Long-term outcome of chronic Drug use: The Amsterdam Cohort Study among Drug Users

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...

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Bibliographic Details
Published in:American journal of epidemiology 2005-02, Vol.161 (3), p.271-279
Main Authors: TERMORSHUIZEN, Fabian, KROL, Anneke, PRINS, Maria, VAN AMEIJDEN, Erik J. C
Format: Article
Language:English
Subjects:
Adult
Analysis. Health state
Biological and medical sciences
Cause of Death
Drug abuse
Epidemiology
Female
General aspects
HIV Infections - complications
HIV Infections - epidemiology
Human immunodeficiency virus
Humans
Long term
Longitudinal Studies
Male
Medical sciences
Netherlands - epidemiology
Prevalence
Public health. Hygiene
Public health. Hygiene-occupational medicine
Risk Factors
Substance-Related Disorders - complications
Substance-Related Disorders - mortality
Substance-Related Disorders - rehabilitation
Surveys and Questionnaires
Survival Analysis
Citations: Items that cite this one
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Summary: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.
ISSN:0002-9262
0002-9262
1476-6256
DOI:10.1093/aje/kwi035