MORTALITY AND SURVIVAL AMONG A COHORT OF DRUG INJECTORS IN GLASGOW, 1982-1994

There has been much speculation about the nature and extent of mortali ty among drug injectors in Glasgow. In order to determine injectors' m ortality rate and compare this rate to the general population, identif ier information from 459 drug injectors who received treatment for dru g misuse in Glasgow between 1982 and 1994 was linked to the Scottish M ortality Register. The average duration of follow-up from cohort entry was 5.5 years and 10.2 years from commencement of drug injection. By the end of 1994, 53 cohort members had died. The average annual mortal ity rate of 1.8% was the same as that observed in a London cohort foll owed-up from 1969 to 1991. However, the excess mortality ratio (EMR) o f 22.0 was almost double the London rate (11.9) because of the much lo wer average age of mortality (26.3 vs. 38.2 years). There was no signi ficant time trend in EMR. Kaplan-Meier hazard analyses show that young er patients and those who were HIV positive had significantly elevated mortality rates. The main cause of death was overdose, although it is unclear how many were accidental and how many intentional. Three of t he six fatalities among HIV positive injectors were AIDS related. This study enables the first realistic assessment of the hypothesis that d rug-related deaths in Glasgow are especially high. In relation to othe r populations of drug injectors, the annual mortality rate is comparab le, although the average age of mortality is much lower in Glasgow. Co nsequently, in comparison to the general population, the mortality rat e of drug injectors is higher in Glasgow compared to other cities.