title: Mortality of registered drug users in Central Asia.
abstract: BACKGROUND
  Within the fifth phase of the Central Asia Drug Action Programme (CADAP) covering five post-Soviet Central Asian countries, an analysis of the mortality of drug users was performed. The results for Kazakhstan and Uzbekistan are presented in detail in this paper since results from Kyrgyzstan and Tajikistan are not considered valid and Turkmenistan did not provide data at all.
  
  
  METHODS
  A system of registration of all users of illegal drugs known to the health and/or law enforcement authorities ("narcological registers") exists in Central Asian countries inherited from the system of Soviet "narcology". According to the legal norms, the death of a registered person should be recorded. We conducted indirect standardisation of crude mortality rates and computed the standardised mortality ratio (SMR) comparing observed number of deaths with expected number of deaths according to age and gender specific mortality rates in the general population of the same country.
  
  
  RESULTS
  The results show excess mortality in registered drug users, particularly in registered females, in Uzbekistan (the latest available SMR for all those registered is 7.4; the SMR in females is 16.3) and Kazakhstan (4.0 and 12.9). The excess mortality is highest among young adults (18-34) in all the studies.
  
  
  CONCLUSIONS
  Taking into account the limited quality and reliability of the data - first of all, the likely under-reporting of deaths in the narcological registers - the crude mortality rate among registered drug users is quite high when compared to EU countries. The SMR in total is comparably lower as a result of the high background mortality in the general population. This excess mortality is preventable and should be targeted by the national drug policies. Specifically, the programmes should target registered and unregistered female drug users.
authors.affiliation: ResAd, Prague - Research and Development in Drug Epidemiology and Policy, Prague, Czech Republic; Department of Addictology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic; National Monitoring Centre for Drugs and Drug Addiction, Czech Republic.
authors.forename: Viktor
authors.initials: V
authors.lastname: Mravcik
authors.affiliation: ResAd, Prague - Research and Development in Drug Epidemiology and Policy, Prague, Czech Republic; Department of Addictology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic. Electronic address: twz@resad.cz.
authors.forename: Tomas
authors.initials: T
authors.lastname: Zabransky
authors.affiliation: ResAd, Prague - Research and Development in Drug Epidemiology and Policy, Prague, Czech Republic; Department of Public Health, University of Tartu, Estonia.
authors.forename: Ave
authors.initials: A
authors.lastname: Talu
authors.affiliation: ResAd, Prague - Research and Development in Drug Epidemiology and Policy, Prague, Czech Republic; Drug Control Department under the Government of the Republic of Lithuania, Lithuanian REITOX National Focal Point, Lithuania.
authors.forename: Ernestas
authors.initials: E
authors.lastname: Jasaitis
authors.affiliation: National Research Center on Medical and Social Problems of Drug Addiction, Kazakhstan.
authors.forename: Nuriya
authors.initials: N
authors.lastname: Gafarova
authors.affiliation: National Research Center on Medical and Social Problems of Drug Addiction, Kazakhstan.
authors.forename: Zhannat
authors.initials: Z
authors.lastname: Musabekova
authors.affiliation: Ministry of Health of the Republic of Uzbekistan, Uzbekistan.
authors.forename: Luiza
authors.initials: L
authors.lastname: Baymirova
authors.affiliation: National Center for Monitoring and Prevention of Drug Addiction, Tajikistan.
authors.forename: Makhsut
authors.initials: M
authors.lastname: Makhsutov
authors.affiliation: National Center for Forensic Medicine and Toxicology, Tajikistan.
authors.forename: Furkat
authors.initials: F
authors.lastname: Ganiev
mesh_terms: D017677:Age Distribution; D055030:Drug Users / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007623:Kazakhstan / Q000453:epidemiology; D008297:Male; D012042:Registries / Q000706:statistics & numerical data*; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000401:mortality*; D014610:Uzbekistan / Q000453:epidemiology
keywords: Central Asia; Drug users; Heroin; Mortality; Narcological register; Standardised mortality ratio