Causes of death in a cohort treated for opioid dependence between 1985 and 2005
In this paper the authors examine data from approximately 44,000 people in NSW who were registered for opioid substitution therapy (OST) to determine three key things: avoidable causes of death among the group; how causes of death have changed over time and with age; and how many years of potential life were lost.
The authors found accidental drug overdose was the largest contributor to death, especially among younger users. Overdoses, suicides, transport accidents and violent deaths declined with age, while deaths from cardiovascular disease, liver disease and cancer increased with age. Eighty-eight per cent of deaths were from potentially avoidable causes (by way of comparison, 73% of deaths among the Australian population aged 15–64 years from 1997 to 2001 were considered avoidable). There was an average of 44 years of potential life lost per deceased person.
The research is important because it shows nearly nine out of 10 deaths among this population were avoidable. It also paints a picture of the health of Australia’s ageing opioid users. The authors suggest deaths may be reduced among younger OST users via increased retention in treatment and the provision of naloxone to reduce deaths outside treatment. Older users may benefit from strategies to reduce blood borne virus infections, liver disease, heart disease and respiratory disease.