Mortality of drug addicts in the United Kingdom 1967-1993.
BACKGROUND
Mortality in specified clinical populations has often been regarded as a measure of treatment effectiveness. This study examined time trends in mortality of drug addicts in the UK notified to the Home Office over a 27-year period.


METHODS
The study was a longitudinal analysis of routine mortality data of a population of newly notified addicts from 1967 to 1993. Altogether, 92 802 addicts were newly notified during the study period, and they accounted for 687 673 person-years of observation. The main outcome measures were age-specific all-causes mortality; drug-related mortality; and age- and sex-specific standardized mortality ratios (SMR) 1967-1993.


RESULTS
There were significant differences in death rates between the periods 1967-1976 (19/1000 person-years) and 1984-1993 (10.5/1000 person-years). Excess deaths were significantly higher among the 1967-1976 cohorts than in the 1984-1993 cohorts (SMR ratio = 1.80, 95% CI: 1.64-1.97). The majority of deaths were drug-related, with those aged <45 years more likely to die of a drug-related cause than those older (OR = 6.29, 95% CI: 4.97-7.96).


CONCLUSIONS
It appears that service provision has some impact on all-causes mortality among opiate addicts. As services improved, there was a corresponding decline in mortality rates during the study period. Further preventive measures, however, should be devised to reduce drug-related deaths.
Department of Psychiatry of Addictive Behaviour, St George's Hospital Medical School, London, UK.
H
H
Ghodse
A
A
Oyefeso
B
B
Kilpatrick
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002423:Cause of Death; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000401:mortality / Q000534:rehabilitation; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000401:mortality* / Q000534:rehabilitation; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology