Darke Shane, Marel Christina, Mills Katherine L, Ross Joanne, Slade Tim, Tessson Maree
National Drug and Alcohol Research Centre, University of New South Wales, Australia.
National Drug and Alcohol Research Centre, University of New South Wales, Australia; NHMRC Centre for Research Excellence in Mental Health and Substances Use, Australia.
Drug Alcohol Depend. 2016 May 1;162:206-10. doi: 10.1016/j.drugalcdep.2016.03.010. Epub 2016 Mar 18.
Heroin use carries the highest burden of disease of any drug of dependence. The study aimed to determine mortality rates of the Australian Treatment Outcome Study cohort over the period 2001-2015, and the years of potential life lost (YPLL).
The cohort consisted of 615 heroin users. Crude mortality rates per 1000 person years (PY) and Standardised Mortality Ratios (SMR) were calculated. YPLL were calculated using two criteria: years lost prior to age 65, and years lost prior to average life expectancy.
The cohort was followed for 7,790.9 PY. At 2015, 72 (11.7%) of the cohort were deceased, with a crude mortality rate of 9.2 per 1000 PYs. Neither age nor gender associated with mortality. The SMR was 10.2 (males 7.3, females 17.2), matched for age, gender and year of death. The most common mortality cause was opioid overdose (52.8%). Using the<65 years criterion, there were 1988.3 YPLL, with a mean of 27.6 (males 27.6, females 27.7). Using the average life expectancy criterion, there were 3135.1 YPLL, with a mean of 43.5 (males 41.9, females 46.3). Accidental overdose (<65 yr 63.0%, average life expectancy 63.7%) and suicide (<65 yr 12.8%, average life expectancy 13.3%) accounted for three quarters of YPLL where cause of death was known.
YPLL associated with heroin use was a quarter of a century, or close to half a century, depending on the criteria used. Given the prominent role of overdose and suicide, the majority of these fatalities, and the associated YPLL, appear preventable.
海洛因使用带来的疾病负担高于任何一种成瘾性药物。本研究旨在确定2001年至2015年期间澳大利亚治疗结果研究队列的死亡率以及潜在寿命损失年数（YPLL）。
该队列由615名海洛因使用者组成。计算了每1000人年的粗死亡率和标准化死亡率（SMR）。YPLL使用两个标准进行计算：65岁之前损失的年数以及平均预期寿命之前损失的年数。
该队列随访了7790.9人年。到2015年，队列中有72人（11.7%）死亡，粗死亡率为每1000人年9.2人。年龄和性别均与死亡率无关。标准化死亡率为10.2（男性7.3，女性17.2），按年龄、性别和死亡年份进行了匹配。最常见的死亡原因是阿片类药物过量（52.8%）。使用<65岁标准，有1988.3个潜在寿命损失年，平均为27.6年（男性27.6年，女性27.7年）。使用平均预期寿命标准，有3135.1个潜在寿命损失年，平均为43.5年（男性41.9年，女性46.3年）。意外过量用药（<65岁时占63.0%，平均预期寿命时占63.7%）和自杀（<65岁时占12.8%，平均预期寿命时占13.3%）占已知死亡原因的潜在寿命损失年数的四分之三。
根据所使用的标准，与海洛因使用相关的潜在寿命损失年数为四分之一个世纪，或接近半个世纪。鉴于过量用药和自杀的突出作用，这些死亡中的大多数以及相关的潜在寿命损失年数似乎是可以预防的。
