title: Mortality among cocaine users: a systematic review of cohort studies.
abstract: OBJECTIVE
  To conduct a systematic review of mortality among cohort studies of cocaine users.
  
  
  METHODS
  Three electronic databases were searched (EMBASE, Medline and PsychINFO); other online databases were searched using online libraries and repositories of reports and literature in the drug and alcohol field, with requested contributions from trained librarians and experts. Searches and extraction were undertaken using protocols and cross-checking of decisions by two authors. Additional data were requested from study investigators where studies did not report relevant data.
  
  
  RESULTS
  1911 articles and 2 reports were identified from searches, with data from another four studies located from review articles. Seven cohorts of "problem" or dependent cocaine users reported data that permitted mortality rates to be estimated. Crude mortality rates ranged from 0.53 (95% CI: 0.10-1.58) to 6.16 (95% CI: 5.21-7.11) per 100 PY. Standardised mortality ratios (SMRs) reported in four studies suggested that mortality was four to eight times higher among cocaine users than age and sex peers in the general population.
  
  
  CONCLUSIONS
  There are limited data on the extent of elevated mortality among problematic or dependent cocaine users and it is unclear how generalisable the results of these studies may be to other populations of problematic cocaine users. Greater attention to both the method of recruitment, and the characteristics of cocaine users, would enhance our understanding of the mortality risks of problematic cocaine use.
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales 2052, Australia. l.degenhardt@unsw.edu.au
authors.forename: Louisa
authors.initials: L
authors.lastname: Degenhardt
authors.forename: Jessica
authors.initials: J
authors.lastname: Singleton
authors.forename: Bianca
authors.initials: B
authors.lastname: Calabria
authors.forename: Jennifer
authors.initials: J
authors.lastname: McLaren
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
authors.forename: Shruti
authors.initials: S
authors.lastname: Mehta
authors.forename: Gregory
authors.initials: G
authors.lastname: Kirk
authors.forename: Wayne D
authors.initials: WD
authors.lastname: Hall
mesh_terms: D002423:Cause of Death; D019970:Cocaine-Related Disorders / Q000401:mortality*; D015331:Cohort Studies; D006801:Humans