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Causes of premature mortality in Swedish drug abusers: a prospective longitudinal study 1970-2006.

Abstract：

AIMS:To evaluate premature mortality and causes of death from young adulthood to middle age in a cohort of drug users followed during almost four decades. DESIGN:Follow-up study of a consecutive cohort of patients with drug abuse/dependence. METHODS:A cohort of 561 drug abusers, admitted to a detoxification and short-term rehabilitation unit 1970-1978 was followed to December 31st, 2006. Standardized interviews and hospital records with toxicological analyses were used for demographic data, substance use and psychiatric diagnoses at admission. For Follow-up analyses, autopsy protocols including toxicology tests and death certificates were obtained for assessment of causes of death which were coded according to ICD-10. Age-group standardized mortality ratios were calculated independently for both sexes. RESULTS:204 persons (36.4%) were deceased by 2006. SMR was 5.94 for the cohort. Compared to an age- and gender-matched population, the risk of premature death was about eighteen times higher between the ages of 20-44 and about five times higher from 45 up to the age of 69. Of 120 (59%) drug-related deaths, 43 were opiate overdoses, and 3 were overdose from amphetamine. A total of 53 (26%) persons died violent deaths: 39 suicides, of which 25 were drug-related, 3 homicides and 12 accidents. The Swedish national causes of death register underestimated drug-related death by 37% and suicide by 85% compared to the results from this study. CONCLUSIONS:The cohort of drug abusers had an increased risk of premature often drug-related and violent death well into middle age, and to a great extent the drug addicts died from the same drug they had abused when they were first admitted for treatment. The underestimation of drug-related death and suicide in some national death cause registers could be reduced if the doctor routinely records ICD codes when issuing death certificates and autopsy protocols.

journal_name

J Forensic Leg Med

journal_title

Journal of forensic and legal medicine

authors

Nyhlén A,Fridell M,Hesse M,Krantz P

doi

10.1016/j.jflm.2011.01.003

subject

Has Abstract

pub_date

2011-02-01 00:00:00

pages

66-72

issue

2

eissn

1752-928X

issn

1878-7487

pii

S1752-928X(11)00009-6

journal_volume

18

pub_type

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