Prevalence of opioid dependence in New South Wales, Australia, 2014–16: indirect estimation from multiple data sources using a Bayesian approach

Beatrice C Downing*, Matt Hickman, Nicola R. Jones, Sarah Larney, Michael J. Sweeting, Yixin Xu, Michael Farrell, Louisa Degenhardt, Hayley E Jones

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

2 Citations (Scopus)

Abstract

Aims
To estimate the prevalence of, and number of unobserved people with opioid dependence by sex and age group in New South Wales (NSW), Australia.

Design
We applied a Bayesian statistical modelling approach to opioid agonist treatment records linked to adverse event rate data. We estimated prevalence from three types of adverse event separately: opioid mortality, opioid-poisoning hospitalizations and opioid-related charges. We extended the model and produced prevalence estimates from a ‘multi-source’ model based on all three types of adverse event data.

Setting, Participants and Measurements
This study was conducted in NSW, Australia, 2014–16 using data from the Opioid Agonist Treatment and Safety (OATS) study, which included all people who had received treatment for opioid dependence in NSW. Aggregate data were obtained on numbers of adverse events in NSW. Rates of each adverse event type within the OATS cohort were modelled. Population data were provided by State and Commonwealth agencies.

Findings
Prevalence of opioid dependence among those aged 15–64 years in 2016 was estimated to be 0.96% (95% credible interval [CrI] = 0.82%, 1.12%) from the mortality model, 0.75% (95% CrI = 0.70%, 0.83%) from hospitalizations, 0.95% (95% CrI = 0.90%, 0.99%) from charges and 0.92% (95% CrI = 0.88%, 0.96%) from the multi-source model. Of the estimated 46 460 (95% CrI = 44 680, 48 410) people with opioid dependence in 2016 from the multi-source model, approximately one-third (16 750, 95% CrI = 14 960, 18 690) had no record of opioid agonist treatment within the last 4 years. From the multi-source model, prevalence in 2016 was estimated to be 1.24% (95% CrI = 1.18%, 1.31%) in men aged 15–44, 1.22% (95% CrI = 1.14%, 1.31%) in men 45–64, 0.63% (95% CrI = 0.59%, 0.68%) in women aged 15–44 and 0.56% (95% CrI = 0.50%, 0.63%) in women aged 45–64.

Conclusions
A Bayesian statistical approach to estimate prevalence from multiple adverse event types simultaneously calculates that the estimated prevalence of opioid dependence in NSW, Australia in 2016 was 0.92%, higher than previous estimates.
Original languageEnglish
Pages (from-to)1994-2006
Number of pages13
JournalAddiction
Volume118
Issue number10
Early online date8 Jun 2023
DOIs
Publication statusPublished - 6 Sept 2023

Bibliographical note

Funding Information:
Record linkage was conducted by the NSW Ministry of Health and the Centre for Health Record Linkage. The Cause of Death Unit Record File (COD URF) was provided by the Australian Coordinating Registry for the COD URF on behalf of the NSW Registry of Births Deaths and Marriages, NSW Coroner and the National Coronial Information System. We also acknowledge the Bureau of Crime Statistics and Research for their support in data provision and linkage. Estimates are based on Australian Bureau of Statistics data (customized report, 2019). B.C.D. was funded by the National Institute for Health and Care Research (NIHR) grant RM‐FI‐2017‐09‐007‐001. M.H. and H.E.J. acknowledge support from the National Institute for Health Research Health Protection Research Unit in Behavioural Science and Evaluation at University of Bristol, in partnership with the UK Health Security Agency (UKHSA), NIHR200877. M.H. acknowledges funding from the NIHR School of Public Health Research (SPHR) and NIHR Bristol Biomedical Research Centre (BRC), NIHR203315. This paper presents independent research. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The OATS study is funded by the National Institute on Drug Abuse (R01 DA144740; Principal Investigator: L.D.). L.D. is supported by a Australian National Health and Medical Research Council Research Fellowship (1135991). NDARC is supported by funding from the Australian Government Department of Health under the Drug and Alcohol Program. S.L. is supported by a Fonds de Recherche du Québec—Santé career award (296569). M.J.S. is an employee of AstraZeneca.

Funding Information:
Record linkage was conducted by the NSW Ministry of Health and the Centre for Health Record Linkage. The Cause of Death Unit Record File (COD URF) was provided by the Australian Coordinating Registry for the COD URF on behalf of the NSW Registry of Births Deaths and Marriages, NSW Coroner and the National Coronial Information System. We also acknowledge the Bureau of Crime Statistics and Research for their support in data provision and linkage. Estimates are based on Australian Bureau of Statistics data (customized report, 2019). B.C.D. was funded by the National Institute for Health and Care Research (NIHR) grant RM-FI-2017-09-007-001. M.H. and H.E.J. acknowledge support from the National Institute for Health Research Health Protection Research Unit in Behavioural Science and Evaluation at University of Bristol, in partnership with the UK Health Security Agency (UKHSA), NIHR200877. M.H. acknowledges funding from the NIHR School of Public Health Research (SPHR) and NIHR Bristol Biomedical Research Centre (BRC), NIHR203315. This paper presents independent research. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The OATS study is funded by the National Institute on Drug Abuse (R01 DA144740; Principal Investigator: L.D.). L.D. is supported by a Australian National Health and Medical Research Council Research Fellowship (1135991). NDARC is supported by funding from the Australian Government Department of Health under the Drug and Alcohol Program. S.L. is supported by a Fonds de Recherche du Québec—Santé career award (296569). M.J.S. is an employee of AstraZeneca.

Publisher Copyright:
© 2023 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

Keywords

  • Evidence synthesis
  • Prevalence estimation
  • opioid use disorder

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