Mortality of treated alcoholics and drug addicts: the benefits of abstinence.

A study of 2-yr treatment outcome and of mortality in the following 8 yr was conducted on all first admissions to Eagleville Hospital in 1970 (503 alcoholics and 221 drug addicts; 9% women). The average age of the alcoholics was 41.6 vs 23.0 for the drug addicts. Status (misusing vs not misusing) 2 yr after admission for treatment or at death was ascertained for 92% of the subjects. The 108 known deaths occurred in 18.5% of the alcoholics and 6.8% of the addicts. Death rates per 1000 person yr at risk were compared with expected general population rates, controlling for age, race and sex. Overall, mortality per 1000 person yr was 25.9 for alcoholics and 8.8 for addicts, each higher than expectancy (p less than .001). Ratios of observed to expected rates were similar (2.5 and 3.1, respectively). Excess mortality occurred only among those misusing alcohol or drugs at 2 yr; nonmisusers had expected death rates. Disease and violent deaths were excessive among alcoholics, but only violent deaths exceeded expectancy among drug addicts. Of the 108 deaths, 66 were excess deaths, attributable to substance misuse and the associated way of life. However, among the 254 who were not misusing on follow-up, 19 died rather than the 51 who would have died if their mortality had been that of the persistent misusers.