Mortality and causes of death: 6 years of monitoring treated drug users

Background

This study aims to analyse mortality among deceased cohort members in the years 2009-2015 in Slovenia in terms of causes of death. Cohort follows illicit drug users who were registered for the first time or repeatedly in Centres for illicit drug usage prevention and treatment.

Methods

5157 subjects entered in a retrospective cohort study who were observed for 29.146 years. Data on deceased drug users who were treated in Centres for illicit drug usage prevention and treatment from 2009, 2010, 2011 and 2012 were cross-linked with data from the General Mortality Register for the period 2009–2015.

Results

During 2009–2015 total of 153 deaths were recorded, mean age at death was 39.5 years. In almost three quarters violent death was the prevalent cause; among somatic causes (26%) alcoholic liver cirrhosis was the most frequent cause of death, followed by malignancies. Violent deaths occurred due to unintentional poisoning in 37%, followed by deaths from unidentified causes (11%), suicides (17%) and road accidents (2%), all other causes of death were much less common.

Illicit drugs that most commonly caused poisoning (intentional, unintentional or unidentified cause) were heroin and methadone (one third of cases for both), other drugs represented less than 10%. Almost one half of suicides were committed by hanging.

Conclusions

The causes of death among treated drug users in Slovenia are mostly unintentional overdoses, but also somatic diseases (alcoholic liver disease) and external causes of death (accidents, violence, suicides, etc.). Public health policies in the field of addiction should be more intensely focused on education on alcohol and liver damage due to drinking, screening for patients with overdose risk and in establishing specific programs and strategies for reducing the risk of suicide in this population.