The natural history of injecting drug use: a 25-year longitudinal study of a cohort of injecting drug users in inner city Dublin

O'Kelly, Fergus Desmond; O'Kelly, CM

doi:10.1007/s11845-012-0814-9

Cited by 9 publications

(6 citation statements)

References 21 publications

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“…Given that these immune-related deaths were likely to be HIV-related, the true HIV-related mortality rate may be greater than reported here. It is possible that those who experienced early mortality due to HIV may have been a particularly vulnerable population with more advanced disease progression and limited access to health services such as HIV testing and antiretroviral treatment (Murray et al, 2012;O'Kelly and O'Kelly, 2012).…”

Section: Discussionmentioning

confidence: 99%

Mortality and cause of death in a cohort of people who had ever injected drugs in Glasgow: 1982–2012

Nambiar

Weir

Aspinall

et al. 2015

Drug and Alcohol Dependence

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Section: Discussionmentioning

confidence: 99%

Mortality and cause of death in a cohort of people who had ever injected drugs in Glasgow: 1982–2012

Nambiar

Weir

Aspinall

et al. 2015

Drug and Alcohol Dependence

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“…[15][16][17] Most of the causes of death associated with the greatest excess mortality, including infection, "other" causes and mental or behavioural disorders, were consistent with major causes of death identified in other studies. 14,15,[18][19][20][21][22][23] Of note was the elevated excess mortality related to respiratory disease (primarily pneumonia). A study involving drug users entering treatment in Rome, Italy, reported a similar SMR of 10.2 for respiratoryrelated death.…”

Section: Discussionmentioning

confidence: 99%

Mortality in a large community-based cohort of inner-city residents in Vancouver, Canada

et al. 2013

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Background:The Downtown Eastside is a robust and densely populated neighbourhood in Vancouver, Canada, that is characterized by low-income housing and drug use and a high prevalence of HIV infection. We evaluated mortality and excess mortality among the broader community of individuals living in this neighbourhood. Compared with the population of Vancouver, significant excess mortality was observed in the study population (SMR 7.1, 95% CI 6.4-7.9). Excess mortality was higher among women (SMR 15.4, 95% CI 12.8-18.5) than among men (SMR 5.8, 95% CI 5.1-6.6). Although crude mortality increased with age, excess mortality was greatest among participants less than 35 years old (SMR 13.2, 95% CI 9.4-18.5) and those 35-39 years old (SMR 13.3, 95% CI 10.3-17.1). Excess risk was also elevated among participants with hepatitis C virus (HCV), HIV and HCV/HIV infection, with SMRs of 5.9 (95% CI 4.9-7.1), 19.2 (95% CI 12.8-28.9) and 23.0 (95% CI 19.3-27.4), respectively. Methods Interpretation:Our study showed high mortality in this inner-city population, particularly when compared with the general population of Vancouver. Excess mortality was highest among women, younger participants and those infected with either HCV or HIV or both. AbstractCMAJ OPEN, 1(2) E69Research

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“…As a result, youth mental health [32,33] and problem drug use are priority issues [34]. In Dublin South Inner City, this has been the case for over thirty years [25]. …”

Section: Methodsmentioning

confidence: 99%

Primary care and youth mental health in Ireland: qualitative study in deprived urban areas

et al. 2013

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BackgroundMental disorders account for six of the 20 leading causes of disability worldwide with a very high prevalence of psychiatric morbidity in youth aged 15–24 years. However, healthcare professionals are faced with many challenges in the identification and treatment of mental and substance use disorders in young people (e.g. young people’s unwillingness to seek help from healthcare professionals, lack of training, limited resources etc.) The challenge of youth mental health for primary care is especially evident in urban deprived areas, where rates of and risk factors for mental health problems are especially common. There is an emerging consensus that primary care is well placed to address mental and substance use disorders in young people especially in deprived urban areas. This study aims to describe healthcare professionals’ experience and attitudes towards screening and early intervention for mental and substance use disorders among young people (16–25 years) in primary care in deprived urban settings in Ireland.MethodsThe chosen method for this qualitative study was inductive thematic analysis which involved semi-structured interviews with 37 healthcare professionals from primary care, secondary care and community agencies at two deprived urban centres.ResultsWe identified three themes in respect of interventions to increase screening and treatment: (1) Identification is optimised by a range of strategies, including raising awareness, training, more systematic and formalised assessment, and youth-friendly practices (e.g. communication skills, ensuring confidentiality); (2) Treatment is enhanced by closer inter-agency collaboration and training for all healthcare professionals working in primary care; (3) Ongoing engagement is enhanced by motivational work with young people, setting achievable treatment goals, supporting transition between child and adult mental health services and recognising primary care’s longitudinal nature as a key asset in promoting treatment engagement.ConclusionsEspecially in deprived areas, primary care is central to early intervention for youth mental health. Identification, treatment and continuing engagement are likely to be enhanced by a range of strategies with young people, healthcare professionals and systems. Further research on youth mental health and primary care, including qualitative accounts of young people’s experience and developing complex interventions that promote early intervention are priorities. (350 words)

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The natural history of injecting drug use: a 25-year longitudinal study of a cohort of injecting drug users in inner city Dublin

Cited by 9 publications

References 21 publications

Mortality and cause of death in a cohort of people who had ever injected drugs in Glasgow: 1982–2012

Mortality and cause of death in a cohort of people who had ever injected drugs in Glasgow: 1982–2012

Mortality in a large community-based cohort of inner-city residents in Vancouver, Canada

Primary care and youth mental health in Ireland: qualitative study in deprived urban areas

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