Rising incidence of ageing opioid users within the EU wide treatment demand indicator; The Irish opioid epidemic from 1996 to 2014

Carew, Anne Marie; Comiskey, Catherine

doi:10.1016/j.drugalcdep.2018.08.031

Cited by 10 publications

(6 citation statements)

References 51 publications

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“…International trends indicate that patients in OMT are living longer [31]. Several settings have seen increases in the age of patients in OMT [13,[32][33][34], including an increasing age for treatment initiation [32]. However, despite these improvements in longevity, this ageing cohort can be considered a neglected group within an already marginalized population [12,35] with unique challenges and needs.…”

Section: Discussionmentioning

confidence: 99%

Cause-Specific Mortality among Patients in Treatment for Opioid Use Disorder in Multiple Settings: A Prospective Comparative Cohort Study

et al. 2023

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Introduction: Among people receiving current or previous opioid maintenance treatment (OMT), the leading cause of premature death is an opioid overdose. However, other causes of mortality remain high in this group. An understanding of causes of deaths across multiple settings can be useful in informing more comprehensive prevention responses. The aim of this study was to describe all non-overdose causes of death in three national cohorts (Czechia, Denmark, and Norway) among OMT patients and to explore associations of non-overdose mortality with age and gender. Methods: This prospective comparative cohort study used national mortality registry databases for OMT patients from Czechia (2000–2019), Denmark (2000–2018), and Norway (2010–2019). Crude mortality rates and age-standardized mortality rates (ASMRs) were calculated as deaths per 1,000 person years for cause-specific mortality. Results: In total, 29,486 patients were included, with 5,322 deaths recorded (18%). We found variations in causes of death among the cohorts and within gender and age groups. The leading non-overdose causes of death were accidents in Czechia and Denmark, and neoplasms in Norway. Cardiovascular deaths were highest in Czechia, particularly for women in OMT (ASMR 3.59 vs. 1.24 in Norway and 1.87 in Denmark). Conclusion: This study found high rates of preventable death among both genders and all age groups. Different demographic structures, variations in risk exposure, as well as variations in coding practices can explain the differences. The findings support increased efforts towards screening and preventative health initiatives among OMT patients specific to the demographic characteristics in different settings.

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Section: Discussionmentioning

confidence: 99%

Cause-Specific Mortality among Patients in Treatment for Opioid Use Disorder in Multiple Settings: A Prospective Comparative Cohort Study

et al. 2023

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“…Injection of opioids is responsible for the majority of HIV cases among PWID world‐wide [1], including Ireland, with heroin being the primary drug of misuse in 82% of cases in the 2001 Irish hospital study [7]. Reductions in drug injecting as reflected by the drop in new registrations for OAT have been reported from 1996 to 2014 [15], particularly among individuals aged less than 30 years. These findings suggest that reduction in heroin injection accounts for some of the decline in HIV burden in Ireland since 2000.…”

Section: Discussionmentioning

confidence: 99%

Changes in HIV incidence in people who inject drugs in Ireland from 2000 to 2018: longitudinal observational study

McCarron

Smyth

2023

Addiction

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Background and Aims People who inject drugs (PWID) have a substantial risk of acquiring human immunodeficiency virus (HIV) infection. From 1999 to 2000 in Ireland, there were 115 new HIV cases among PWID, 40% in individuals aged under 22 years. However, over the past two decades, HIV incidence has declined among PWID in western Europe, including Ireland. We investigated secular changes in HIV incidence among PWID in Ireland. Also, new HIV cases in two time‐periods 2000–09 and 2010–18 were compared by sex, age group, area of residence and country of birth. Design and Setting Longitudinal observational study in the Republic of Ireland, 2000–18. Cases and Measurements A total of 753 new cases of HIV in PWID were diagnosed. Diagnosis rates of HIV in PWID were calculated and changes in rates over the period were modelled. Findings During the period 2000–18, HIV incidence among 15–29‐year‐old PWID in Ireland declined from 5.69 to 0.11 cases per 100 000, equivalent to a yearly decline of 0.22 [95% confidence interval (CI) = 0.14–0.31, P < 0.001] cases per 100 000. Among PWID aged 30–64 years, HIV incidence declined annually by 0.06 (95% CI = 0.02–0.10, P = 0.007) cases per 100 000 from 1.80 to 0.57 cases per 100 000. Comparing 2000–09 to 2010–18, there was a relative increase in HIV cases among older adults (P < 0.001), and those born outside Ireland accounted for a growing minority of cases (from 14.7 to 28.0%, P < 0.001). Changes by sex (P = 0.10) and area residence (P = 0.39) were not statistically significant. Conclusion Since 2000, Ireland has achieved an ongoing reduction in the incidence of human immunodeficiency virus among PWID, and this is most evident among young adults. The reduction has occurred in the context of a reasonably comprehensive, health‐led and harm reduction‐orientated national drugs strategy.

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“…In the UK, the number of recorded heroin consumers declined before and during the Great Recession, although, the number of consumers in the 35–64 age bracket increased (Wakeman, 2016). Irish research, by Carew and Comiskey (2018), has also identified an aging population entering treatment for opiate misuse. Furthermore, Smyth et al (2000) reported a 330% increase in presentations for heroin addiction in Dublin between 1991 and 1996, suggesting that heroin consumption peaked as the country was recovering from recession.…”

Section: Drug Consumption and Recessionmentioning

confidence: 99%

The impact of the Celtic Tiger and Great Recession on drug consumption

Windle

Cambridge

Leonard³

et al. 2022

DHS

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Purpose This paper aims to explore how the Celtic Tiger economic boom and Great Recession influenced drug and alcohol use in one Irish city. Design/methodology/approach Semi-structured interviews were conducted with 48 people, living in Cork City, who had previously used drugs and/or alcohol problematically. All participants had engaged with services for their problematic use and had at least one year of abstinence at time of interview. Findings Some participants reported that their drug and/or alcohol consumption increased during the economic boom; others, who were already in (self-defined) active addiction, reported how full employment lessened some of the harms of their problematic use. For others, problematic use struck once the economy entered a downturn and, heavy drink and drug use became a means of soothing the strains of economic recession. Originality/value The paper provides two key contributions. Methodologically, it demonstrates how large-scale national quantitative data can mask local idiosyncratic tendencies, suggesting the need for mixed-method approaches for understanding drug market trends. The paper also provides insights into the impact of global and local economic conditions on drug and alcohol consumption in Ireland.

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Rising incidence of ageing opioid users within the EU wide treatment demand indicator; The Irish opioid epidemic from 1996 to 2014

Cited by 10 publications

References 51 publications

Cause-Specific Mortality among Patients in Treatment for Opioid Use Disorder in Multiple Settings: A Prospective Comparative Cohort Study

Cause-Specific Mortality among Patients in Treatment for Opioid Use Disorder in Multiple Settings: A Prospective Comparative Cohort Study

Changes in HIV incidence in people who inject drugs in Ireland from 2000 to 2018: longitudinal observational study

The impact of the Celtic Tiger and Great Recession on drug consumption

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