Prevalence of opioid dependence in Scotland 2015-2020: a Multi-Parameter Estimation of Prevalence (MPEP) Study

Andreas Markoulidakis, Matt Hickman, Andrew McAuley, Lee R Barnsdale, Nicky J Welton, Megan Glancy, Tara Shivaji, Craig Collins, Hayley E Jones, et al

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

Abstract

Aims: Drug-related deaths in Scotland more than doubled between 2011 and 2020. To inform
policymakers and understand drivers of this increase, we estimated the number of people with
opioid dependence aged 15-64 from 2014/15–2019/20.

Design:
We fitted a Bayesian Multi-Parameter Estimation of Prevalence (MPEP) model, using adverse event
rates to estimate prevalence of opioid dependence jointly from Opioid Agonist Therapy (OAT), opioid related mortality and hospital admissions data. Estimates are stratified by age group, sex and year.

Setting: Scotland, 2014/15-2019/20

Participants: People with opioid dependence and potential to benefit from OAT, whether ever
treated or not. Using data from the Scottish Public Health Drug Linkage Programme, we identified a
baseline cohort of individuals who had received OAT within the last five years, and all opioid-related deaths and hospital admissions (whether among or outside of this cohort).
Measurements: Rates of each adverse event type and (unobserved) prevalence were jointly modelled.

Findings: The estimated number and prevalence of people with opioid dependence in Scotland in
2019/20 was 47,100 (95% Credible Interval (CrI) 45,700 to 48,600) and 1.32% (95%CrI 1.28% to
1.37%). Of these, 61% received OAT during 2019/20. Prevalence in Greater Glasgow and Clyde was
estimated as 1.77% (95%CrI 1.69% to 1.85%). There was weak evidence that overall prevalence fell
slightly from 2014/15 (change -0.07%, 95%CrI -0.14% to 0.00%). The population of people with
opioid dependence is ageing, with the number of people aged 15-34 reducing by 5,100 (95%CrI
3,800 to 6,400) and number aged 50-64 increasing by 2,800 (95%CrI 2,100 to 3,500) between
2014/15 and 2019/20.

Conclusions: Prevalence of opioid dependence in Scotland remains high but was relatively stable,
with only weak evidence of a small reduction, between 2014/15 and 2019/20. Increased numbers of opioid-related deaths can be attributed to increased risk among people with opioid dependence,
rather than increasing prevalence.
Original languageEnglish
JournalAddiction
Publication statusAccepted/In press - 20 Mar 2024

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