Mortality Trends in a Cohort of Opiate Addicts, Catalonia, Spain

Ortí, Rafael; Domingo‐Salvany, Antònia; Muñoz, Álvaro; Macfarlane, Dave; Suelves, Josep M.; Antó, Josep M.

doi:10.1093/ije/25.3.545

Cited by 53 publications

(37 citation statements)

References 37 publications

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“…Most studies seem to indicate a higher mortality rate among men than women [18][19][20]. A higher mortality rate among men implies that NARKSYS, as a source for estimating the male-to-female ratio, will underestimate the male portion.…”

Section: Datamentioning

confidence: 99%

Where Have All the Young Girls Gone or Where Do All the Men Come from?

Ødegård¹,

Bretteville-Jensen²

2002

Eur Addict Res

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A rough estimate indicates that women amount to one third of the heroin user population in Norway. However, among the youngest users females account and have accounted for a larger proportion. Given this greater representation of females in the younger age groups one would expect that the gender difference in the general population of users would be reduced over time due to a cohort effect. However, the ratio of male to female users has remained stable. The prevailing explanation for this stability is based on the claim that women are more likely to overcome their abuse. This paper addresses both the basis for the assumption of a missing cohort effect and examines an alternative explanation linked to the way into abuse rather than the way out. The study primarily draws upon two distinct data sources. The first body of material consists of interviews carried out in the period 1993–1997 with people attending the only needle exchange service in Oslo. The second data source consists of police records, which provide the number of persons arrested each year in the period 1984–1997 for using, possessing or selling heroin distributed by age and gender. We find that the age of injection debut has increased and that this is especially true for male users. Applying a simple quantitative model, the effect a change in recruitment may have on the male-to-female ratio is analysed. The results indicate that a higher debut age may have contributed to stabilizing the gender gap. The finding suggests that more research is needed on the conditions of recruitment in order to better predict the future population demographics and to avoid hasty and incorrect conclusions.

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Section: Datamentioning

confidence: 99%

Where Have All the Young Girls Gone or Where Do All the Men Come from?

Ødegård¹,

Bretteville-Jensen²

2002

Eur Addict Res

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“…The overlap between various drug-using populations in developed countries can be calculated using polydrug-use patterns reported in the peer-reviewed literature. Goedert et al [45] Goldstein and Herrera [46] Orti et al [50] Wahren et al [52] Fugelstad et al [53] Davoli et al [74] van Ameijden et al [57] …”

Section: Prevalence Of Exposurementioning

confidence: 99%

“…Estimates of the all cause crude annual death rate varied from 1.05 [44] to 3.01 [50] with an estimated mean mortality rate of 2.04. Pooled crude death rates from the specific causes of death identified by English et al [7] were calculated from data reported in these studies.…”

Section: Quantification Of Riskmentioning

confidence: 99%

Challenges and Approaches to Estimating Mortality Attributable to the Use of Selected Illicit Drugs

et al. 2001

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A number of unique challenges are faced when attempting to estimate mortality attributable to illicit drugs. The hidden nature of illicit drug use creates difficulties in quantifying the prevalence of such use; identifying adverse health effects associated with exposure, and calculating the risk of these effects. The use of cohort studies of drug users allows the identification of causes of mortality associated with drug use and the determination of the risk of these causes. This risk estimate can then be used in conjunction with estimates of the prevalence of drug use to extrapolate the burden of mortality. We identify a number of such studies and present some solutions to the major challenges faced when attempting to estimate the global burden of mortality attributable to illicit drug use.

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“…Annual mortality among opioid users has been estimated at 2.1 per 100 person-years (py) [2], which is 10-20 times higher than among their peers in the general population [2,3]. During the 1990s all-cause mortality among opioid users in Barcelona reached 3.5 deaths per 100 py [4,5], and in 1999 standardized opioid overdose mortality in the city was 0.5 per 100 py [6]. The decline in mortality was probably due mainly to a decrease in heroin use, drug injection and HIV infection among drug injectors [7,8].…”

Section: Introductionmentioning

confidence: 99%

Lethality of Opioid Overdose in a Community Cohort of Young Heroin Users

Espelt¹,

Barrio

Álamo-Junquera

et al. 2015

Eur Addict Res

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Background: The aim of the study was to estimate the lethality of opioid overdose among young heroin users. Methods: A prospective community cohort study was conducted in Barcelona and Madrid, Spain. Participants included 791 heroin users aged 18-30 years who were followed up between 2001 and 2006. Fatal overdoses were identified by record linkage of the cohort with the general mortality register, while non-fatal overdoses were self-reported at baseline and follow-up interviews. The person-years (py) at risk were computed for each participant. Fatal and non-fatal overdose rates were estimated by city. Transition towards injection shortly before the overdose could not be measured. Overdose lethality (rate of fatal overdose in proportion to total overdose) and its 95% CI was estimated using Bayesian models. Results: The adjusted rates of fatal and non-fatal opioid overdose were 0.7/100 py (95% CI: 0.4-1.1) and 15.8/100 py (95% CI: 14.3-17.6), respectively. The adjusted lethality was 4.2% (95% CI: 2.5-6.5). Conclusions: Four out of 100 opioid overdoses are fatal. These are preventable deaths that could be avoided before or after the overdose takes place. Resources are urgently needed to prevent fatal opioid overdose.

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Mortality Trends in a Cohort of Opiate Addicts, Catalonia, Spain

Abstract: A threefold increase in mortality rates was observed during the period, mainly accounted for by AIDS and direct addiction-related causes. Length of opiate use was an important determinant of mortality.

Cited by 53 publications

References 37 publications

Where Have All the Young Girls Gone or Where Do All the Men Come from?

Where Have All the Young Girls Gone or Where Do All the Men Come from?

Challenges and Approaches to Estimating Mortality Attributable to the Use of Selected Illicit Drugs

Lethality of Opioid Overdose in a Community Cohort of Young Heroin Users

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