Canadians at a Higher Risk of Overdose, Death from Codeine than Immigrants

A new study has found that immigrants face a reduced risk of an overdose or death from prescribed codeine as compared to people born in Canada.

Most of the immigrants in Ontario from East Africa, mainly Ethiopia and Eritrea, easily metabolize codeine into morphine at a faster rate as compared to people from other parts of the world.  Several anecdotal reports showed how babies died after being breastfed by mothers who were prescribed codeine as pain killer after delivery. This is prescribed as there were very few options available for controlling pain. 

In this study, the researchers evaluated the data retrieved from the Institute for Clinical Evaluative Sciences. They found that when compared to those born in Canada immigrants face a lower risk of overdose or death from codeine.

Researcher Dr. Joel Ray, a physician and researcher, said that it stands true even for English or French immigrants, which might be thought to hamper their ability to read prescription labels or instructions.

In this study, the researchers worked on data of all Ontario residents between 2001 and 2012. As many as 553,504 people were given codeine, an opioid. Out of the total number of recipients, nearly 50,247 i.e. 9.1 percent were immigrants or were born to an immigrant mother.

It was noticed that those born in Canada had the highest risk of overdose, though the number was very small i.e. 0.6 overdoses for every 10 years of codeine-use; whereas among the immigrant groups, the risk was less than half of that.

 They also calculated the risk of death after taking codeine, but could not identify from the data whether codeine triggered death or whether any other underlying condition was responsible.

Dr. Ray said, "The very small number of overdoses and deaths suggests physicians may not need to be as cautious as they have been in prescribing codeine as a painkiller for adults, or among new mothers from East Africa."

The finding as documented in Journal of Epidemiology and Community Health.