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      Mortality among heroin users and users of other internationally regulated drugs: A 27-year follow-up of users in the Epidemiologic Catchment Area Program household samples

      , , , , , ,
      Drug and Alcohol Dependence
      Elsevier BV

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          Abstract

          <div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d14843188e196">Background</h5> <p id="P2">In contrast to research on more restricted samples of drug users, epidemiological studies open up a view of death rates and survivorship of those who have tried heroin a few times, with no acceleration toward sustained use patterns often seen in treatment and criminal justice samples. At their best, epidemiological estimates of heroin effects on risk of dying are not subject to serious selection biases faced with more restricted samples. </p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="section-title" id="d14843188e201">Methods</h5> <p id="P3">Data are from 7207 adult participants aged 18–48 years in United States Epidemiologic Catchment Area Program field surveys, launched in 1980–1984. US National Death Index (NDI) records through 2007 disclosed 723 deaths. NDI enabled estimation of heroin-associated risk of dying as well as survivorship. </p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="section-title" id="d14843188e206">Results</h5> <p id="P4">Estimated cumulative mortality for all 18–48 year old participants is 3.9 deaths per 1000 person-years (95% confidence interval, CI = 3.7, 4.2), relative to 12.4 deaths per 1000 person-years for heroin users (95% CI = 8.7, 17.9). Heroin use, even when non-sustained, predicted a 3–4 fold excess of risk of dying prematurely. Post-estimation record review showed trauma and infections as top-ranked causes of these deaths. </p> </div><div class="section"> <a class="named-anchor" id="S4"> <!-- named anchor --> </a> <h5 class="section-title" id="d14843188e211">Conclusions</h5> <p id="P5">Drawing strengths from epidemiological sampling, standardized baseline heroin history assessments, and very long-term NDI follow-up, this study of community-dwelling heroin users may help clinicians and public health officials who need facts about heroin when they seek to prevent and control heroin outbreaks. Heroin use, even when sporadic or non-sustained, is predictive of premature death in the US, with expected causes of death such as trauma and infections. </p> </div>

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          Most cited references18

          • Record: found
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          Comparative epidemiology of dependence on tobacco, alcohol, controlled substances, and inhalants: Basic findings from the National Comorbidity Survey.

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            The day-to-day criminality of heroin addicts in Baltimore--a study in the continuity of offence rates.

            A representative sample of 354 male heroin addicts living in the Baltimore metropolitan area was traced from onset of opiate use to time of interview to ascertain any changes in the frequency or type of offences committed during their years at risk. Five basic measures of criminality were employed: crime-day theft, crime-day violence, crime-day dealing, crime-day con games and crime-day other offences. A sixth measure -- composite crime day -- incorporated all five crime-day measures. Crime rates per year were derived from these six measures. It was found that the start of addiction was associated with a high level of criminality (255 composite crime-days per year), and that this high rate continued over numerous subsequent periods of addiction. Theft of property was the most common type of crime, followed by drug sales, other offences, con games, and violent offences. In contrast to the addiction periods, criminality decreased over successive non-addiction periods. Thus, the composite crime rate (82 composite crime-days per year) for the first non-addiction period was only 32% of the rate of the first addiction period and this lower rate of criminality decreased markedly thereafter.
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              Mortality among young injection drug users in San Francisco: a 10-year follow-up of the UFO study.

              This study examined associations between mortality and demographic and risk characteristics among young injection drug users in San Francisco, California, and compared the mortality rate with that of the population. A total of 644 young (<30 years) injection drug users completed a baseline interview and were enrolled in a prospective cohort study, known as the UFO ("U Find Out") Study, from November 1997 to December 2007. Using the National Death Index, the authors identified 38 deaths over 4,167 person-years of follow-up, yielding a mortality rate of 9.1 (95% confidence interval: 6.6, 12.5) per 1,000 person-years. This mortality rate was 10 times that of the general population. The leading causes of death were overdose (57.9%), self-inflicted injury (13.2%), trauma/accidents (10.5%), and injection drug user-related medical conditions (13.1%). Mortality incidence was significantly higher among those who reported injecting heroin most days in the past month (adjusted hazard ratio = 5.8, 95% confidence interval: 1.4, 24.3). The leading cause of death in this group was overdose, and primary use of heroin was the only significant risk factor for death observed in the study. These findings highlight the continued need for public health interventions that address the risk of overdose in this population in order to reduce premature deaths.
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                Author and article information

                Journal
                Drug and Alcohol Dependence
                Drug and Alcohol Dependence
                Elsevier BV
                03768716
                November 2015
                November 2015
                : 156
                :
                : 104-111
                Article
                10.1016/j.drugalcdep.2015.08.030
                4787597
                26386826
                7989e82b-064d-4a09-bdf2-86916386bd14
                © 2015
                History

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