Mortality among people who inject drugs: a systematic review and meta-analysis
TLDR
Any comprehensive approach to improving health outcomes in this group must include efforts to reduce HIV infection as well as other causes of death, particularly drug overdose, according to the authors.Abstract:
OBJECTIVE: To systematically review cohort studies of mortality among people who inject drugs, examine mortality rates and causes of death in this group, and identify participant- and study-level variables associated with a higher risk of death. METHODS: Tailored search strings were used to search EMBASE, Medline and PsycINFO. The grey literature was identified through online grey literature databases. Experts were consulted to obtain additional studies and data. Random effects meta-analyses were performed to estimate pooled crude mortality rates (CMRs) and standardized mortality ratios (SMRs). FINDINGS: Sixty-seven cohorts of people who inject drugs were identified, 14 of them from low- and middle-income countries. The pooled CMR was 2.35 deaths per 100 person-years (95% confidence interval, CI: 2.12-2.58). SMRs were reported for 32 cohorts; the pooled SMR was 14.68 (95% CI: 13.01-16.35). Comparison of CMRs and the calculation of CMR ratios revealed mortality to be higher in low- and middle-income country cohorts, males and people who injected drugs that were positive for human immunodeficiency virus (HIV). It was also higher during off-treatment periods. Drug overdose and acquired immunodeficiency syndrome (AIDS) were the primary causes of death across cohorts. CONCLUSION: Compared with the general population, people who inject drugs have an elevated risk of death, although mortality rates vary across different settings. Any comprehensive approach to improving health outcomes in this group must include efforts to reduce HIV infection as well as other causes of death, particularly drug overdose.read more
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Global Burden of Disease Attributable to Illicit Drug Use and Dependence: Findings From the Global Burden of Disease Study 2010
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TL;DR: Efficient strategies to reduce disease burden of opioid dependence and injecting drug use, such as delivery of opioid substitution treatment and needle and syringe programmes, are needed to reduce this burden at a population scale.
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The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness
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TL;DR: This Commission summarises advances in understanding on the topic of physical health in people with mental illness, and presents clear directions for health promotion, clinical care, and future research.
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Morbidity and mortality in homeless individuals, prisoners, sex workers, and individuals with substance use disorders in high-income countries: a systematic review and meta-analysis
Robert W Aldridge,Alistair Story,Stephen W. Hwang,Merete Nordentoft,Serena Luchenski,Greg Hartwell,Emily J Tweed,Dan Lewer,Srinivasa Vittal Katikireddi,Andrew Hayward +9 more
TL;DR: This study shows that homeless populations, individuals with substance use disorders, sex workers, and imprisoned individuals experience extreme health inequities across a wide range of health conditions, with the relative effect of exclusion being greater in female individuals than male individuals.
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Public health and international drug policy
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TL;DR: The Johns Hopkins-Lancet Commission on Drug Policy and Health as mentioned in this paper examined the emerging scientific evidence on public health issues arising from drug control policy and to inform and encourage a central focus on health evidence and outcomes in drug-policy debates, such as the important deliberations of the 2016 UNGASS on drugs.
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Global statistics on addictive behaviours: 2014 status report.
TL;DR: Tobacco and alcohol use are by far the most prevalent addictive behaviours and cause the large majority of the harm, however, the quality of data on prevalence and addiction-related harms is mostly low, and comparisons between countries and regions must be viewed with caution.
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