Addict death rates during a four-year posttreatment follow-up.

Abstract

Mortality rates were examined among 3,324 Black and White daily opioid drug users for a four-year period following treatment in communitybased agencies located across the United States. A total of 179 of these addicts died during this follow-up period, yielding a death rate of 15.2 per 1,000 personyears at risk. When adjusted for age, addict death rates were found to be three to 14 times higher than those in the general US population. Life table analysis was also used to examine these rates in relation to clientThe mortality rate among drug users in the United States represents a significant public health concern, but reliable estimates of these data are subject to many limitations. For instance, official reports from medical examiner offices as well as hospital emergency rooms (such as those included in the national Drug Abuse Warning Network, sponsored by the Drug Enforcement Administration and the National Institute on Drug Abuse) are incomplete in their coverage of drug-related incidents. In addition, studies based on these types of information are generally retrospective in design and the size of the base population cannot be determined to allow precise estimates of mortality rates.Defining the appropriate base population for such studies is also difficult because of the variety of licit and illicit drugs involved, the frequency and amount of drug use required to define the population at risk, and the problems of identifying "hidden" users who do not come to the attention of legal, medical, or other treatment authorities. Furthermore, mortality rates for heterogeneous populations of drug users have limited applicability if they cannot be assessed in relation to individual characteristics (e.g., demographic variables, drug use patterns, and other background measures).The best solution to these problems involves the use of prospectively designed research samples, but there are relatively few such studies in the drug abuse literature. demographic, background, and treatment variables obtained prospectively, both prior to and during treatment. Age, alcohol use, and criminal history were positively associated with higher death rates. With regard to causes of death, age proved to be the only significant predictor; older addicts (over 30) had the highest percentages of deaths due to "natural" causes, while over three-fourths of the deaths among younger addicts were drug related or involved violence. (Am J Public Health 1982; 72:703-709.) the best defined contemporary samples of drug users includes daily opioid users admitted to community-based drug abuse treatment programs. For this type of sample, death rates and causes of death have been examined for opiate addicts in different types of treatments in the nationallyoriented Drug Abuse Reporting Program, but only for the time clients remained in treatment.2-4 Research by Concool, et al, addressed addict death rates both during and after treatment, but their data were limited to a single methadone maintenance program.5Previous research has found higher...

Projecting future complications of chronic hepatitis C in the United States

“…Some evidence suggests that the nonhepatic mortality rate is higher in chronic hepatitis patients because of comorbid conditions and risk factors for other diseases. 7,42 Furthermore, the model might have underestimated nonvirologic benefits of treatment, if they occur, because only SVR rates were used. Finally, we did not consider the likely availability of more effective therapies or increased transplant volume in the future.…”

Estimating future hepatitis C morbidity, mortality, and costs in the United States

“…Table 2 presents the data used. 13,16,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] To make conservative assumptions (possibly underestimating the disease burden from hepatitis C), we assumed that 2 million of the 3.9 million who were antibody positive could develop progressive liver disease. We excluded 1.9 million by assuming a benign prognosis for 2 subgroups: (1) the 30% who had no detectable viral RNA and (2) the 25% of those remaining because they presumably had normal serum liver transaminase tests.…”

“…33 Although CDC data regarding the risk factors associated with acute HCV infection are available, the specific route of transmission (injection drug use or transfusion) for the hepatitis C cases found in the NHANES III survey is unknown. We therefore explored the effects of excess mortality (beyond that occurring in an age-and sex-matched sample from the general population) associated with the source of HCV infection: injection drug use 35 or the disease leading to transmission of hepatitis C by transfusion. 22,34 Depending on the available data, we used an additive or a multiplicative mortality model.…”

Mortality of intravenous drug users in Rome: a cohort study.

“…There are some indications, however, that IVDUs are at increased risk of overall mortality, deaths from overdose, trauma, infectious diSeaseS. [6][7][8][9][10][11][12] This study describes the pattern ofmortality in a large cohort of IVDUs in Rome during the period of transition into the "AIDS era. "…”