Morbidity and mortality from heroin dependence. 1. Survey of heroin addicts known to home office.

Bewley, Thomas; Ben-Arie, O; James, I. Pierce

doi:10.1136/bmj.1.5594.725

Cited by 104 publications

(20 citation statements)

References 3 publications

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“…This death rate falls in the 1 to 2 per cent per year range consistently reported in the literature for other posttreatment follow-up studies of addicts treated in the old Public Health Service Hospitals at Lexington and Fort Worth, 34-36in the Veterans Administration,37 and in outpatient methadone maintenance programs similar to those included in the present study.5338 It is also consistent with results of studies on heroin addicts in England. 39,40 This overall rate is twice as high as in the general US population,33 but appears to be even higher when controlled for age.…”

Section: Discussionmentioning

confidence: 87%

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

Joe¹,

Lehman²,

Simpson³

1982

Am J Public Health

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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...

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Section: Discussionmentioning

confidence: 87%

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

Joe¹,

Lehman²,

Simpson³

1982

Am J Public Health

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“…Again, to contextualise, how do the rates of death seen among substance dependent cohorts compare with those of the broader population? As would be expected, given the proximal and distal risk factors involved, the homicide specific mortality rates of substance using cohorts typically far exceed population rates [105,106,108,110,111,[113][114][115][116]119,120,127,128,130,136,138,139]. Thus, although mortality rates because of homicide in countries, such as the USA, the UK/Europe and Australia, range 0.01-0.06 per 1000 [142][143][144], incidence rates in cohort studies are frequently double or more these rates [1].…”

Section: Homicide As a Cause Of Death Among Substance Usersmentioning

confidence: 97%

The toxicology of homicide offenders and victims: A review

Darke

2010

Drug and Alcohol Review

117

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“…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. "…”

Section: Inrodictonmentioning

confidence: 99%

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

Perucci¹,

et al. 1991

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A historical cohort study was carried out in Rome to examine overall and cause-specific mortality among intravenous drug users (IVDUs). A total of 4200 IVDUs (3411 men and 789 women) enrolled in methadone treatment centers between 1980 and 1988 were studied. There were 239 deaths during the follow-up period. The overall SMR was 10.10 in the entire cohort (95% confidence interval, 8.86-11.47), 9.30 in males and 18.07 in females. A large excess of mortality in both sexes was found for infectious, circulatory, respiratory, and digestive diseases as well as for violence, overdose, AIDS, and unknown or ill-defined causes. Tumors and suicide were excessive only in males. Deaths due to drug overdose, violence or trauma, and cirrhosis accounted for 63.6%, AIDS for 7.1%, endocarditis and other bacterial infections for 7.1%, and neoplasms for 3.8% of total mortality. These findings document serious health consequences of drug abuse in Italy.

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Morbidity and mortality from heroin dependence. 1. Survey of heroin addicts known to home office.

Cited by 104 publications

References 3 publications

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

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

The toxicology of homicide offenders and victims: A review

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

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