"Drug dependence" and death: Survival analysis of the Baltimore ECA samplefrom 1981 to 1995

Aims: Illicit drug use and dependence often are associated with premature d eath, but available evidence comes mainly from clinical samples. The presen t paper examines drug-related mortality experience over 14 years in a Unite d States community sample. Participants: Following probability sampling, 3, 481 adult community household residents were recruited for the 1981 NIMH Ba ltimore Epidemiologic Catchment Area survey. Follow-up occurred in 1993-199 6 Methods: Survival analyses were used to estimate median age at death and relative risk of dying in relation to drug use and dependence as assessed i n 1981 using the Diagnostic Interview Schedule (DIS). Findings: Cases with DIS "drug dependence" were more likely to have died and to have a younger m edian age at death (p < .05), with and without statistical adjustment for c onfounding variables. Higher levels of drug involvement also were associate d with increased age-adjusted mortality. Conclusions: The evidence favors t he hypothesis that DIS-elicited "drug dependence." as well as subthreshold drug use, help to account thr premature death in this community sample.