Death from liver disease in a cohort of injecting opioid users in a Swedish city in relation to registration for opioid substitution therapy

Jerkeman, Anna; Håkansson, Anders; Rylance, Rebecca; Wagner, Philippe; Blomé, Marianne Alanko; Björkman, Per

doi:10.1111/dar.12425

Cited by 9 publications

(5 citation statements)

References 45 publications

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“…Pawan et al [26] studied the damaging effects of opium use on the liver and lungs in chronic opium addicts in Rajasthan, India, and indicated that longterm and chronic opium use raised the risk of liver and lung damage. Elsewhere, Jerkeman et al [27] carried out a study on death from liver disease in a cohort of injecting opioid users in a Swedish city; they reported that the death rate significantly increased in these people. Thus, seemingly, the inhaled opium brings about inflammatory reactions in the liver more than its oral consumption.…”

Section: Discussionmentioning

confidence: 99%

Examining the association between opium use, cigarette smoking and alcohol consumption with the liver enzyme levels in a population-based study: Fasa Persian cohort data

et al. 2022

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Objectives Opium use, cigarette smoking, and alcohol consumption are serious health problems in many countries including Iran. The present study aimed to examine the association between the opium use, cigarette smoking and alcohol consumption with liver enzyme levels in Southern Iran. This analytical cross-sectional study was conducted in 2020. The entire population of the Fasa Persian cohort study in the southern region of Iran was selected as the sample. Accordingly, 10,145 people participated in the study. Results Results indicated that there was a significant relationship between cigarette smoking and alcohol consumption with liver enzymes (AST, ALT, and ALP). There was also a significant relationship between inhaled opium and liver enzymes, but oral opium revealed no significant relationship with the activity of liver enzymes. Accordingly, policymakers of the health care system are recommended to hold educational programs to improve the health literacy level of the society and take effective preventative strategies in reducing the use of these substances.

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Section: Discussionmentioning

confidence: 99%

Examining the association between opium use, cigarette smoking and alcohol consumption with the liver enzyme levels in a population-based study: Fasa Persian cohort data

et al. 2022

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“…Definitions vary between countries, and each definition has its limitations [ 57 ]. There is a wide range of plausible mechanisms between substance use and death [ 58 , 59 ]. Acute poisoning, chronic organ damage caused by drugs as well as accidents during intoxication may all be considered to be drug-related.…”

Section: Discussionmentioning

confidence: 99%

Causes and circumstances of death in stimulant and opioid use—A comparative study

Åhman,

Wingren,

Håkansson

2024

PLoS ONE

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Aims To investigate the individual characteristics, causes and circumstances around deaths in stimulant use, and to examine how individuals who died with stimulants in their body differ from individuals who died with opioids in their body. Methods This study includes individuals who died during the years 2000–2018 and underwent a forensic autopsy at Forensic Medicine in Lund, Skåne County, Sweden. All individuals over 18 years of age with stimulants (n = 310), opioids (n = 2,039) or both stimulants and opioids (n = 385) in the body at the time of death, were included. The three groups were assessed regarding gender, age, place of death, BMI, other substances detected in forensic toxicological analysis, organ weights and underlying and contributing causes of death. The data were analysed by frequency and proportion calculations, cross-tabulations and comparisons of medians. Results The median age at death of the study population (n = 2,734) was 45.5 years (interquartile range ☯IQR] 32–60 years) and 73.2% were men. The most common cause of death in the stimulant group was suicide (26.8%), higher proportion compared to the opioid group (20.8%) (p = 0.017) and in the polysubstance group accidental poisoning (38.2%), higher proportion compared to the opioid group (18.0%) (p<0.001). Death by transport accidents was significantly associated with the stimulant group (p<0.001) as well as death by other accidents (p = 0.016). Conclusions Individuals who died with stimulants in their body died at a higher rate from suicide, transport accidents and other accidents, compared to individuals who died with opioids in their body. This study indicates the need to identify and prevent psychiatric conditions, elevated suicide risk, and risk-taking behaviors among people who use stimulants.

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“…This enables systematic and longitudinal research including NEP patients in the present setting, including follow-up of NEP attendance over time. Several previous research studies from the present setting have originating from the identification of patients attending NEP units in the region [42,[84][85][86].…”

Section: Methodsmentioning

confidence: 99%

Protocol for a multi-site study of the effects of overdose prevention education with naloxone distribution program in Skåne County, Sweden

et al. 2020

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Background Continuously high rates of overdose deaths in Sweden led to the decision by the Skåne County to initiate the first regional take-home naloxone program in Sweden. The project aims to study the effect of overdose prevention education and naloxone distribution on overdose mortality in Skåne County. Secondary outcome measures include non-fatal overdoses and overdose-related harm in the general population, as well as cohort-specific effects in study participants regarding overdoses, mortality and retention in naloxone program. Methods Implementation of a multi-site train-the-trainer cascade model was launched in June 2018. Twenty four facilities, including opioid substitution treatment units, needle exchange programs and in-patient addiction units were included for the first line of start-up, aspiring to reach a majority of individuals at-risk within the first 6 months. Serving as self-sufficient naloxone hubs, these units provide training, naloxone distribution and study recruitment. During 3 years, questionnaires are obtained from initial training, follow up, every sixth month, and upon refill. Estimated sample size is 2000 subjects. Naloxone distribution rates are reported, by each unit, every 6 months. Medical diagnoses, toxicological raw data and data on mortality and cause of death will be collected from national and regional registers, both for included naloxone recipients and for the general population. Data on vital status and treatment needs will be collected from registers of emergency and prehospital care. Discussion Despite a growing body of literature on naloxone distribution, studies on population effect on mortality are scarce. Most previous studies and reports have been uncontrolled, thus not being able to link naloxone distribution to survival, in relation to a comparison period. As Swedish registers present the opportunity to monitor individuals and entire populations over time, conditions for conducting systematic follow-ups in the Swedish population are good, serving the opportunity to study the impact of large scale overdose prevention education and naloxone distribution and thus fill the knowledge gap. Trial registration Naloxone Treatment in Skåne County - Effect on Drug-related Mortality and Overdose-related Complications, NCT 03570099, registered on 26 June 2018.

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Death from liver disease in a cohort of injecting opioid users in a Swedish city in relation to registration for opioid substitution therapy

Cited by 9 publications

References 45 publications

Examining the association between opium use, cigarette smoking and alcohol consumption with the liver enzyme levels in a population-based study: Fasa Persian cohort data

Examining the association between opium use, cigarette smoking and alcohol consumption with the liver enzyme levels in a population-based study: Fasa Persian cohort data

Causes and circumstances of death in stimulant and opioid use—A comparative study

Protocol for a multi-site study of the effects of overdose prevention education with naloxone distribution program in Skåne County, Sweden

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