Mortality Among People Who Inject Drugs: Ten-Year Follow-Up Of The Hepatitis C Virus Cohort

Introduction and Aims Mortality studies of people who inject drugs (PWID) are mostly of older people and drug treatment cohorts. We estimate mortality rates, describe causes of death, and years of potential life lost in a community-recruited cohort of young PWID characterised by high incidence of hepatitis C virus (HCV) infection. Design and Methods Participant identifiers of 215 PWID from the south-western Sydney sub-cohort of the HCV Cohort were linked to National Death Index records from 1999 to 2010 and crude mortality rates and standardised mortality ratios estimated. Australian life tables were used to calculate years of potential of life lost. Results Fifteen participants died (7.0%) in 2095 person years (PY) of follow-up. Median age at death was 30.6 years (interquartile range 24.9-32.2). The crude mortality rate was 0.72 per 100PY (95% confidence interval 0.29-0.79) with a standardised mortality ratio of 11.09 (95% confidence interval 6.68-18.39). One-third of deaths were due to accidental drug overdose (5/15) and one-fifth were suicides (3/15). All deaths from defined causes (13/15) were potentially avoidable. Decedents lost on average 49.8 years of potential life. Discussion and Conclusions Mortality and potential life lost further highlight the impact of accidental overdose deaths and suicide among young PWID. Integration of overdose and suicide prevention into youth-orientated outreach, including innovation in online and mobile technology should be evaluated.