title: Years of potential life lost amongst heroin users in the Australian Treatment Outcome Study cohort, 2001-2015.
abstract: BACKGROUND
  Heroin use carries the highest burden of disease of any drug of dependence. The study aimed to determine mortality rates of the Australian Treatment Outcome Study cohort over the period 2001-2015, and the years of potential life lost (YPLL).
  
  
  METHODS
  The cohort consisted of 615 heroin users. Crude mortality rates per 1000 person years (PY) and Standardised Mortality Ratios (SMR) were calculated. YPLL were calculated using two criteria: years lost prior to age 65, and years lost prior to average life expectancy.
  
  
  RESULTS
  The cohort was followed for 7,790.9 PY. At 2015, 72 (11.7%) of the cohort were deceased, with a crude mortality rate of 9.2 per 1000 PYs. Neither age nor gender associated with mortality. The SMR was 10.2 (males 7.3, females 17.2), matched for age, gender and year of death. The most common mortality cause was opioid overdose (52.8%). Using the<65 years criterion, there were 1988.3 YPLL, with a mean of 27.6 (males 27.6, females 27.7). Using the average life expectancy criterion, there were 3135.1 YPLL, with a mean of 43.5 (males 41.9, females 46.3). Accidental overdose (<65 yr 63.0%, average life expectancy 63.7%) and suicide (<65 yr 12.8%, average life expectancy 13.3%) accounted for three quarters of YPLL where cause of death was known.
  
  
  CONCLUSIONS
  YPLL associated with heroin use was a quarter of a century, or close to half a century, depending on the criteria used. Given the prominent role of overdose and suicide, the majority of these fatalities, and the associated YPLL, appear preventable.
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Australia. Electronic address: s.darke@unsw.edu.au.
authors.forename: Shane
authors.initials: S
authors.lastname: Darke
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Australia; NHMRC Centre for Research Excellence in Mental Health and Substances Use, Australia.
authors.forename: Christina
authors.initials: C
authors.lastname: Marel
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Australia; NHMRC Centre for Research Excellence in Mental Health and Substances Use, Australia.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Mills
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Australia; NHMRC Centre for Research Excellence in Mental Health and Substances Use, Australia.
authors.forename: Joanne
authors.initials: J
authors.lastname: Ross
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Australia; NHMRC Centre for Research Excellence in Mental Health and Substances Use, Australia.
authors.forename: Tim
authors.initials: T
authors.lastname: Slade
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Australia; NHMRC Centre for Research Excellence in Mental Health and Substances Use, Australia.
authors.forename: Maree
authors.initials: M
authors.lastname: Tessson
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D002423:Cause of Death; D015331:Cohort Studies; D062787:Drug Overdose / Q000401:mortality; D005260:Female; D006556:Heroin Dependence / Q000401:mortality*; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D013405:Suicide / Q000706:statistics & numerical data; D016896:Treatment Outcome; D055815:Young Adult
keywords: ATOS; Cohort; Heroin; Life expectancy; Mortality; Years of potential life lost