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.
Abstract
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.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.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.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.
Type
Journal articleSubject
HumansSubstance-Related Disorders
Heroin Dependence
Heroin
Survival Rate
Logistic Models
Risk
Follow-Up Studies
Public Health
Adolescent
Adult
Middle Aged
United States
Female
Male
Drug Users
Young Adult
Mortality, Premature
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https://hdl.handle.net/10161/19950Published Version (Please cite this version)
10.1016/j.drugalcdep.2015.08.030Publication Info
Lopez-Quintero, Catalina; Roth, Kimberly B; Eaton, William W; Wu, Li-Tzy; Cottler,
Linda B; Bruce, Martha; & Anthony, James C (2015). 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.
Drug and alcohol dependence, 156. pp. 104-111. 10.1016/j.drugalcdep.2015.08.030. Retrieved from https://hdl.handle.net/10161/19950.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Li-Tzy Wu
Professor in Psychiatry and Behavioral Sciences
Education/Training: Pre- and post-doctoral training in mental health service research,
psychiatric epidemiology (NIMH T32), and addiction epidemiology (NIDA T32) from Johns
Hopkins University School of Public Health (Maryland); Fellow of the NIH Summer Institute
on the Design and Conduct of Randomized Clinical Trials.Director: Duke Community Based
Substance Use Disorder Research Program.Research interests: COVID-19, Opioid misuse,
Opioid overdose, Opioid use disorder, Opio

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