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J Subst Abuse Treat. 2017 Nov;82:22-28. doi: 10.1016/j.jsat.2017.09.001. Epub 2017 Sep 5.

Exploring mortality among drug treatment clients: The relationship between treatment type and mortality.

Author information

1
Turning Point, Eastern Health, 54-62 Gertrude Street, Fitzroy 3065, Victoria, Australia; Eastern Health Clinical School, Monash University, Victoria, Australia.
2
Institute for Social Science Research, University of Queensland, St Lucia, Queensland, Australia.
3
Drug Policy Modelling Program, National Drug and Alcohol Research Centre, UNSW, Sydney, NSW, Australia; National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia; Behaviours and Health Risks Program, Burnet Institute, Melbourne, VIC, Australia.
4
Turning Point, Eastern Health, 54-62 Gertrude Street, Fitzroy 3065, Victoria, Australia; Department of Law and Criminology, Sheffield Hallam University, Sheffield, England, United Kingdom.
5
Institute for Social Science Research, University of Queensland, St Lucia, Queensland, Australia. Electronic address: j.ferris@uq.edu.au.

Abstract

AIMS:

Studies consistently identify substance treatment populations as more likely to die prematurely compared with age-matched general population, with mortality risk higher out-of-treatment than in-treatment. While opioid-using pharmacotherapy cohorts have been studied extensively, less evidence exists regarding effects of other treatment types, and clients in treatment for other drugs. This paper examines mortality during and following treatment across treatment modalities.

METHODS:

A retrospective seven-year cohort was utilised to examine mortality during and in the two years following treatment among clients from Victoria, Australia, recorded on the Alcohol and Drug Information Service database by linking with National Death Index. 18,686 clients over a 12-month period were included. Crude (CMRs) and standardised mortality rates (SMRs) were analysed in terms of treatment modality, and time in or out of treatment.

RESULTS:

Higher risk of premature death was associated with residential withdrawal as the last type of treatment engagement, while mortality following counselling was significantly lower than all other treatment types in the year post-treatment. Both CMRs and SMRs were significantly higher in-treatment than post-treatment.

CONCLUSION:

Better understanding of factors contributing to elevated mortality risk for clients engaged in, and following treatment, is needed to ensure that treatment systems provide optimal outcomes during and after treatment.

KEYWORDS:

Cohort; Drug; Linkage; Mortality; Treatment

PMID:
29021111
DOI:
10.1016/j.jsat.2017.09.001
[Indexed for MEDLINE]

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