Journal Article

Long-term Outcome of Chronic Drug Use

Fabian Termorshuizen, Anneke Krol, Maria Prins and Erik J. C. van Ameijden

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 161, issue 3, pages 271-279
Published in print February 2005 | ISSN: 0002-9262
Published online February 2005 | e-ISSN: 1476-6256 | DOI: http://dx.doi.org/10.1093/aje/kwi035
Long-term Outcome of Chronic Drug Use

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In the present study, mortality rates and prevalence of abstinence from illicit drugs among persons with a history of addiction to heroin, cocaine, and/or amphetamines were estimated along the drug-using career time scale. Follow-up data on drug use and vital status were analyzed for participants in the Amsterdam Cohort Study among Drug Users (n = 899; 1985–2002). Participants in the study were primarily recruited at low-threshold methadone outposts. It was estimated that at least 27% of drug users had died within 20 years after starting regular drug use; for half, death had been due to causes unrelated to human immunodeficiency virus. A favorable trend towards abstinence with increasing time since initiation of regular use was observed. However, among those alive, the estimated prevalence of abstinence for at least 4 months from the above drugs and methadone was only 27% at 20 years since initiation. A higher age at initiation, a calendar year of initiation before 1980, and a Western European ethnic origin were associated with higher prevalence of abstinence. These results indicate that the concept of “maturing out” to a drug-free state does not apply to the majority of drug users. Further studies on determinants of individual transitions in drug use are important in order to establish evidence-based intervention strategies.

Keywords: behavior; fatal outcome; harm reduction; longitudinal studies; substance-related disorders; ACS, Amsterdam Cohort Study; AIDS, acquired immunodeficiency syndrome; GEE, generalized estimating equations; HIV, human immunodeficiency virus.

Journal Article.  5885 words.  Illustrated.

Subjects: Public Health and Epidemiology

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