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Drug and Alcohol Dependence . Vol.171Mention de date : February 2017
Paru le : 01/02/2017
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Excess mortality among people who report lifetime use of illegal drugs in the United States: A 20-year follow-up of a nationally representative survey / E. R. WALKER ; L. A. PRATT ; C. A. SCHOENBORN ; B. G. DRUSS in Drug and Alcohol Dependence, Vol.171 (February 2017)
in Drug and Alcohol Dependence > Vol.171 (February 2017) . - 31-38
Titre : Excess mortality among people who report lifetime use of illegal drugs in the United States: A 20-year follow-up of a nationally representative survey Type de document : Périodique Auteurs : E. R. WALKER ; L. A. PRATT ; C. A. SCHOENBORN ; B. G. DRUSS Année de publication : 2017 Article en page(s) : 31-38 Langues : Anglais Mots-clés : Thésaurus Géographique
PRODUIT ILLICITE ; HEROINE ; COCAINE ; MORTALITE ; FACTEUR DE RISQUE ; CAUSE DE DECES ; ENQUETE
Discipline : EPI Epidémiologie / Epidemiology Domaine : Drogues illicites / Illicit drugs Résumé : Objective: The purpose of this study was to determine the mortality risks, over 20 years of follow-up in a nationally representative sample, associated with illegal drug use and to describe risk factors for mortality.
Methods: We analyzed data from the 1991 National Health Interview Survey, which is a nationally representative household survey in the United States, linked to the National Death Index through 2011. This study included 20,498 adults, aged 18-44 years in 1991, with 1047 subsequent deaths. A composite variable of self-reported lifetime illegal drug use was created (hierarchical categories of heroin, cocaine, hallucinogens/inhalants, and marijuana use).
Results: Mortality risk was significantly elevated among individuals who reported lifetime use of heroin (HR = 2.40, 95% CI: 1.65-3.48) and cocaine (HR = 1.27, 95% CI: 1.04-1.55), but not for those who used hallucinogens/inhalants or marijuana, when adjusting for demographic characteristics. Baseline health risk factors (smoking, alcohol use, physical activity, and BMI) explained the greatest amount of this mortality risk. After adjusting for all baseline covariates, the association between heroin or cocaine use and mortality approached significance. In models adjusted for demographics, people who reported lifetime use of heroin or cocaine had an elevated mortality risk due to external causes (poisoning, suicide, homicide, and unintentional injury). People who had used heroin, cocaine, or hallucinogens/inhalants had an elevated mortality risk due to infectious diseases.
Conclusions: Heroin and cocaine are associated with considerable excess mortality, particularly due to external causes and infectious diseases. This association can be explained mainly by health risk behaviors.
Heroin users had a 2.4 times higher risk of mortality, adjusting for demographics.
Cocaine users had a 1.3 times higher risk of mortality, adjusting for demographics.
Adjusted for all covariates, heroin and cocaine use were not linked with mortality.
Health risk factors explained most of the mortality risk for drug users.
Main causes of death for drug users were external causes, poisoning, and infections.
Affiliation : Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA Permalink : http://bdoc.ofdt.fr/index.php?lvl=notice_display&id=78614[article]A systematic review of injecting-related injury and disease among people who inject drugs / S. LARNEY ; A. PEACOCK ; B. M. MATHERS ; M. HICKMAN ; L. DEGENHARDT in Drug and Alcohol Dependence, Vol.171 (February 2017)
in Drug and Alcohol Dependence > Vol.171 (February 2017) . - 39-49
Titre : A systematic review of injecting-related injury and disease among people who inject drugs Type de document : Périodique Auteurs : S. LARNEY ; A. PEACOCK ; B. M. MATHERS ; M. HICKMAN ; L. DEGENHARDT Année de publication : 2017 Article en page(s) : 39-49 Langues : Anglais Mots-clés : Thésaurus TOXIBASE
INJECTION ; FACTEUR DE RISQUE ; USAGER ; VOIE INTRAVEINEUSE ; ABCES ; ENDOCARDITE ; INFECTION ; PEAU
Discipline : PAT Pathologie organique / Organique disease Domaine : Drogues illicites / Illicit drugs Résumé : Background: Non-viral injecting-related injuries and diseases (IRID), such as abscesses and vascular damage, can result in significant morbidity and mortality if untreated. There has been no systematic assessment of the prevalence of non-viral IRID among people who inject drugs; this review aimed to address this gap, as well as identify risk factors for experience of specific IRID.
Methods: We searched MEDLINE, Embase and CINAHL databases to identify studies on the prevalence of, or risk factors for, IRID directly linked to injecting in samples of people who inject illicit drugs.
Results: We included 33 studies: 29 reported IRID prevalence in people who inject drugs, and 17 provided data on IRID risk factors. Skin and soft tissue infections at injecting sites were the most commonly reported IRID, with wide variation in lifetime prevalence (6-69%). Female sex, more frequent injecting, and intramuscular and subcutaneous injecting appear to be associated with skin and soft tissue infections at injecting sites. Cleaning injecting sites was protective against skin infections. Other IRID included infective endocarditis (lifetime prevalence ranging from 0.5-12%); sepsis (2-10%); bone and joint infections (0.5-2%); and thrombosis and emboli (3-27%).
Conclusions: There were significant gaps in the data, including a dearth of research on prevalence of IRID in low- and middle-income countries, and potential risk and protective factors for IRID. A consistent approach to measurement, including standardised definitions of IRID, is required for future research.
Skin and soft tissue infections are common among people who inject drugs.
There are few data on other injecting-related injuries and diseases.
Cleaning injecting sites and avoiding intramuscular and subcutaneous injecting may reduce injecting-related injury and disease (IRID) risk.
Better epidemiological data are needed to inform prevention and care interventions.
Sous-type de document : Revue de la littérature / Literature review Affiliation : National Drug and Alcohol Research Centre, UNSW Australia, Sydney, Australia Permalink : http://bdoc.ofdt.fr/index.php?lvl=notice_display&id=78615[article]