Overall mortality among opiate users

Opiate users have an overall mortality that is up to 20 times or more higher than that of the general population of the same age. This increased mortality is particularly high among injectors. Despite the low prevalence of opiate addiction, this condition has a significant impact on the mortality of young adults in Europe (Bargagli et al., 2004).

Causes of mortality among opiate users include not only overdoses, but also AIDS and other infectious diseases, and external causes of death (accidents, violence, suicides, etc.). The main cause of death among cohorts with a low prevalence of HIV infection is overdose. AIDS deaths have decreased substantially in recent years, even among cohorts with a high prevalence of HIV infection, due to increased availability of HAART treatment after 1995 (see above for the overall figures in Europe) (159).

As opiate users age, mortality progressively increases as deaths from chronic conditions (such as cirrhosis, cancer, respiratory diseases, endocarditis, AIDS) are added to deaths from overdose and external causes such as suicide and violence (Dutch national report).

In addition, living conditions and factors other than drug use per se (homelessness, mental illness, violence, poor nutrition, etc.) may contribute substantially to the high mortality among drug users. Studies have shown that mortality among psychiatric patients is four times higher than that of the general population (Korkeila, 2000) and that mortality among homeless people is also three to four times higher than in the general population (Hwang, 2001).

(159) Mortality of drug users in the EU: coordination of implementation of new cohort studies, follow-up and analysis of existing cohorts and development of new methods and outputs. EMCDDA report CT.00.EP.13, 2002.