Viktor Mravcik1, Tomas Zabransky2, Ave Talu3, Ernestas Jasaitis4, Nuriya Gafarova5, Zhannat Musabekova5, Luiza Baymirova6, Makhsut Makhsutov7, Furkat Ganiev8. 1. ResAd, Prague - Research and Development in Drug Epidemiology and Policy, Prague, Czech Republic; Department of Addictology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic; National Monitoring Centre for Drugs and Drug Addiction, Czech Republic. 2. ResAd, Prague - Research and Development in Drug Epidemiology and Policy, Prague, Czech Republic; Department of Addictology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic. Electronic address: twz@resad.cz. 3. ResAd, Prague - Research and Development in Drug Epidemiology and Policy, Prague, Czech Republic; Department of Public Health, University of Tartu, Estonia. 4. ResAd, Prague - Research and Development in Drug Epidemiology and Policy, Prague, Czech Republic; Drug Control Department under the Government of the Republic of Lithuania, Lithuanian REITOX National Focal Point, Lithuania. 5. National Research Center on Medical and Social Problems of Drug Addiction, Kazakhstan. 6. Ministry of Health of the Republic of Uzbekistan, Uzbekistan. 7. National Center for Monitoring and Prevention of Drug Addiction, Tajikistan. 8. National Center for Forensic Medicine and Toxicology, Tajikistan.
Abstract
BACKGROUND: Within the fifth phase of the Central Asia Drug Action Programme (CADAP) covering five post-Soviet Central Asian countries, an analysis of the mortality of drug users was performed. The results for Kazakhstan and Uzbekistan are presented in detail in this paper since results from Kyrgyzstan and Tajikistan are not considered valid and Turkmenistan did not provide data at all. METHODS: A system of registration of all users of illegal drugs known to the health and/or law enforcement authorities ("narcological registers") exists in Central Asian countries inherited from the system of Soviet "narcology". According to the legal norms, the death of a registered person should be recorded. We conducted indirect standardisation of crude mortality rates and computed the standardised mortality ratio (SMR) comparing observed number of deaths with expected number of deaths according to age and gender specific mortality rates in the general population of the same country. RESULTS: The results show excess mortality in registered drug users, particularly in registered females, in Uzbekistan (the latest available SMR for all those registered is 7.4; the SMR in females is 16.3) and Kazakhstan (4.0 and 12.9). The excess mortality is highest among young adults (18-34) in all the studies. CONCLUSION: Taking into account the limited quality and reliability of the data - first of all, the likely under-reporting of deaths in the narcological registers - the crude mortality rate among registered drug users is quite high when compared to EU countries. The SMR in total is comparably lower as a result of the high background mortality in the general population. This excess mortality is preventable and should be targeted by the national drug policies. Specifically, the programmes should target registered and unregistered female drug users.
BACKGROUND: Within the fifth phase of the Central Asia Drug Action Programme (CADAP) covering five post-Soviet Central Asian countries, an analysis of the mortality of drug users was performed. The results for Kazakhstan and Uzbekistan are presented in detail in this paper since results from Kyrgyzstan and Tajikistan are not considered valid and Turkmenistan did not provide data at all. METHODS: A system of registration of all users of illegal drugs known to the health and/or law enforcement authorities ("narcological registers") exists in Central Asian countries inherited from the system of Soviet "narcology". According to the legal norms, the death of a registered person should be recorded. We conducted indirect standardisation of crude mortality rates and computed the standardised mortality ratio (SMR) comparing observed number of deaths with expected number of deaths according to age and gender specific mortality rates in the general population of the same country. RESULTS: The results show excess mortality in registered drug users, particularly in registered females, in Uzbekistan (the latest available SMR for all those registered is 7.4; the SMR in females is 16.3) and Kazakhstan (4.0 and 12.9). The excess mortality is highest among young adults (18-34) in all the studies. CONCLUSION: Taking into account the limited quality and reliability of the data - first of all, the likely under-reporting of deaths in the narcological registers - the crude mortality rate among registered drug users is quite high when compared to EU countries. The SMR in total is comparably lower as a result of the high background mortality in the general population. This excess mortality is preventable and should be targeted by the national drug policies. Specifically, the programmes should target registered and unregistered female drug users.
Authors: Paulo Rossi Menezes; Cristina Marta Del-Ben; Daiane Leite da Roza; Marcos Gonçalves de Rezende; Régis Eric Maia Barros; João Mazzoncini de Azevedo-Marques; Jair Lício Ferreira Santos; Lilian Cristina Correia Morais; Carlos Eugenio de Carvalho Ferreira; Bernadette Cunha Waldvogel Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2022-05-31 Impact factor: 4.328