Janneke Berecki-Gisolf, Behrooz Hassani-Mahmooei, Angela Clapperton, Roderick McClure

To describe recent trends in opioid prescribing and prescription opioid poisoning resulting in hospitalisation or death in Victoria, Australia. This is a population-based ecological study of residents of Victoria, 2006 - 14. Australian Bureau of Statistics residential population data were combined with Pharmaceutical Benefits Scheme (PBS) opioid prescription data, Victorian Admitted Episodes Data (VAED) and cause of death data. Annual opioid dispensings increased by 78% in 2006 - 13, from 0.33 to 0.58 per population. Opioid use increased with age: in 2013, 14% of Victorian residents aged ≥65 years filled at least one oxycodone prescription. In 2006 - 14, prescription opioid related hospital admissions increased by 6.8% per year, from 107 to 187 /1,000,000 person-years; 56% were due to intentional self-poisoning. Annual deaths increased from 21 to 28 /1,000,000 persons, in 2007 - 11. Admissions and deaths peaked at 25-44 years. Although both opioid prescribing and poisoning have increased, there is discrepancy between the exposed group (dispensings increased with age) and those with adverse consequences (rates peaked at ages 25-44 years). A better understanding is needed of drivers of prescribing and adverse consequences. Together with monitoring of prescribing and poisoning, this will facilitate early detection and prevention of a public health problem.