Department of Medicine, Sunnybrook Health Sciences Centre, ICES, the Sunnybrook Research Institute, the Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, and the Leslie Dan Faculty of Pharmacy and the Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.

Corresponding author: Jonathan Zipursky MD, PhD, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; [email protected].

This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health (MOH) and the Ministry of Long-Term Care. This document used data adapted from the MOH Postal Code Conversion File, which contains data copied under license from Canada Post Corporation and Statistics Canada. Parts of this material are based on data and information compiled and provided by MOH, the Canadian Institute for Health Information, and IQVIA Solutions Canada Inc. The analyses, conclusions, opinions, and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred.

Financial Disclosure Jonathan S. Zipursky has received payments for medicolegal opinions regarding the safety and effectiveness of analgesics, including opioids. David N. Juurlink is an unpaid member of Physicians for Responsible Opioid Prescribing (PROP), which is sometimes cast as an “anti-opioid” group but is invested in safer and more evidence-based opioid prescribing. Dr. Juurlink is also a member of the American College of Medical Toxicology. Both PROP and ACMT have publicly available positions related to opioid prescribing. He has received payment for lectures and medicolegal opinions regarding the safety and effectiveness of analgesics, including opioids. Tara Gomes is supported by a Canada Research Chair in Drug Policy Research and Evaluation and has received funding from the Ontario MOH. The other authors did not report any potential conflicts of interest.

This research was funded by a Canadian Institute for Health Research project grant. Dr. Tara Gomes is supported by a Tier 2 Canada Research Chair in Drug Policy Research & Evaluation. David Juurlink was supported by an award from the Mak Pak Chiu and Mak-Soo Lai Hing Chair in General Internal Medicine, University of Toronto. The data set from this study is held securely in coded form at ICES. Although legal data-sharing agreements between ICES and data providers (eg, health care organizations and governments) prohibit ICES from making the data set publicly available, access may be granted to those who meet prespecified criteria for confidential access, available at https://www.ices.on.ca/DAS ([email protected]). The full data set creation plan and underlying analytical code are available from the authors on request, with the understanding that the computer programs may rely on coding templates or macros that are unique to ICES and therefore either are inaccessible or may require modification.

Each author has confirmed compliance with the journal's requirements for authorship.

Peer reviews and author correspondence are available at https://links.lww.com/AOG/D462.