Over 1200 drugs-related deaths and 190,000 opiate-user-years of follow-up: Relative risks by sex and age group

Abstract

Heroin users/injectors’ risk of drugs-related death by sex and current age is weakly estimated both in individual cohorts of under 1000 clients, 5000 person-years or 50 drugs-related deaths and when using cross-sectional data. A workshop in Cambridge analysed six cohorts who were recruited according to a common European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) protocol from drug treatment agencies in Barcelona, Denmark, Dublin, Lisbon, Rome and Vienna in the 1990s; and, as external reference, opiate-user arrestees in France and Hepatitis C diagnosed ever-injectors in Scotland in 1993–2001, both followed by database linkage to December 2001. EMCDDA cohorts recorded approximately equal numbers of drugs-related deaths (864) and deaths from other non-HIV causes (865) during 106,152 person-years of follow-up. External cohorts contributed 376 drugs-related deaths (Scotland 195, France 181) and 418 deaths from non-HIV causes (Scotland 221, France 197) during 86,417 person-years of follow-up (Scotland 22, 670, France 63, 747).

EMCDDA cohorts reported 707 drugs-related deaths in 81,367 man-years (8.7 per 1000 person-years, 95% CI: 8.1–9.4) but only 157 in 24,785 person-years for females (6.3 per 1000 person-years, 95% CI: 5.4–7.4).

Except in external cohorts, relative risks by current age group were not particularly strong, and more modest in Poisson regression than in cross-sectional analyses: relative risk was 1.2 (95% CI: 1.0–1.4) for 35–44 year olds compared to 15–24 year olds, but 1.4 for males (95% CI: 1.2–1.6), and dramatically lower at 0.44 after the first year of follow-up (95% CI: 0.37–0.52).

• Drugs-related deaths
• heroin users
• injectors
• sex
• age group
• non-HIV mortality