Mortality among young people seeking residential treatment for problematic drug and alcohol use: A data linkage study. (1st November 2021)

• Record Type: Journal Article
• Authors: Bista, Sarita; Nathan, Sally; Rawstorne, Patrick; Palmer, Kieran; Ferry, Mark; Williams, Megan; Hayen, Andrew
• Is Part Of: Drug and alcohol dependence. Volume 228(2021)
• Publication Date: 2021-11-01
• Subjects: Young people -- Drug and alcohol use -- Residential treatment -- Mortality -- Causes of death -- Data linkage; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2021.109030
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: Data linkage study with young people referred to a residential treatment program. Elevated mortality rates in this population of five times those in the general population. Females had mortality rates of nearly ten times those in the general population. Drugs or alcohol involved directly or indirectly in two-thirds of deaths. Drug overdose as the main cause of death followed by suicide and transport accidents. Abstract: Background: Young people with problematic alcohol and other drug (AOD) use are often referred to residential treatment. Subsequent mortality rates among this high-risk group is not known. This study estimates mortality rates and determines causes of death amongst young people referred to residential treatment in Sydney, Australia. Design: Retrospective data linkage study. Data of young people (13–18 years) referred to a residential treatment service 2001–2015 (n = 3256) linked with Australian death registration data, and followed up to 16 years (2001–2016). Methods: Mortality rates (CMRs) and standardised mortality ratios (SMRs, age-, gender-, calendar-year-adjusted) calculated using population mortality rates. Causes of death were analysed using ICD-10 codes for AOD-induced, AOD as contributory and non-AOD related causes. Results: During follow-up of the cohort (28, 838 person-years), 63 people died (71.4 % males; 48 % Indigenous; median age at death = 21.9 years; median follow-up = 5.1years), with 76 % dying before aged 25 years. Overall mortality (SMR = 4.91, 95 % CI: 3.8−6.2; CMR = 2.18/1000 person-years, 95 % CI: 1.7−2.8) was significantly higher than age-gender-matched general population, particularly in females (SMR = 9.55; males: SMR = 4.11; RR: 2.3, 95 % CI: 1.3–4.1). SMRs were not significantly different between treatment groups (SMRs>5.5) and non-attend group (SMR = 3.7) ( p = 0.359). Two-thirds of deaths involved AOD, with AOD-induced deaths comprising 42 % and AOD as contributory for 22 % deaths. Overdose, mainly opioids (including opiates), suicide, and transport accidents were major causes of deaths. Conclusion: Very high mortality rates, particularly among females, and the high incidence of overdose and suicide emphasise early screening for those at high-risk, targeted and culturally appropriate interventions, and maximised continuing after-care accessible to young people.