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Mortality in the SuperMIX cohort of people who inject drugs in Melbourne, Australia: a prospective observational study
Author(s) -
Hill Penelope L.,
Stoové Mark,
Agius Paul A.,
Maher Lisa,
Hickman Matthew,
Crawford Sione,
Dietze Paul
Publication year - 2022
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.15975
Subject(s) - medicine , national death index , hazard ratio , prospective cohort study , mortality rate , cohort study , confidence interval , demography , observational study , cohort , sociology
Aims To measure mortality rates and factors associated with mortality risk among participants in the SuperMIX study, a prospective cohort study of people who inject drugs. Design A prospective observational study using self‐reported behavioural and linked mortality data. Setting Melbourne, Australia. Participants/cases A total of 1209 people who inject drugs (67% male) followed‐up between 2008 and 2019 for 6913 person‐years (PY). Measurements We linked participant identifiers from SuperMIX to the Australian National Death Index and estimated all‐cause and drug‐related mortality rates and standardized mortality ratios (SMRs). We used Cox regression to examine associations between mortality and fixed and time‐varying socio‐demographic, alcohol and other drug use and health service‐related exposures. Findings Between 2008 and 2019 there were 76 deaths in the SuperMIX cohort. Of those with a known cause of death ( n = 68), 35 (51%) were drug‐related, yielding an all‐cause mortality rate of 1.1 per 100 PY [95% confidence interval (CI) = 0.88–1.37] with an estimated SMR of 16.64 (95% CI = 13.29–20.83) and overall accidental drug‐induced mortality rate of 0.5 per 100 PY (95% CI = 0.36–0.71). Reports of recent use of ambulance services [adjusted hazard ratio (aHR) = 3.77, 95% CI =1.78–7.97] and four or more incarcerations (aHR = 2.78, 95% CI = 1.55–4.99) were associated with increased mortality risk. Conclusions In Melbourne, Australia, mortality among people who inject drugs appears to be positively associated with recent ambulance attendance and experience of incarceration.