Mortality and survival among a cohort of drug injectors in Glasgow, 1982–1994

Frischer, Martin; Goldberg, David J.; Rahman, Mohammed; Berney, Lee

doi:10.1111/j.1360-0443.1997.tb03373.x

Cited by 111 publications

(31 citation statements)

References 14 publications

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“…Approximately 60–70% of drug users experience an overdose during their lifetime (Sergeev et al, 2003; Warner-Smith et al, 2002). Drug users have mortality rates 6.9–22.0 times greater than rates among the general population (Frischer et al, 1997; Hulse et al, 1999; Joe and Simpson, 1987), and much of this excess mortality is attributable to drug overdose. In New York City (NYC), drug overdose is a significant problem; in 2007 death due to drug use and accidental overdose was the third leading cause of death among residents aged 15–34, and the fourth leading cause of death among residents aged 35–54 (NYC Bureau of Vital Statistics, 2008).…”

Section: Introductionmentioning

confidence: 99%

Policing and risk of overdose mortality in urban neighborhoods

Bohnert

Nandi

Tracy

et al. 2011

Drug and Alcohol Dependence

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Background Accidental drug overdose is a major cause of mortality among drug users. Fears of police arrest may deter witnesses of drug overdose from calling for medical help and may be a determinant of drug overdose mortality. To our knowledge, no studies have empirically assessed the relation between levels of policing and drug overdose mortality. We hypothesized that levels of police activity, congruent with fears of police arrest, are positively associated with drug overdose mortality. Methods We assembled cross-sectional time-series data for 74 New York City (NYC) police precincts over the period 1990–1999 using data collected from the Office of the Chief Medical Examiner of NYC, the NYC Police Department, and the US Census Bureau. Misdemeanor arrest rate—reflecting police activity—was our primary independent variable of interest, and overdose rate our primary dependent variable of interest. Results The mean overdose rate per 100,000 among police precincts in NYC between 1990 and 1999 was 10.8 (standard deviation = 10.0). In a Bayesian hierarchical model that included random spatial and temporal effects and a space-time interaction, the misdemeanor arrest rate per 1,000 was associated with higher overdose mortality (posterior median = 0.003, 95% Credible Interval = 0.001, 0.005) after adjustment for overall drug use in the precinct and demographic characteristics. Conclusions Levels of police activity in a precinct are associated with accidental drug overdose mortality. Future research should examine aspects of police-community interactions that contribute to higher overdose mortality.

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Section: Introductionmentioning

confidence: 99%

Policing and risk of overdose mortality in urban neighborhoods

Bohnert

Nandi

Tracy

et al. 2011

Drug and Alcohol Dependence

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“…The mortality was particularly high among those treated for opioid poisonings (SMR 29). Although they were not identical cohorts, the SMRs among those poisoned by opioids were similar to those of intravenous drug users in Glasgow, Scotland (SMR 22) and heroin addicts in Catalonia, Spain (SMR 29) [12,13]. A higher proportion of the patients treated in hospital for opioid poisoning died, but the SMR was lower in this cohort, which reflected their older age.…”

Section: Discussionmentioning

confidence: 69%

Five-year mortality after acute poisoning treated in ambulances, an Emergency outpatient clinic and hospitals in Oslo

Lund

Bjornaas

Sandvik

et al. 2013

Scand J Trauma Resusc Emerg Med

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BackgroundThe long-term mortality after prehospital treatment for acute poisoning has not been studied previously. Thus, we aimed to estimate the five-year mortality and examine the causes of death and predictors of death for all acutely poisoned patients treated in ambulances, the emergency outpatient clinic, and hospitals in Oslo during 2003–2004.MethodsA prospective cohort study included all adults (≥16 years; n=2045, median age=35 years, male=58%) who were discharged after treatment for acute poisoning in ambulances, the emergency outpatient clinic, and the four hospitals in Oslo during one year. The patients were observed until the end of 2008. Standardized mortality rates (SMRs) were calculated and multivariate Cox regression analysis was applied.ResultsThe study comprised 2045 patients; 686 treated in ambulances, 646 treated in the outpatient clinic, and 713 treated in hospitals. After five years, 285 (14%) patients had died (four within one week). The SMRs after ambulance, outpatient, and hospital treatment were 12 (CI 9–14), 10 (CI 8–12), and 6 (CI 5–7), respectively. The overall SMR was 9 (CI 8–10), while the SMR after opioid poisoning was 27 (CI 21–32). The most frequent cause of death was accidents (38%). In the regression analysis, opioids as the main toxic agents (HR 2.3, CI 1.6–3.0), older age (HR 1.6, CI 1.5–1.7), and male sex (HR 1.4, CI 1.1–1.9) predicted death, whereas the treatment level did not predict death.ConclusionsThe patients had high mortality compared with the general population. Those treated in hospital had the lowest mortality. Opioids were the major predictor of death.

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“…Of note, we assume SVR does not benefit PWID apropos risk of reinfection and the subsequent chance of spontaneous clearance. Finally, at every stage of the model, death from non-liver-related causes occurs at a rate of 1.8%33 and 1.4% per annum, in PWID and former/never PWID states, respectively (see online supplementary appendix D regarding estimation of the latter mortality rate).…”

Section: Methodsmentioning

confidence: 99%