Using population-level data to support the response to the public health emergency on illicit drug overdose
An epidemic of opioid misuse and overdose death has spread across much of North America. British Columbia (BC) counted 1439 illicit drug overdose deaths in 2017; up 44.3% from 2016 and 177% from 2015. BC declared a public health emergency in April of 2016, prompting a coordinated and multi-faceted public health response.
Establishing an empirical evidence base to evaluate current healthcare practices and identify aspects of care delivery that may be improved with public health intervention forms one critical aspect of this response. Fortunately, BC is home to among the most comprehensive, linkable population-based databases worldwide. We describe our ongoing and planned work supporting the BC Ministry of Mental Health and Addiction in their public health response, using health administrative data on all medication dispensations, physician billing records, hospitalizations and deaths available for the population of people with opioid use disorders (PWOUD) in BC from 1996 to 2017, with further linkage to perinatal, corrections and First Nations ancestry databases forthcoming.
We will provide a comprehensive descriptive analysis of the data made available to us, and describe a modified Delphi panel approach we’ve used to develop and validate a set of health system performance metrics for opioid use disorder. We will then describe our planned research to improve the evidence base on best practices for the clinical management of PWOUD, making use of a range of methodological tools for causal inference in non-experimental settings from the fields of economics, data sciences, epidemiology and biostatistics.