The increasing mortality burden of liver disease among opioid-dependent people: cohort study
ABSTRACT Aims Hepatitis C (HCV) infection is highly prevalent among injection drug users (IDUs) and likely to cause significant mortality over time, but little research attention has focused upon the magnitude of this risk, particularly among ageing users. This study examined trends over time in mo...
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| Veröffentlicht in: | Addiction (Abingdon, England) England), 2011-12, Vol.106 (12), p.2186-2192 |
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| creator | Gibson, Amy Randall, Deborah Degenhardt, Louisa |
| description | ABSTRACT
Aims Hepatitis C (HCV) infection is highly prevalent among injection drug users (IDUs) and likely to cause significant mortality over time, but little research attention has focused upon the magnitude of this risk, particularly among ageing users. This study examined trends over time in mortality attributed to liver disease, and in particular contrasting this with other more commonly studied causes of death [acquired immune deficiency syndrome (AIDS), suicide and overdose] among an ageing cohort of heroin‐dependent people in Australia.
Design Data linkage study of methadone treatment entrants with the National Deaths Index.
Setting A cohort entering methadone treatment for heroin dependence in New South Wales, Australia, 1980–85.
Participants A total of 2489 people entering methadone treatment for heroin dependence and 54 847 person‐years (PY) of follow‐up.
Measurements Linkage of data on all methadone entrants between 1980 and 1985 with data from the Australian National Deaths Index, linked using probabilistic record linkage software.
Findings There were 8.2 deaths per 1000 PY [95% confidence interval (CI) 7.5–9.0], with standardized mortality ratios (SMRs) of 4.6 (95% CI 4.2–5.0). Almost one in five (17%) of deaths were from underlying liver‐related causes, most commonly viral hepatitis. The overall mortality rate for any liver cause was 1.4 deaths per 1000 PY (95% CI 1.1–1.7), 17 times higher than to the general population (95% CI 13.4–21.3), with relative elevations more marked for females (SMR 27.9; 95% CI 17.7–41.9) than males (SMR 14.5; 95% CI 10.8–19.0). Liver mortality increased over time, becoming the most common cause of death by the end of follow‐up.
Conclusions Liver disease has become the most common cause of mortality among ageing opioid‐dependent people in an ageing Australian cohort. There is an imperative to reduce the long‐term risks of HCV and other risks to the liver, including alcohol consumption, which are typically not the major clinical focus for this group. |
| doi_str_mv | 10.1111/j.1360-0443.2011.03575.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_920047018</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2502622621</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5775-af6242c959be1e9d6e868016d596b29115c2c7b742c1b9baea844eabca72503a3</originalsourceid><addsrcrecordid>eNqN0U-L1DAYBvAgijuufgUJgnhqTdKkaQQP666O4uIfdsSLENL0HTdj29Sk1Zlvb-qMI3hZc0kgv-cl4UEIU5LTtJ5uclqUJCOcFzkjlOakEFLk21tocby4jRZElSJjlJMTdC_GDSFEVorfRSeMSq4EEwv0ZXUN2PU2gImu_4o7H0bTunGH6yk00GO_xq37AQE3LiYD2HQ-OT8475qsgQH6xEY8gB9aeIatv04jcBynZncf3VmbNsKDw36KPr16uTp_nV2-X745P7vMrJBSZGZdMs6sEqoGCqopoSorQstGqLJmilJhmZW1TIbWqjZgKs7B1NZIJkhhilP0ZD93CP77BHHUnYsW2tb04KeoFSOES0KrmyWtSCmIpDdLwoqCCyGSfPSP3Pgp9OnDM6KUM6kSqvbIBh9jgLUegutM2GlK9Nyp3ui5Oj1Xp-dO9e9O9TZFHx7mT3UHzTH4p8QEHh-Aida062B66-Jfx2X6PJ_f8HzvfroWdv_9AH12cTGfUj7b510cYXvMm_BNl7JI9PO7pb5avf24vGIv9IfiFz1YytM</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>902114279</pqid></control><display><type>article</type><title>The increasing mortality burden of liver disease among opioid-dependent people: cohort study</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Gibson, Amy ; Randall, Deborah ; Degenhardt, Louisa</creator><creatorcontrib>Gibson, Amy ; Randall, Deborah ; Degenhardt, Louisa</creatorcontrib><description>ABSTRACT
Aims Hepatitis C (HCV) infection is highly prevalent among injection drug users (IDUs) and likely to cause significant mortality over time, but little research attention has focused upon the magnitude of this risk, particularly among ageing users. This study examined trends over time in mortality attributed to liver disease, and in particular contrasting this with other more commonly studied causes of death [acquired immune deficiency syndrome (AIDS), suicide and overdose] among an ageing cohort of heroin‐dependent people in Australia.
Design Data linkage study of methadone treatment entrants with the National Deaths Index.
Setting A cohort entering methadone treatment for heroin dependence in New South Wales, Australia, 1980–85.
Participants A total of 2489 people entering methadone treatment for heroin dependence and 54 847 person‐years (PY) of follow‐up.
Measurements Linkage of data on all methadone entrants between 1980 and 1985 with data from the Australian National Deaths Index, linked using probabilistic record linkage software.
Findings There were 8.2 deaths per 1000 PY [95% confidence interval (CI) 7.5–9.0], with standardized mortality ratios (SMRs) of 4.6 (95% CI 4.2–5.0). Almost one in five (17%) of deaths were from underlying liver‐related causes, most commonly viral hepatitis. The overall mortality rate for any liver cause was 1.4 deaths per 1000 PY (95% CI 1.1–1.7), 17 times higher than to the general population (95% CI 13.4–21.3), with relative elevations more marked for females (SMR 27.9; 95% CI 17.7–41.9) than males (SMR 14.5; 95% CI 10.8–19.0). Liver mortality increased over time, becoming the most common cause of death by the end of follow‐up.
Conclusions Liver disease has become the most common cause of mortality among ageing opioid‐dependent people in an ageing Australian cohort. There is an imperative to reduce the long‐term risks of HCV and other risks to the liver, including alcohol consumption, which are typically not the major clinical focus for this group.</description><identifier>ISSN: 0965-2140</identifier><identifier>EISSN: 1360-0443</identifier><identifier>DOI: 10.1111/j.1360-0443.2011.03575.x</identifier><identifier>PMID: 21749525</identifier><identifier>CODEN: ADICE5</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Acquired immune deficiency syndrome ; Acquired Immunodeficiency Syndrome - mortality ; Addiction ; Addictive behaviors ; Adult ; Adult and adolescent clinical studies ; Aging ; Alcohol ; Australia ; Biological and medical sciences ; Cancer ; Cause of Death - trends ; cohort ; Cohort analysis ; Computer programs ; Death ; Diseases ; Drug addiction ; Drug Overdose - mortality ; Epidemiologic Methods ; Epidemiology ; Female ; General aspects ; Hepatitis ; Hepatitis C virus ; Heroin ; Heroin Dependence - mortality ; Humans ; Liver ; Liver diseases ; Liver Diseases - mortality ; Male ; Medical sciences ; Middle Aged ; Miscellaneous ; Mortality ; New South Wales - epidemiology ; Opiates ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Risk factors ; Substance Abuse, Intravenous - mortality ; suicide ; Suicide - statistics & numerical data ; Wounds and Injuries - mortality ; Young Adult</subject><ispartof>Addiction (Abingdon, England), 2011-12, Vol.106 (12), p.2186-2192</ispartof><rights>2011 The Authors, Addiction © 2011 Society for the Study of Addiction</rights><rights>2015 INIST-CNRS</rights><rights>2011 The Authors, Addiction © 2011 Society for the Study of Addiction.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5775-af6242c959be1e9d6e868016d596b29115c2c7b742c1b9baea844eabca72503a3</citedby><cites>FETCH-LOGICAL-c5775-af6242c959be1e9d6e868016d596b29115c2c7b742c1b9baea844eabca72503a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1360-0443.2011.03575.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1360-0443.2011.03575.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24747049$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21749525$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gibson, Amy</creatorcontrib><creatorcontrib>Randall, Deborah</creatorcontrib><creatorcontrib>Degenhardt, Louisa</creatorcontrib><title>The increasing mortality burden of liver disease among opioid-dependent people: cohort study</title><title>Addiction (Abingdon, England)</title><addtitle>Addiction</addtitle><description>ABSTRACT
Aims Hepatitis C (HCV) infection is highly prevalent among injection drug users (IDUs) and likely to cause significant mortality over time, but little research attention has focused upon the magnitude of this risk, particularly among ageing users. This study examined trends over time in mortality attributed to liver disease, and in particular contrasting this with other more commonly studied causes of death [acquired immune deficiency syndrome (AIDS), suicide and overdose] among an ageing cohort of heroin‐dependent people in Australia.
Design Data linkage study of methadone treatment entrants with the National Deaths Index.
Setting A cohort entering methadone treatment for heroin dependence in New South Wales, Australia, 1980–85.
Participants A total of 2489 people entering methadone treatment for heroin dependence and 54 847 person‐years (PY) of follow‐up.
Measurements Linkage of data on all methadone entrants between 1980 and 1985 with data from the Australian National Deaths Index, linked using probabilistic record linkage software.
Findings There were 8.2 deaths per 1000 PY [95% confidence interval (CI) 7.5–9.0], with standardized mortality ratios (SMRs) of 4.6 (95% CI 4.2–5.0). Almost one in five (17%) of deaths were from underlying liver‐related causes, most commonly viral hepatitis. The overall mortality rate for any liver cause was 1.4 deaths per 1000 PY (95% CI 1.1–1.7), 17 times higher than to the general population (95% CI 13.4–21.3), with relative elevations more marked for females (SMR 27.9; 95% CI 17.7–41.9) than males (SMR 14.5; 95% CI 10.8–19.0). Liver mortality increased over time, becoming the most common cause of death by the end of follow‐up.
Conclusions Liver disease has become the most common cause of mortality among ageing opioid‐dependent people in an ageing Australian cohort. There is an imperative to reduce the long‐term risks of HCV and other risks to the liver, including alcohol consumption, which are typically not the major clinical focus for this group.</description><subject>Acquired immune deficiency syndrome</subject><subject>Acquired Immunodeficiency Syndrome - mortality</subject><subject>Addiction</subject><subject>Addictive behaviors</subject><subject>Adult</subject><subject>Adult and adolescent clinical studies</subject><subject>Aging</subject><subject>Alcohol</subject><subject>Australia</subject><subject>Biological and medical sciences</subject><subject>Cancer</subject><subject>Cause of Death - trends</subject><subject>cohort</subject><subject>Cohort analysis</subject><subject>Computer programs</subject><subject>Death</subject><subject>Diseases</subject><subject>Drug addiction</subject><subject>Drug Overdose - mortality</subject><subject>Epidemiologic Methods</subject><subject>Epidemiology</subject><subject>Female</subject><subject>General aspects</subject><subject>Hepatitis</subject><subject>Hepatitis C virus</subject><subject>Heroin</subject><subject>Heroin Dependence - mortality</subject><subject>Humans</subject><subject>Liver</subject><subject>Liver diseases</subject><subject>Liver Diseases - mortality</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Mortality</subject><subject>New South Wales - epidemiology</subject><subject>Opiates</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Risk factors</subject><subject>Substance Abuse, Intravenous - mortality</subject><subject>suicide</subject><subject>Suicide - statistics & numerical data</subject><subject>Wounds and Injuries - mortality</subject><subject>Young Adult</subject><issn>0965-2140</issn><issn>1360-0443</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqN0U-L1DAYBvAgijuufgUJgnhqTdKkaQQP666O4uIfdsSLENL0HTdj29Sk1Zlvb-qMI3hZc0kgv-cl4UEIU5LTtJ5uclqUJCOcFzkjlOakEFLk21tocby4jRZElSJjlJMTdC_GDSFEVorfRSeMSq4EEwv0ZXUN2PU2gImu_4o7H0bTunGH6yk00GO_xq37AQE3LiYD2HQ-OT8475qsgQH6xEY8gB9aeIatv04jcBynZncf3VmbNsKDw36KPr16uTp_nV2-X745P7vMrJBSZGZdMs6sEqoGCqopoSorQstGqLJmilJhmZW1TIbWqjZgKs7B1NZIJkhhilP0ZD93CP77BHHUnYsW2tb04KeoFSOES0KrmyWtSCmIpDdLwoqCCyGSfPSP3Pgp9OnDM6KUM6kSqvbIBh9jgLUegutM2GlK9Nyp3ui5Oj1Xp-dO9e9O9TZFHx7mT3UHzTH4p8QEHh-Aida062B66-Jfx2X6PJ_f8HzvfroWdv_9AH12cTGfUj7b510cYXvMm_BNl7JI9PO7pb5avf24vGIv9IfiFz1YytM</recordid><startdate>201112</startdate><enddate>201112</enddate><creator>Gibson, Amy</creator><creator>Randall, Deborah</creator><creator>Degenhardt, Louisa</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QG</scope><scope>7TK</scope><scope>8BJ</scope><scope>FQK</scope><scope>JBE</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope></search><sort><creationdate>201112</creationdate><title>The increasing mortality burden of liver disease among opioid-dependent people: cohort study</title><author>Gibson, Amy ; Randall, Deborah ; Degenhardt, Louisa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5775-af6242c959be1e9d6e868016d596b29115c2c7b742c1b9baea844eabca72503a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>Acquired Immunodeficiency Syndrome - mortality</topic><topic>Addiction</topic><topic>Addictive behaviors</topic><topic>Adult</topic><topic>Adult and adolescent clinical studies</topic><topic>Aging</topic><topic>Alcohol</topic><topic>Australia</topic><topic>Biological and medical sciences</topic><topic>Cancer</topic><topic>Cause of Death - trends</topic><topic>cohort</topic><topic>Cohort analysis</topic><topic>Computer programs</topic><topic>Death</topic><topic>Diseases</topic><topic>Drug addiction</topic><topic>Drug Overdose - mortality</topic><topic>Epidemiologic Methods</topic><topic>Epidemiology</topic><topic>Female</topic><topic>General aspects</topic><topic>Hepatitis</topic><topic>Hepatitis C virus</topic><topic>Heroin</topic><topic>Heroin Dependence - mortality</topic><topic>Humans</topic><topic>Liver</topic><topic>Liver diseases</topic><topic>Liver Diseases - mortality</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Mortality</topic><topic>New South Wales - epidemiology</topic><topic>Opiates</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Risk factors</topic><topic>Substance Abuse, Intravenous - mortality</topic><topic>suicide</topic><topic>Suicide - statistics & numerical data</topic><topic>Wounds and Injuries - mortality</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gibson, Amy</creatorcontrib><creatorcontrib>Randall, Deborah</creatorcontrib><creatorcontrib>Degenhardt, Louisa</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Animal Behavior Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>International Bibliography of the Social Sciences (IBSS)</collection><collection>International Bibliography of the Social Sciences</collection><collection>International Bibliography of the Social Sciences</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Addiction (Abingdon, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gibson, Amy</au><au>Randall, Deborah</au><au>Degenhardt, Louisa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The increasing mortality burden of liver disease among opioid-dependent people: cohort study</atitle><jtitle>Addiction (Abingdon, England)</jtitle><addtitle>Addiction</addtitle><date>2011-12</date><risdate>2011</risdate><volume>106</volume><issue>12</issue><spage>2186</spage><epage>2192</epage><pages>2186-2192</pages><issn>0965-2140</issn><eissn>1360-0443</eissn><coden>ADICE5</coden><abstract>ABSTRACT
Aims Hepatitis C (HCV) infection is highly prevalent among injection drug users (IDUs) and likely to cause significant mortality over time, but little research attention has focused upon the magnitude of this risk, particularly among ageing users. This study examined trends over time in mortality attributed to liver disease, and in particular contrasting this with other more commonly studied causes of death [acquired immune deficiency syndrome (AIDS), suicide and overdose] among an ageing cohort of heroin‐dependent people in Australia.
Design Data linkage study of methadone treatment entrants with the National Deaths Index.
Setting A cohort entering methadone treatment for heroin dependence in New South Wales, Australia, 1980–85.
Participants A total of 2489 people entering methadone treatment for heroin dependence and 54 847 person‐years (PY) of follow‐up.
Measurements Linkage of data on all methadone entrants between 1980 and 1985 with data from the Australian National Deaths Index, linked using probabilistic record linkage software.
Findings There were 8.2 deaths per 1000 PY [95% confidence interval (CI) 7.5–9.0], with standardized mortality ratios (SMRs) of 4.6 (95% CI 4.2–5.0). Almost one in five (17%) of deaths were from underlying liver‐related causes, most commonly viral hepatitis. The overall mortality rate for any liver cause was 1.4 deaths per 1000 PY (95% CI 1.1–1.7), 17 times higher than to the general population (95% CI 13.4–21.3), with relative elevations more marked for females (SMR 27.9; 95% CI 17.7–41.9) than males (SMR 14.5; 95% CI 10.8–19.0). Liver mortality increased over time, becoming the most common cause of death by the end of follow‐up.
Conclusions Liver disease has become the most common cause of mortality among ageing opioid‐dependent people in an ageing Australian cohort. There is an imperative to reduce the long‐term risks of HCV and other risks to the liver, including alcohol consumption, which are typically not the major clinical focus for this group.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>21749525</pmid><doi>10.1111/j.1360-0443.2011.03575.x</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Acquired immune deficiency syndrome Acquired Immunodeficiency Syndrome - mortality Addiction Addictive behaviors Adult Adult and adolescent clinical studies Aging Alcohol Australia Biological and medical sciences Cancer Cause of Death - trends cohort Cohort analysis Computer programs Death Diseases Drug addiction Drug Overdose - mortality Epidemiologic Methods Epidemiology Female General aspects Hepatitis Hepatitis C virus Heroin Heroin Dependence - mortality Humans Liver Liver diseases Liver Diseases - mortality Male Medical sciences Middle Aged Miscellaneous Mortality New South Wales - epidemiology Opiates Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Public health. Hygiene Public health. Hygiene-occupational medicine Risk factors Substance Abuse, Intravenous - mortality suicide Suicide - statistics & numerical data Wounds and Injuries - mortality Young Adult |
| title | The increasing mortality burden of liver disease among opioid-dependent people: cohort study |
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