Mortality risk among new onset injection drug users

  1. David Vlahov1,2,*,
  2. Cun-lin Wang1,
  3. Noya Galai1,
  4. Joseph Bareta1,
  5. Shruti H. Mehta1,
  6. Steffanie A. Strathdee1,
  7. Kenrad E. Nelson1

Article first published online: 24 JUN 2004

DOI: 10.1111/j.1360-0443.2004.00780.x

Issue

Addiction

Addiction

Volume 99, Issue 8, pages 946–954, August 2004

Additional Information

How to Cite

Vlahov, D., Wang, C.-l., Galai, N., Bareta, J., Mehta, S. H., Strathdee, S. A. and Nelson, K. E. (2004), Mortality risk among new onset injection drug users. Addiction, 99: 946–954. doi: 10.1111/j.1360-0443.2004.00780.x

Author Information

  1. 1

    Department of Epidemiology, the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD

  2. 2

    and the Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York, USA

*David Vlahov New York Academy of Medicine 1216 Fifth Avenue New York, NY 10029 USA E-mail: dvlahov@nyam.org

Publication History

  1. Issue published online: 24 JUN 2004
  2. Article first published online: 24 JUN 2004
  3. Submitted 19 November 2003; initial review completed 20 January 2004; final version accepted 11 March 2004

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Keywords:

  • Bisexual;
  • homosexual;
  • human immunodeficiency virus;
  • incidence;
  • injection drug use;
  • mortality

ABSTRACT

Aims  To characterize mortality experience among those who only recently started injection.

Design  Prospective study.

Setting  Independent study clinic within high drug use neighborhoods.

Participants  In 1988–1989, we enrolled 256 adult injection drug users (IDUs) recruited through street outreach who had initiated injection within the prior 2 years.

Measurements  Consenting participants underwent venipuncture for HIV antibody testing and interviews. We prospectively ascertained date and cause of death through follow-up contact and registry linkages. Analyses included standardized mortality ratios (SMRs) with local, state and national mortality data, adjusted for age, gender and race.

Findings  Baseline median age was 30 years, 70% were male, 95% were African-American and 90% injected within the prior 6 months. We identified 69 deaths through October 2000; mortality rate was 3.3/100 person-years. The adjusted SMR with the USA (and Baltimore) as the reference for IDUs was 4.40 (2.43) for 1991–1992, which increased to 8.12 (4.13) by 1993–1994, decreased to 4.43 (2.13) by 1997–1998 and increased slightly to 5.35 (2.79) during 1999–2000. Excluding HIV-related mortality, SMRs remained elevated. Decline in SMRs was not linked to drug abuse treatment.

Conclusions  These data demonstrate excess mortality among new-onset IDUs compared with demographically similar peers in the general population, indicating the need for interventions to prevent premature death among young IDUs.

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