The aim of this study was to examine changes in causes of death in a cohort treated for opioid dependence, across time and age; quantify years of potential life lost (YPLL); and identify avoidable causes of death. People in New South Wales (NSW) who registered for opioid substitution therapy (OST), 1985-2005 were linked to a register of all deaths in Australia. Measurements were crude mortality rates (CMRs), age-sex-standardised mortality rates (ASSRs) and standardised mortality ratios (SMRs) across time, sex and age. Years of potential life lost (YPLL) were calculated with reference to Australian life tables and by calculating years lost before the age of 65. There were 43,789 people in the cohort, with 412,216 person-years of follow-up. The proportion of the cohort aged 40+ years increased from 1% in 1985 to 39% in 2005. Accidental opioid overdoses, suicides, transport accidents and violent deaths declined with age; deaths from cardiovascular disease, liver disease and cancer increased. Among men, 89% of deaths were potentially avoidable; among women, 86% of deaths were avoidable. There were an estimated 160,847 YPLL in the cohort, an average of 44 YPLL per decedent, and an average of 29 YPLL before age 65. Among a cohort of opioid dependent people in New South Wales, 1985-2005, almost 9 in 10 deaths in the cohort were avoidable. There is huge scope to improve mortality among opioid dependent people. (Author/publisher)
Abstract