Mortality among a national population sentenced to compulsory care for substance use disorders in Sweden: descriptive study

Eval Program Plann. 2015 Apr:49:153-62. doi: 10.1016/j.evalprogplan.2014.12.013. Epub 2014 Dec 18.

Abstract

Sweden's compulsory addiction system treats individuals with severe alcohol and narcotics use disorders. Merging data from three national level register databases of those sentenced to compulsory care from 2001 to 2009 (n=4515), the aims of this study were to: (1) compute mortality rates to compare to the general Swedish population; (2) identify leading cause of mortality by alcohol or narcotics use; and (3) identify individual level characteristics associated with mortality among alcohol and narcotics users. In this population, 24% were deceased by 2011. The most common cause of death for alcohol users was physical ailments linked to alcohol use, while narcotics users commonly died of drug poisoning or suicide. Average age of death differed significantly between alcohol users (55.0) and narcotics users (32.5). Multivariable logistic regression analysis identified the same three factors predicting mortality: older age (alcohol users OR=1.28, narcotic users OR=1.16), gender [males were nearly 3 times more likely to die among narcotics users (p<.000) and 1.6 times more likely to die among alcohol users (p<.01)] and reporting serious health problems (for alcohol users p<.000, for narcotics users p<.05). Enhanced program and government efforts are needed to implement overdose-prevention efforts and different treatment modalities for both narcotic and alcohol users.

Keywords: Alcohol; Mortality; Narcotics; Swedish compulsory care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Alcoholism / mortality
  • Alcoholism / therapy
  • Cause of Death
  • Drug Overdose / mortality
  • Female
  • Humans
  • Logistic Models
  • Male
  • Mandatory Programs* / statistics & numerical data
  • Middle Aged
  • Mortality
  • Opioid-Related Disorders / mortality
  • Opioid-Related Disorders / therapy
  • Registries
  • Sex Factors
  • Substance-Related Disorders / mortality
  • Substance-Related Disorders / therapy*
  • Suicide / statistics & numerical data
  • Sweden / epidemiology
  • Young Adult