Mortality and cause of death among 1705 illicit drug users: A 37 year follow up

Introduction and Aims. To examine the overall mortality and causes of deaths of a large cohort of users of illicit drugs in Stockholm over 37 years. Design and Methods. People with substance abuse were identified through records collected by different institutions in Stockholm in 1967. Subjects were followed in registers recording mortality and cause of death and in-patient care stays until 2003. Results. More than half (n = 860) of the 1705 identified substance abusers died at an average age of 47 years, 25-30 years younger than the general population. The standardised rate ratio (SRR) for mortality was 3.3 among men and 3.5 among women. Incidence of mortality per 1000 person-years was also increased, but somewhat lower for women. The difference between these two measures is mainly explained by a lower mortality among women in general. In-patient care stays with both alcohol and drug-related diagnoses were associated with higher risk of dying among women than men: SRR = 14.5 and SRR = 4.0, respectively. Accidents and suicide were the most common cause of death among the youngest subjects (15-24 years) and cardiovascular diseases and tumours among the oldest (>= 55 years). Discussion and Conclusions. Accidents and suicide, especially at a young age, are two common causes of death that might be prevented by increased awareness in medical personnel, along with better treatment and supportive measures. [Stenbacka M, Leifman A, Romelsjo A. Mortality and cause of death among 1705 illicit drug users: A 37 year follow up. Drug Alcohol Rev 2009].