Long-term outcome of chronic drug use: the Amsterdam Cohort Study among Drug Users.
In the present study, mortality rates and prevalence of abstinence from illicit drugs among persons with a history of addiction to heroin, cocaine, and/or amphetamines were estimated along the drug-using career time scale. Follow-up data on drug use and vital status were analyzed for participants in the Amsterdam Cohort Study among Drug Users (n = 899; 1985-2002). Participants in the study were primarily recruited at low-threshold methadone outposts. It was estimated that at least 27% of drug users had died within 20 years after starting regular drug use; for half, death had been due to causes unrelated to human immunodeficiency virus. A favorable trend towards abstinence with increasing time since initiation of regular use was observed. However, among those alive, the estimated prevalence of abstinence for at least 4 months from the above drugs and methadone was only 27% at 20 years since initiation. A higher age at initiation, a calendar year of initiation before 1980, and a Western European ethnic origin were associated with higher prevalence of abstinence. These results indicate that the concept of "maturing out" to a drug-free state does not apply to the majority of drug users. Further studies on determinants of individual transitions in drug use are important in order to establish evidence-based intervention strategies.
Termorshuizen
Fabian
F
Infectious Diseases Cluster, Department of HIV and STD Research, Municipal Health Service Amsterdam, Amsterdam, the Netherlands. ftermorshuizen@gggd.amsterdam.nl
Krol
Anneke
A
Prins
Maria
M
van Ameijden
Erik J C
EJ
D000328:Adult; D002423:Cause of Death; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000150:complications* / Q000401:mortality* / Q000534:rehabilitation; D011795:Surveys and Questionnaires; D016019:Survival Analysis