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Mortality among individuals with cannabis, cocaine, amphetamine, MDMA, and opioid use disorders: a nationwide follow-up study of danish substance users in treatment

Published online by Cambridge University Press:  16 April 2020

M. Arendt ,
P. Munk-Jørgensen ,
L. Sher  and
S.O.W. Jensen
M. Arendt
Affiliation:
Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aarhus University Hospital, Aalborg, Denmark
P. Munk-Jørgensen
Affiliation:
Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aarhus University Hospital, Aalborg, Denmark
L. Sher
Affiliation:
Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY, USA
S.O.W. Jensen
Affiliation:
Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aarhus University Hospital, Aalborg, Denmark

Abstract

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Introduction

Little is known about the excess mortality associated with use of some illicit substances. In particular, this concerns the risks associated with injection drug use and psychiatric disorders.

Aims

This study estimated mortality following substance abuse treatment among primary users of cannabis, cocaine, amphetamine, MDMA, and opioids. The risks associated with injection drug use and psychiatric comorbidity were assessed.

Methods

A register of individuals in treatment for illicit substance disorders was linked with registers on psychiatric treatment and mortality. The study population consisted of 20581 individuals who received treatment in Denmark between 1996 and 2006. There were 1441 deaths recorded over 111445 person-years of follow-up.

Results

Standardized Mortality Ratios (SMRs) for primary users of specific substances were: Cannabis: 4.9, cocaine: 6.4, amphetamine: 6.0, heroin: 9.1, and other opioids 7.7. For MDMA the crude mortality rate was 1.75/1000 person-years, and the SMR was not significantly elevated. Sharing of syringes was associated with increased mortality in both primary users of opioids (hazard ratio (HR): 1.58 [95% CI 1.22–1.99], p < .001) and cocaine/amphetamine (HR: 9.52 (95% CI 3.94–23.02, p < .001). Overall, psychiatric comorbidity was associated with modestly increased mortality (HR: 1.15 [95% CI 1.03–1.29], p = .012) and in particular for primary users of cocaine/amphetamine (HR: 2.74 [95% CI 1.56–4.80], p < .001).

Conclusions

High SMRs were found among individuals who had received treatment for cannabis, cocaine, amphetamine, and opioid use disorders. Injection drug use was clearly associated with excess mortality, while the impact of psychiatric comorbidity was generally modest.

Type
P01-08
Information
European Psychiatry , Volume 26 , Issue S2: Abstracts of the 19th European Congress of Psychiatry , March 2011 , pp. 8
Copyright
Copyright © European Psychiatric Association 2011
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