Fatal overdoses and deaths by other causes in a cohort of Norwegian drug abusers—A competing risk approach

Ødegård, Einar; Amundsen, Ellen Johanna; Kielland, Knut Boe

doi:10.1016/j.drugalcdep.2006.12.016

Cited by 38 publications

(32 citation statements)

References 18 publications

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“…Only three of the deceased were females. This harmonises with other studies, showing that males have a significantly higher risk of death Gossop et al, 2002;Ødegård et al, 2007;Clausen et al, 2007).…”

Section: Discussionsupporting

confidence: 91%

Mortality among drug users after discharge from inpatient treatment: An 8-year prospective study

Ravndal

Amundsen²

2010

Drug and Alcohol Dependence

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106

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Background:Drug users who are leaving/completing inpatient medication-free treatment may, like drug users released from prison, have an elevated risk of dying from fatal overdoses. This is mainly explained by their low drug tolerance. Methods:Two hundred and seventy-six drug users who had been admitted to eleven inpatient facilities in Norway, were followed prospectively after discharge from treatment during an eight year period (1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006). The following instruments were used: EuropASI, SCL-25 and MCMI-II.Information on deaths and causes of death were obtained from the National Death Register. Results:A total of 36 deaths were registered after discharge from treatment during the observation period, of which 24 were classified as overdose deaths. During the first 4 weeks after discharge six persons died, yielding an unadjusted excess mortality of 15.7 (rate ratio) in this period (CI 5.3-38.3). All were dropouts and all deaths were classified as opiate overdoses.There was no significant association between time in index treatment and mortality after discharge, nor did any background characteristics correlate significantly with elevated mortality shortly after discharge. Conclusions:The elevated risk of dying from overdose within the first four weeks of leaving medicationfree inpatient treatment is so dramatic that preventive measures should be taken. More studies from similar inpatient programmes are needed in order to obtain systematic knowledge about determinants of overdose deaths shortly after leaving treatment, and possible preventive measures..

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Section: Discussionsupporting

confidence: 91%

Mortality among drug users after discharge from inpatient treatment: An 8-year prospective study

Ravndal

Amundsen²

2010

Drug and Alcohol Dependence

Self Cite

106

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“…The competing risk approach is necessary because OST registrants are at increased risk of more than one cause of death, several of which share risk factors (Odegard et al, 2007). With this method, individuals who die from a cause other than the one under study remain in the risk set, and the subdistribution hazards estimate the 'real world' probabilities of death due to specific causes.…”

Section: Discussionmentioning

confidence: 99%

The impact of blood-borne viruses on cause-specific mortality among opioid dependent people: An Australian population-based cohort study

Vajdic

Marashi-Pour

Olivier

et al. 2015

Drug and Alcohol Dependence

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“…The variables used in the multiple regression models were based upon known risk factors for overdoses, injection frequency, substance use and criminal activity available in the data. These variables were age, gender, length of injecting career, homelessness and shelter use (Bird and Robertson, 2007, Hickman et al, 2007, Loyd-Smith et al, 2008, Nordentoft et al, 2003Ødegård et al, 2007). Length of injecting career is only known as a risk factor for overdoses (Ødegård et al, 2007), and it was therefore not used in the other multiple regression models.…”

Section: Data Analysesmentioning

confidence: 99%

Is opioid substitution treatment beneficial if injecting behaviour continues?

Gjersing¹,

Bretteville-Jensen²

2013

Drug and Alcohol Dependence

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Title: Is opioid substitution treatment beneficial if injecting behaviour continues? Background Opioid substitution treatment (OST) is recognised as an effective treatment for opioid dependence. Still, a subgroup of OST users continues to inject drugs. This study examines health risks and criminal activity in a population of needle exchange programme (NEP) participants by comparing those identified as current OST users to i) those identified as former OST users and ii) those with no OST experience. MethodsThis was a semi-annual cross-sectional study conducted from 2002 to 2011. NEP participants were interviewed in Oslo, Norway (n=1,760); 341 were identified as current OST users, 356 as former OST users and 1,063 had no OST experience. The associations between OST status and health risk and criminal activity were assessed through univariate and multiple logistic regression analyses. Overall, there was a high level of polysubstance use and no group differences on this measure. Results Among Conclusions 3NEP participants who are currently in OST have substantially reduced health risks and criminal activity than other NEP participants. The high level of polysubstance use nevertheless poses a public health challenge.

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Fatal overdoses and deaths by other causes in a cohort of Norwegian drug abusers—A competing risk approach

Cited by 38 publications

References 18 publications

Mortality among drug users after discharge from inpatient treatment: An 8-year prospective study

Mortality among drug users after discharge from inpatient treatment: An 8-year prospective study

The impact of blood-borne viruses on cause-specific mortality among opioid dependent people: An Australian population-based cohort study

Is opioid substitution treatment beneficial if injecting behaviour continues?

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