Mortality among a national population sentenced to compulsory care for substance use disorders in Sweden: Descriptive study. (April 2015)

• Record Type: Journal Article
• Authors: Hall, Taylor; Chassler, Deborah; Blom, Björn; Grahn, Robert; Blom-Nilsson, Marcus; Sullivan, Lisa; Lundgren, Lena
• Is Part Of: Evaluation and program planning. Volume 49(2015:Apr.)
• Page Start: 153
• Page End: 162
• Publication Date: 2015-04
• Subjects: Mortality -- Alcohol -- Narcotics -- Swedish compulsory care; Health planning -- Periodicals; Medical care -- Evaluation -- Periodicals; 362.1068
• DOI: 10.1016/j.evalprogplan.2014.12.013
• Languages: English
• ISSNs: 0149-7189

Abstract

Highlights: For those sentenced to compulsory care between 2001 and 2009, 24% had died by 2011. Age-adjusted death rate was 8–9 times higher for those in compulsory care. Age of death differed significantly: alcohol users (55.0) and narcotics users (32.5). Primary cause of death for alcohol users was physical ailments due to alcohol use. Primary cause of death for narcotics users was drug poisoning or suicide. 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.