title: All-cause mortality among individuals with disorders related to the use of methamphetamine: a comparative cohort study.
abstract: BACKGROUND
  Understanding the mortality rate of methamphetamine users, especially in relation to other drug users, is a core component of any evaluation of methamphetamine-related harms. Although methamphetamine abuse has had a major impact on United States (U.S.) drug policy and substance-abuse treatment utilization, large-scale cohort studies assessing methamphetamine-related mortality are lacking.
  
  
  METHODS
  The current study identified cohorts of individuals hospitalized in California from 1990 to 2005 with ICD-9 diagnoses of methamphetamine- (n=74,139), alcohol- (n=582,771), opioid- (n=67,104), cannabis- (n=46,548), or cocaine-related disorders (n=48,927), and these groups were followed for up to 16 years. Age-, sex-, and race-adjusted standardized mortality rates (SMRs) were generated.
  
  
  RESULTS
  The methamphetamine cohort had a higher SMR (4.67, 95% CI 4.53, 4.82) than did users of cocaine (2.96, 95% CI 2.87, 3.05), alcohol (3.83, 95% CI 3.81, 3.85), and cannabis (3.85, 95% CI 3.67, 4.03), but lower than opioid users (5.71, 95% CI 5.60, 5.81).
  
  
  CONCLUSIONS
  Our study demonstrates that individuals with methamphetamine-use disorders have a higher mortality risk than those with diagnoses related to cannabis, cocaine, or alcohol, but lower mortality risk than persons with opioid-related disorders. Given the lack of long-term cohort studies of mortality risk among individuals with methamphetamine-related disorders, as well as among those with cocaine- or cannabis-related conditions, the current study provides important information for the assessment of the comparative drug-related burden associated with methamphetamine use.
authors.affiliation: Centre for Addiction and Mental Health, Social, Epidemiological Research Department, 33 Russell St., Toronto, Ontario, M5S 2S1, Canada. Russell_Callaghan@CAMH.net
authors.forename: Russell C
authors.initials: RC
authors.lastname: Callaghan
authors.forename: James K
authors.initials: JK
authors.lastname: Cunningham
authors.forename: Marina
authors.initials: M
authors.lastname: Verdichevski
authors.forename: Jenna
authors.initials: J
authors.lastname: Sykes
authors.forename: Sukaina R
authors.initials: SR
authors.lastname: Jaffer
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Kish
mesh_terms: D000328:Adult; D000367:Age Factors; D019969:Amphetamine-Related Disorders / Q000150:complications / Q000453:epidemiology / Q000401:mortality*; D002140:California / Q000453:epidemiology; D000697:Central Nervous System Stimulants; D015331:Cohort Studies; D016208:Databases, Factual; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008694:Methamphetamine; D008875:Middle Aged; D018401:Sample Size; D012737:Sex Factors
chemical_list: D000697:Central Nervous System Stimulants; D008694:Methamphetamine