Mortality of drug addicts in the United Kingdom 1967-1993

Mortality in specified clinical populations has often been regarded as a measure of treatment effectiveness. This study examined time trends in mortality of drug addicts in the UK notified to the Home Office over a 27-year period.

The study was a longitudinal analysis of routine mortality data of a population of newly notified addicts from 1967 to 1993. Altogether, 92 802 addicts were newly notified during the study period, and they accounted for 687 673 person-years of observation. The main outcome measures were age-specific all-causes mortality; drug-related mortality; and age- and sex-specific standardized mortality ratios (SMR) 1967-1993.

There were significant differences in death rates between the periods 1967-1976 (19/1000 person-years) and 1984-1993 (10.5/1000 person-years). Excess deaths were significantly higher among the 1967-1976 cohorts than in the 1984-1993 cohorts (SMR ratio = 1.80, 95% CI: 1.64-1.97). The majority of deaths were drug-related, with those aged <45 years more likely to die of a drug-related cause than those older (OR = 6.29, 95% CI: 4.97-7.96).

It appears that service provision has some impact on all-causes mortality among opiate addicts. As services improved, there was a corresponding decline in mortality rates during the study period. Further preventive measures, however, should be devised to reduce drug-related deaths.