title: Nonmedical Opioid Pain Relievers and All-Cause Mortality: A 27-Year Follow-Up From the Epidemiologic Catchment Area Study.
abstract: OBJECTIVE
  We investigated whether nonmedical opioid pain reliever use is associated with higher mortality in the general US population.
  
  
  METHODS
  We assessed the history of nonmedical opioid pain reliever use among 9985 people interviewed at baseline of the Epidemiologic Catchment Area Program initiated in 1981 to 1983 in Baltimore, Maryland; St. Louis, Missouri; and Durham, North Carolina. We linked the data with the National Death Index through 2007.
  
  
  RESULTS
  Nonmedical opioid pain reliever use was 1.4%. Compared with no nonmedical drug use, mortality was increased for nonmedical opioid pain reliever use (hazard ratio [HR] = 1.60; 95% confidence interval [CI] = 1.01, 2.53) or nonmedical use of other drugs (HR = 1.31; 95% CI = 1.07, 1.62). Mortality was also higher for males and for those beginning nonmedical opioid pain reliever use before aged 15 years.
  
  
  CONCLUSIONS
  A history of nonmedical opioid pain reliever use was associated with increased mortality, in particular for males and early onset users.
authors.affiliation: Linda B. Cottler, Hui Hu, and Bryan A. Smallwood are with the Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville. James C. Anthony is with the Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing. Li-Tzy Wu is with the Department of Psychiatry and Behavioral Sciences and Duke Clinical Research Institute, Duke University Medical Center, Durham, NC. William W. Eaton is with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Linda B
authors.initials: LB
authors.lastname: Cottler
authors.affiliation: Linda B. Cottler, Hui Hu, and Bryan A. Smallwood are with the Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville. James C. Anthony is with the Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing. Li-Tzy Wu is with the Department of Psychiatry and Behavioral Sciences and Duke Clinical Research Institute, Duke University Medical Center, Durham, NC. William W. Eaton is with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Hui
authors.initials: H
authors.lastname: Hu
authors.affiliation: Linda B. Cottler, Hui Hu, and Bryan A. Smallwood are with the Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville. James C. Anthony is with the Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing. Li-Tzy Wu is with the Department of Psychiatry and Behavioral Sciences and Duke Clinical Research Institute, Duke University Medical Center, Durham, NC. William W. Eaton is with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Bryan A
authors.initials: BA
authors.lastname: Smallwood
authors.affiliation: Linda B. Cottler, Hui Hu, and Bryan A. Smallwood are with the Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville. James C. Anthony is with the Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing. Li-Tzy Wu is with the Department of Psychiatry and Behavioral Sciences and Duke Clinical Research Institute, Duke University Medical Center, Durham, NC. William W. Eaton is with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: James C
authors.initials: JC
authors.lastname: Anthony
authors.affiliation: Linda B. Cottler, Hui Hu, and Bryan A. Smallwood are with the Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville. James C. Anthony is with the Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing. Li-Tzy Wu is with the Department of Psychiatry and Behavioral Sciences and Duke Clinical Research Institute, Duke University Medical Center, Durham, NC. William W. Eaton is with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Li-Tzy
authors.initials: LT
authors.lastname: Wu
authors.affiliation: Linda B. Cottler, Hui Hu, and Bryan A. Smallwood are with the Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville. James C. Anthony is with the Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing. Li-Tzy Wu is with the Department of Psychiatry and Behavioral Sciences and Duke Clinical Research Institute, Duke University Medical Center, Durham, NC. William W. Eaton is with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: William W
authors.initials: WW
authors.lastname: Eaton
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009293:Opioid-Related Disorders / Q000453:epidemiology*; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid