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. 2015 Nov 1:156:104-111.
doi: 10.1016/j.drugalcdep.2015.08.030. Epub 2015 Sep 3.

Mortality among heroin users and users of other internationally regulated drugs: A 27-year follow-up of users in the Epidemiologic Catchment Area Program household samples

Catalina Lopez-Quintero  1 , Kimberly B Roth  2 , William W Eaton  3 , Li-Tzy Wu  4 , Linda B Cottler  5 , Martha Bruce  6 , James C Anthony  7
Affiliations

Mortality among heroin users and users of other internationally regulated drugs: A 27-year follow-up of users in the Epidemiologic Catchment Area Program household samples

Catalina Lopez-Quintero et al. Drug Alcohol Depend. .

Abstract

Background: In contrast to research on more restricted samples of drug users, epidemiological studies open up a view of death rates and survivorship of those who have tried heroin a few times, with no acceleration toward sustained use patterns often seen in treatment and criminal justice samples. At their best, epidemiological estimates of heroin effects on risk of dying are not subject to serious selection biases faced with more restricted samples.

Methods: Data are from 7207 adult participants aged 18-48 years in United States Epidemiologic Catchment Area Program field surveys, launched in 1980-1984. US National Death Index (NDI) records through 2007 disclosed 723 deaths. NDI enabled estimation of heroin-associated risk of dying as well as survivorship.

Results: Estimated cumulative mortality for all 18-48 year old participants is 3.9 deaths per 1000 person-years (95% confidence interval, CI=3.7, 4.2), relative to 12.4 deaths per 1000 person-years for heroin users (95% CI=8.7, 17.9). Heroin use, even when non-sustained, predicted a 3-4 fold excess of risk of dying prematurely. Post-estimation record review showed trauma and infections as top-ranked causes of these deaths.

Conclusions: Drawing strengths from epidemiological sampling, standardized baseline heroin history assessments, and very long-term NDI follow-up, this study of community-dwelling heroin users may help clinicians and public health officials who need facts about heroin when they seek to prevent and control heroin outbreaks. Heroin use, even when sporadic or non-sustained, is predictive of premature death in the US, with expected causes of death such as trauma and infections.

Keywords: Death; Drug use; Drugs; Heroin; Mortality; Opioids; Survivorship.

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Figures

Fig. 1
Fig. 1
Estimated proportion surviving in each of the drug use subgroups, plotted across years of elapsed time from baseline assessment. Data from the United States Epidemiologic Catchment Area Program, 1980–2007 (n = 7207).
See this image and copyright information in PMC

References

    1. Anthony JC, Helzer JE. Epidemiology of drug dependence. In: Tsuang MT, Tohen M, Zahner GEP, editors. Textbook in Psychiatric Epidemiology. Wiley-Liss; New York: 1995. pp. 361–406.
    1. Anthony JC, Warner LA, Kessler RC. Comparative epidemiology of dependence on tobacco, alcohol, controlled substances, and inhalants: basic findings from the National Comorbidity Survey. Exp. Clin. Psychopharmacol. 1994;2:244–268.
    1. Ball JC, Shaffer JW, Nurco DN. The day-to-day criminality of heroin addicts in Baltimore–a study in the continuity of offence rates. Drug Alcohol Depend. 1983;12:119–142. - PubMed
    1. Brittingham A, Choy W, Dewa C, Gerstein D, Ghadialy R, Cerbone F, Hoffmann J, Huang L, Johnson R, Kovar MG, Lane J, Larison C, Ragin A, Toce M, Townsend T, Zhang Z. National Household Survey on Drug Abuse Series. (SMA) 98-3200. United States Department of Health and Human Services, Substance Abuse and Mental Health Services Administration; Rockville, MD: Rockville, MD.: 1998. National Household Survey on Drug Abuse: Main Findings 1996.
    1. Calabria B, Degenhardt L, Briegleb C, Vos T, Hall W, Lynskey M, Callaghan B, Rana U, McLaren J. Systematic review of prospective studies investigating “remission” from amphetamine, cannabis, cocaine or opioid dependence. Addict. Behav. 2010;35:741–749. - PubMed

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