|Titre :||Mortality among heroin users and users of other internationally regulated drugs: A 27-year follow-up of users in the Epidemiologic Catchment Area Program household samples (2015)|
|Auteurs :||C. LOPEZ-QUINTERO ; K. B. ROTH ; W. W. EATON ; L. T. WU ; L. B. COTTLER ; M. BRUCE ; J. C. ANTHONY|
|Type de document :||Article : Périodique|
|Dans :||Drug and Alcohol Dependence (Vol.156, November 2015)|
|Article en page(s) :||104-111|
|Discipline :||EPI (Epidémiologie / Epidemiology)|
Thésaurus TOXIBASEHEROINE ; MORTALITE ; ENQUETE ; CAUSE DE DECES
Background: In contrast to research on more restricted samples of drug users, epidemiological studies open up a view of death rates and survivorship of those who have tried heroin a few times, with no acceleration toward sustained use patterns often seen in treatment and criminal justice samples. At their best, epidemiological estimates of heroin effects on risk of dying are not subject to serious selection biases faced with more restricted samples.
Methods: Data are from 7207 adult participants aged 18-48 years in United States Epidemiologic Catchment Area Program field surveys, launched in 1980-1984. US National Death Index (NDI) records through 2007 disclosed 723 deaths. NDI enabled estimation of heroin-associated risk of dying as well as survivorship.
Results: Estimated cumulative mortality for all 18-48 year old participants is 3.9 deaths per 1000 person-years (95% confidence interval, CI = 3.7, 4.2), relative to 12.4 deaths per 1000 person-years for heroin users (95% CI = 8.7, 17.9). Heroin use, even when non-sustained, predicted a 3-4 fold excess of risk of dying prematurely. Post-estimation record review showed trauma and infections as top-ranked causes of these deaths.
Conclusions: Drawing strengths from epidemiological sampling, standardized baseline heroin history assessments, and very long-term NDI follow-up, this study of community-dwelling heroin users may help clinicians and public health officials who need facts about heroin when they seek to prevent and control heroin outbreaks. Heroin use, even when sporadic or non-sustained, is predictive of premature death in the US, with expected causes of death such as trauma and infections.
Heroin users were 3-4 times more likely to die prematurely as compared to non-using individuals.
Heroin-predicted excess risk of dying is seen even with relatively low intensity heroin use.
Traumatic injury, infections (e.g., HIV/AIDS) and poisonings were prominent causes of death among heroin users.
|Domaine :||Drogues illicites / Illicit drugs|
|Affiliation :||Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA|