title: Causes of death of patients with methamphetamine dependence: a record-linkage study.
abstract: OBJECTIVE
  Methamphetamine use leads to increased likelihood of premature death. The authors investigated the causes of death and risk of mortality in a large cohort of patients with methamphetamine dependence.
  
  
  METHODS
  A cohort of 1254 subjects with methamphetamine dependence, admitted to a psychiatric centre in Taiwan from January 1990 to December 2007, was retrospectively studied. Diagnostic and sociodemographic data for each subject were extracted from the medical records based on a chart review process. Mortality data were obtained by linking to the National Death Certification System and standardised mortality ratios (SMRs) were estimated. The risk and protective factors for all-cause deaths were explored by means of survival analyses.
  
  
  RESULTS
  During the study period, 130 patients died. Of them, 63.1% died unnatural deaths, while the remaining 36.9% died natural deaths. The 1 year cumulative rates for unnatural and natural deaths were 0.018 and 0.006, respectively, and the 5 year rates were 0.046 and 0.023, respectively. The cohort had excessive mortality (SMR = 6.02), and women had a higher SMR for unnatural deaths than men (26.19 vs. 9.82, P = 0.001). For all-cause deaths, comorbidity with other substance use disorders was associated with increased risk of death, despite that being married was associated with a reduced risk.
  
  
  CONCLUSIONS
  A substantial proportion of the deceased died natural deaths, but most died unnatural deaths. The findings show significant evidence to provide valuable insight into premature deaths among methamphetamine-dependent users. This information is valuable for development of prevention and intervention programs.
authors.affiliation: Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan. tcpckuo@gmail.com
authors.forename: Chian-Jue
authors.initials: CJ
authors.lastname: Kuo
authors.forename: Ya-Tang
authors.initials: YT
authors.lastname: Liao
authors.forename: Wei J
authors.initials: WJ
authors.lastname: Chen
authors.forename: Shang-Ying
authors.initials: SY
authors.lastname: Tsai
authors.forename: Shih-Ku
authors.initials: SK
authors.lastname: Lin
authors.forename: Chiao-Chicy
authors.initials: CC
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019969:Amphetamine-Related Disorders / Q000401:mortality*; D002423:Cause of Death; D005260:Female; D006801:Humans; D008297:Male; D008694:Methamphetamine; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology
chemical_list: D008694:Methamphetamine