Takeaway
- All-cause mortality worldwide was significantly higher among people using extramedical opioids than among those who do not, across a range of causes.
- Noncommunicable diseases accounted for almost one-quarter of deaths and infectious diseases, and trauma accounted for almost 20% of deaths.
Why this matters
- The findings point to the need for a greater emphasis on a combination approach that includes opioid agonist treatment, needle exchange programs, and greater naloxone availability, in addition to HIV and hepatitis C treatments.
Study design
- A meta-analysis of 124 studies after search across MEDLINE, PsycINFO, and Embase published during 2009-2019.
- Outcomes: all-cause mortality.
- Funding: Australian Government Department of Health under the Drug and Alcohol Program.
Key results
- People who used extramedical opioids had higher risk for all-cause mortality (1.59/100 person-years; 95% CI, 1.40-1.80/100 person-years; I2=99.7%).
- Highest all-cause mortality was observed in South Asia (7.62/100 person-years; 95% CI, 4.84-12.00/100 person-years) and the lowest was in Australasia (0.80/100 person-years; 95% CI, 0.67-0.96/100 person-years).
- Key causes for excess mortality (95% CIs) in people who used extramedical opioids:
- Noncommunicable diseases: 24.1% (17.1%-31.2%);
- Infectious diseases: 19.7% (11.7%-27.8%); and
- Trauma: 18.1% (12.6%-23.7%).
Limitations
- Heterogeneity among studies.
Coauthored with Chitra Ravi, MPharm
References
References
