Dan Lewer1, Nicola R Jones2, Matthew Hickman3, Suzanne Nielsen4, Louisa Degenhardt2. 1. National Drug and Alcohol Research Centre, 22-32 King St, Randwick, NSW, 2031, Australia; Institute of Epidemiology and Healthcare, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK. Electronic address: d.lewer@ucl.ac.uk. 2. National Drug and Alcohol Research Centre, 22-32 King St, Randwick, NSW, 2031, Australia. 3. Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS2 8DZ, UK. 4. Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Melbourne, Australia.
Abstract
BACKGROUND: People who are dependent on opioids have increased risk of premature death, but there are few estimates of life expectancy. METHODS: We calculated age-specific mortality rates in a cohort of people who had at least one prescription of an opioid agonist (methadone or buprenorphine) between 2001 and 2018 in New South Wales, Australia. We used life tables to estimate life expectancy at age 18. We also estimated the potential years of life lost before age 75, decomposed by cause of death. RESULTS: The cohort included 47,197 people, with a median of 9.8 years of follow-up. 5097 participants died, and the standardised mortality ratio (compared to the general population of New South Wales) was 6.06 (95% CI 5.90-6.23). Life expectancy at age 18 was an additional 47.5 years (95% CI 42.9-50.5) for men and 50.7 years (95% CI 45.4-54.8) for women; deficits of 14.7 and 15.8 years respectively when compared to the general population. The largest cause of death was non-communicable physical diseases, which accounted for 47% of deaths in life tables for men and 42% for women. Drug-related deaths accounted for 16% of deaths for men and 19% for women, but due to the young age at which these deaths occur, they contributed approximately one third of potential years of life lost. CONCLUSION: In common with people with serious mental illnesses, people who are dependent on opioids have substantially reduced life expectancy. In both populations most excess deaths relate to non-communicable physical diseases.
BACKGROUND:People who are dependent on opioids have increased risk of premature death, but there are few estimates of life expectancy. METHODS: We calculated age-specific mortality rates in a cohort of people who had at least one prescription of an opioid agonist (methadone or buprenorphine) between 2001 and 2018 in New South Wales, Australia. We used life tables to estimate life expectancy at age 18. We also estimated the potential years of life lost before age 75, decomposed by cause of death. RESULTS: The cohort included 47,197 people, with a median of 9.8 years of follow-up. 5097 participants died, and the standardised mortality ratio (compared to the general population of New South Wales) was 6.06 (95% CI 5.90-6.23). Life expectancy at age 18 was an additional 47.5 years (95% CI 42.9-50.5) for men and 50.7 years (95% CI 45.4-54.8) for women; deficits of 14.7 and 15.8 years respectively when compared to the general population. The largest cause of death was non-communicable physical diseases, which accounted for 47% of deaths in life tables for men and 42% for women. Drug-related deaths accounted for 16% of deaths for men and 19% for women, but due to the young age at which these deaths occur, they contributed approximately one third of potential years of life lost. CONCLUSION: In common with people with serious mental illnesses, people who are dependent on opioids have substantially reduced life expectancy. In both populations most excess deaths relate to non-communicable physical diseases.
Authors: Dan Lewer; Thomas D Brothers; Naomi Van Hest; Matthew Hickman; Adam Holland; Prianka Padmanathan; Paola Zaninotto Journal: Lancet Public Health Date: 2021-12-11
Authors: Ivar Skeie; Thomas Clausen; Arne Jan Hjemsæter; Anne Signe Landheim; Bent Monsbakken; Magne Thoresen; Helge Waal Journal: Eur Addict Res Date: 2022-08-23 Impact factor: 4.000