterrupted time series analysisMortality trendsOpioid toxicity

Identifiers

PMID40768024
PMCPMC13082398

What OpenQuestion holds

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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.