MORTALITY OF DRUG-ADDICTS IN THE UNITED-KINGDOM 1967-1993

Background Mortality in specified clinical populations has often been regarded as a measure of treatment effectiveness. This study examined time trends in mortality of drug addicts in the UK notified to the Hom e Office over a 27-year period. Methods The study was a longitudinal a nalysis of routine mortality data of a population of newly notified ad dicts from 1967 to 1993. Altogether, 92 802 addicts were newly notifie d during the study period, and they accounted for 687 673 person-years of observation. The main outcome measures were age-specific all-cause s mortality; drug-related mortality: and age- and sex-specific standar dized mortality ratios (SMR) 1967-1993. Results There were significant differences in death rates between the periods 1967-1976 (19/1000 per son-years) and 1984-1993 (10.5/1000 person-years). Excess deaths were significantly higher among the 1967-1976 cohorts than in the 1984-1993 cohorts (SMR ratio = 1.80, 95% Cl:1.64-1.97). The majority of deaths were drug-related, with those aged <45 years more likely to die of a d rug-related cause than those older (OR = 6.29, 95% CI:4.97-7.96). Conc lusions It appears that service provision has some impact on all-cause s mortality among opiate addicts. As services improved, there was a co rresponding decline in mortality rites during the study period. Furthe r preventive measures, however, should be devised to reduce drug-relat ed deaths.