Mortality Risk Among Recent-Onset Injection Drug Users in Five U.S. Cities

Abstract

To quantify the risk of death among recent-onset (< 5 years) injection drug users, we enrolled 2089 injection drug users (IDUs) age <or= 35 years (minimum age = 18 years) between 1997 and 1999. Median age was 24 years, 62.4% were male, 54.5% were non-Hispanic White, mean duration of injecting was 3 years, and 45.4% injected daily within the prior 6 months. Using the National Death Index, we identified 68 deaths over a follow-up period through December 2002 with a mortality rate of 7.10/1000 person years. Using age-, sex-, and race-adjusted data to the census and mortality, we calculated standardized mortality ratios (SMRs) over time. The adjusted SMR (with national data as the reference) for IDUs was 3.66 for 1997, which increased to 9.78 by 1998, decreased slightly to 7.08 by 1999, and continuously declined to 2.54 by 2002. These data confirm considerable excess mortality among recent onset injection drug users compared to non-IDU peers in the general population and indicate need for interventions such as increased quality and accessibility to drug abuse** treatment and overdose prevention to prevent premature death among young IDUs.

Mortality among people who inject drugs: a systematic review and meta-analysis

“…14,17,19,21,24,32,38,49,52,57,58 In 20 studies CMRs were provided separately for people who inject drugs according to their HIV status. 15,16,18,28,34,[36][37][38][39][40]45,48,49,55,57,60,65,70,72,74 Allcause mortality was three times higher among HIV+ than among HIV− subjects (CMR ratio: 3.15) (Fig. 8).…”

“…9). 28,[33][34][35][36][38][39][40][41]48,49,60,65,70,72,74 When we examined mortality from causes other than AIDS, we found it to be 1.63 times higher among HIV+ than among HIV− people who inject drugs (Fig. 10).…”

“…10). 28,34,36,[38][39][40]48,49,60,65,70,72,74 Mortality from drug overdose was presented by HIV status in 9 studies. 28,34,36,38,39,49,65,70,74 Pooled estimates showed mortality to be twice as high among HIV+ than among HIV− people who inject drugs (CMR ratio: 1.99) (Fig.…”

The Impact of Shelter Use and Housing Placement on Mortality Hazard for Unaccompanied Adults and Adults in Family Households Entering New York City Shelters: 1990–2002

“…(E-mail: s.metraux@usp.edu) takes on spatial dimensions, as research identifies Harlem both as a neighborhood that disproportionately generates homelessness, 11 and has elevated mortality rates 12 to the point where, according to one study, men in Bangladesh had better prospects of reaching age 65 than African-American men in Harlem. 13 The homeless population also features other characteristics that are associated with increased mortality hazard, including poorer overall health; 14 mental illness; [15][16][17] substance abuse; [18][19][20][21] incarceration; [22][23][24] and adverse childhood experiences. 25,26 Pointing to the overrepresentation of these conditions, however, must also come with the acknowledgment that these conditions are invariably found only among minorities of the homeless population.…”

Estimated Number of People Who Inject Drugs in San Francisco, 2005, 2009, and 2012

“…Adverse health outcomes are common among people who inject drugs (PWID), including HCV infection, HIV infection, tuberculosis, depression, drug overdose and violent death [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. Resources therefore need to be allocated for multiple health interventions for PWID.…”