Title: Differences in mortality in a cohort of cocaine use disorder patients with concurrent alcohol or opiates disorder
Abstract: AddictionVolume 113, Issue 6 p. 1045-1055 Research Report Differences in mortality in a cohort of cocaine use disorder patients with concurrent alcohol or opiates disorder Esther Colell, Esther Colell Drug Abuse Epidemiology Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, SpainSearch for more papers by this authorAntònia Domingo-Salvany, Corresponding Author Antònia Domingo-Salvany [email protected][email protected] orcid.org/0000-0003-3302-4538 Drug Abuse Epidemiology Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, SpainCorrespondence to: Antònia Domingo-Salvany, Drug Abuse Epidemiology Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Dr Aiguader, 88, 08003 Barcelona, Spain. E-mail: [email protected], [email protected] for more papers by this authorAlbert Espelt, Albert Espelt Public Health Agency of Barcelona, Spain Institute of Biomedical Research Sant Pau, Barcelona, Spain Department of Psychobiology and Methodology of Health Sciences, Autonomous University of Barcelona, Bellaterra, Spain CIBER en Epidemiología y Salud Pública (CIBERESP), Biomedical Research Centre Network for Epidemiology and Public Health (Spain), Madrid, Spain Facultat de Ciències de la Salut de Manresa, Universitat de Vic. Universitat Central de Catalunya (UVicUCC), Av Universitària, Manresa, SpainSearch for more papers by this authorOleguer Parés-Badell, Oleguer Parés-Badell Public Health Agency of Barcelona, Spain Institute of Biomedical Research Sant Pau, Barcelona, SpainSearch for more papers by this authorM. Teresa Brugal, M. Teresa Brugal Public Health Agency of Barcelona, Spain Institute of Biomedical Research Sant Pau, Barcelona, SpainSearch for more papers by this author Esther Colell, Esther Colell Drug Abuse Epidemiology Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, SpainSearch for more papers by this authorAntònia Domingo-Salvany, Corresponding Author Antònia Domingo-Salvany [email protected][email protected] orcid.org/0000-0003-3302-4538 Drug Abuse Epidemiology Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, SpainCorrespondence to: Antònia Domingo-Salvany, Drug Abuse Epidemiology Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Dr Aiguader, 88, 08003 Barcelona, Spain. E-mail: [email protected], [email protected] for more papers by this authorAlbert Espelt, Albert Espelt Public Health Agency of Barcelona, Spain Institute of Biomedical Research Sant Pau, Barcelona, Spain Department of Psychobiology and Methodology of Health Sciences, Autonomous University of Barcelona, Bellaterra, Spain CIBER en Epidemiología y Salud Pública (CIBERESP), Biomedical Research Centre Network for Epidemiology and Public Health (Spain), Madrid, Spain Facultat de Ciències de la Salut de Manresa, Universitat de Vic. Universitat Central de Catalunya (UVicUCC), Av Universitària, Manresa, SpainSearch for more papers by this authorOleguer Parés-Badell, Oleguer Parés-Badell Public Health Agency of Barcelona, Spain Institute of Biomedical Research Sant Pau, Barcelona, SpainSearch for more papers by this authorM. Teresa Brugal, M. Teresa Brugal Public Health Agency of Barcelona, Spain Institute of Biomedical Research Sant Pau, Barcelona, SpainSearch for more papers by this author First published: 22 January 2018 https://doi.org/10.1111/add.14165Citations: 3Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Abstract Aims To study mortality in a cohort of cocaine use disorder patients, and compare results in those with concurrent alcohol or opiates disorder. Design, Setting and Participants A cohort of 10 539 cocaine use disorder individuals entering drug treatment in public out-patient centres in the city of Barcelona was followed from 1997 to 2011. Participants were divided at baseline into three groups: those with only cocaine use disorder (CUD), those with cocaine and alcohol use disorder but not opioid (CAUD) and those with cocaine and opioid use disorder (COUD). Mortality was assessed through the Spanish National Mortality Register. Measurements Crude mortality rates (CMR), standardized mortality ratios (SMR) and rate ratios (RR) were calculated for each group. A multivariable Cox regression model was fitted to obtain adjusted mortality hazard ratios (aHR) of CAUD and COUD with respect to CUD. Specific mortality causes were also examined. Findings The total of 716 deaths registered resulted in a CMR = 6.0/1000 person-years (PY); 95% confidence interval (CI) = 5.1–7.0 for CUD, CMR = 5.8/1000 PY (95% CI = 4.9–6.7) for CAUD and CMR = 20.7/1000 PY (95% CI = 18.8–22.8) for COUD, with no significant differences among sexes. Compared with the general population, mortality was four times higher (SMR = 4.1, 95% CI = 3.5–4.8) among CUD, more than three times among CAUD (SMR = 3.4, 95% CI = 2.9–3.9) and more than 10 times among COUD (SMR = 11.6, 95% CI = 10.5–12.8), being always higher in women. External injuries, led by overdose, accumulated the biggest percentage of deaths among the three groups, but infectious diseases showed the highest excess mortality. Some differences regarding causes of death were observed between the three groups. Conclusions Mortality risk and excess mortality are significantly greater among those with cocaine and opiates use disorder than among people with only cocaine use disorder or cocaine and alcohol use disorder. Citing Literature Supporting Information Filename Description add14165-sup-0001-Supplementary_Data.docxWord 2007 document , 13.8 KB Table S1 International Classification of Diseases (ICD-9 and ICD-10) codes used to classify cause of death in a cohort of cocaine users. Barcelona 1997–11. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article. Volume113, Issue6June 2018Pages 1045-1055 RelatedInformation