Oxycodone is also widely available across Western Canada, but methamphetamine and heroin are more serious problems in the larger cities, while oxycodone is more common in rural towns. Oxycodone is diverted through doctor shopping, prescription forgery, pharmacy theft, and overprescribing.The recent formulations of oxycodone, particularly Purdue Pharmas crush-, chew-, injection- and dissolve-resistant OxyNEO which replaced the banned OxyContin product in Canada in early 2012, have led to a decline in the recreational use of this opiate but have increased the recreational use of the more potent drug fentanyl. According to a Canadian Centre on Substance Abuse study quoted in Macleans magazine, there were at least 655 fentanyl-related deaths in Canada in a five-year period.In Alberta, the Blood Tribe police claimed that from the fall of 2014 through January 2015, oxycodone pills or a lethal fake variation referred to as Oxy 80s containing fentanyl made in illegal labs by members of organized crime were responsible for ten deaths on the Blood Reserve, which is located southwest of Lethbridge, Alberta. Province-wide, approximately 120 Albertans died from fentanyl-related overdoses in 2014. United Kingdom
Prescriptions of Oxycodone rose in Scotland by 430% between 2002 and 2008, prompting fears of usage problems that would mirror those of the United States. The first known death due to overdose in the UK occurred in 2002. Preventive measures
In August 2010, Purdue Pharma reformulated their long-acting oxycodone line, marketed as OxyContin, using a polymer, Intac, to make the pills more difficult to crush or dissolve in water to reduce non-medical use of OxyContin.
A thin decidua can also be a contributing factor to such trophoblastic invasion. Some studies suggest that the rate of incidence is higher when the fetus is female. Other risk factors include low-lying placenta, anterior placenta, congenital or acquired uterine defects (such as uterine septa), leiomyoma, ectopic implantation of placenta (including cornual pregnancy).Pregnant women above 35 years of age who have had a caesarian section and now have a placenta previa overlying the uterine scar have a 40% chance of placenta accreta. Pathogenesis
The placenta forms an abnormally firm and deep attachment to the uterine wall. There is absence of the decidua basalis and incomplete development of the Nitabuchs layer. There are three forms of placenta accreta, distinguishable by the depth of penetration. Diagnosis
When the antepartum diagnosis of placenta accreta is made, it is usually based on ultrasound findings in the second or third trimester. Sonographic findings that may be suggestive of placenta accreta include:

Loss of normal hypoechoic retroplacental zone
Multiple vascular lacunae (irregular vascular spaces) within placenta, giving "Swiss cheese" appearance
Blood vessels or placental tissue bridging uterine-placental margin, myometrial-bladder interface, or crossing the uterine serosa
Retroplacental myometrial thickness of <1 mm
Numerous coherent vessels visualized with 3-dimensional power Doppler in basal viewUnfortunately, the diagnosis is not easy and is affected by a significant interobserver variability. In doubtful cases it is possible to perform a nuclear magnetic resonance (MRI) of the pelvis, which has a very good sensitivity and specificity for this disorder.