Underlying Polysubstance Classes and Associated Sociodemographic Characteristics and Health Histories among People who Died from Substance-Related Acute Toxicity in Canada: A Latent Class Analysis

Abstract The aim of this study was to examine underlying patterns of substances detected among accidental acute toxicity deaths in Canada and their associations with sociodemographic characteristics, location, and substance use and health history. Data abstracted from coroner and medical examiner files for all accidental acute toxicity deaths across Canada (2016 to 2017) were analyzed. Six classes emerged from a latent class analysis conducted to characterize detected substance classes: (1) cocaine and alcohol, (2) benzodiazepines and other pharmaceutical substances, (3) pharmaceutical opioids, (4) multiple pharmaceutical and non-pharmaceutical substances, (5) methamphetamine and fentanyl or analogues, and (6) fentanyl or analogues. Differences were identified between latent classes by sex, age, marital status, location of death, place of residence, and substance use and health history. Patterns of detected substances among deaths characterized in this study emphasize the complex nature of substance-related acute toxicity deaths across Canada and can inform future research and public health action.