TY - JOUR
KW - Adult
KW - California
KW - Detoxification treatment
KW - Female
KW - Gender differences
KW - Humans
KW - longitudinal
KW - Male
KW - methadone treatment
KW - Mortality
KW - opioid dependence
KW - Opioid-Related Disorders/drug therapy/mortality
KW - Proportional Hazards Models
KW - Risk Factors
KW - Sex Characteristics
KW - Sex Factors
KW - Young Adult
AU - E. Evans
AU - A. Kelleghan
AU - L. Li
AU - J. Min
AU - D. Huang
AU - D. Urada
AU - Y. I. Hser
AU - B. Nosyk
A1 - 
AB - AIMS: To assess gender differences in characteristics, mortality rates, and the causes and predictors of death among treated opioid-dependent individuals. METHODS: Linked vital statistics data were obtained for all individuals first enrolled in publicly funded pharmacological treatment for opioid dependence in California from 2006 to 2010. Standardized mortality ratios (SMR) were calculated by gender. Cox proportional hazards models with time-varying covariates were fitted to determine the effect of gender on the hazard of all-cause mortality, controlling for covariates. RESULTS: Over a median 2.6 years (interquartile range: 1.4-3.7), 1.031 deaths were observed, including 2.2% (259/11,564) of women and 3.7% (772/20,758) of men. Women had a greater increased risk of mortality compared to the general population (SMR 5.1 95% CI: 4.5, 5.7) than men (SMR 4.3 95% CI: 4.0, 4.6). The relative risk of death for women compared with men was 1.18 (95% CI: 1.02, 1.36). Women had a lower instantaneous hazard of all-cause mortality than men (HR 0.58, 95% CI 0.50, 0.68), controlling for other factors. Significant interaction effects indicated that among men, mortality risk was decreased by full-time employment and increased by non-daily heroin use (relative to daily use) and medical problems. Concurrent opioid and methamphetamine/cocaine use increased mortality risk among women and decreased it among men. CONCLUSIONS: Treatment for opioid dependence is likely to reduce mortality risk among men by addressing employment and medical problems, and via interventions to reduce overdose risk after heroin abstinence, and among women by attending to the concurrent use of methamphetamine/cocaine and opioids.
BT - Drug and alcohol dependence
C5 - Opioids & Substance Use
CY - Ireland
DO - 10.1016/j.drugalcdep.2015.07.010
JF - Drug and alcohol dependence
N2 - AIMS: To assess gender differences in characteristics, mortality rates, and the causes and predictors of death among treated opioid-dependent individuals. METHODS: Linked vital statistics data were obtained for all individuals first enrolled in publicly funded pharmacological treatment for opioid dependence in California from 2006 to 2010. Standardized mortality ratios (SMR) were calculated by gender. Cox proportional hazards models with time-varying covariates were fitted to determine the effect of gender on the hazard of all-cause mortality, controlling for covariates. RESULTS: Over a median 2.6 years (interquartile range: 1.4-3.7), 1.031 deaths were observed, including 2.2% (259/11,564) of women and 3.7% (772/20,758) of men. Women had a greater increased risk of mortality compared to the general population (SMR 5.1 95% CI: 4.5, 5.7) than men (SMR 4.3 95% CI: 4.0, 4.6). The relative risk of death for women compared with men was 1.18 (95% CI: 1.02, 1.36). Women had a lower instantaneous hazard of all-cause mortality than men (HR 0.58, 95% CI 0.50, 0.68), controlling for other factors. Significant interaction effects indicated that among men, mortality risk was decreased by full-time employment and increased by non-daily heroin use (relative to daily use) and medical problems. Concurrent opioid and methamphetamine/cocaine use increased mortality risk among women and decreased it among men. CONCLUSIONS: Treatment for opioid dependence is likely to reduce mortality risk among men by addressing employment and medical problems, and via interventions to reduce overdose risk after heroin abstinence, and among women by attending to the concurrent use of methamphetamine/cocaine and opioids.
PP - Ireland
PY - 2015
SN - 1879-0046; 0376-8716
SP - 228
EP - 235
EP - 
T1 - Gender differences in mortality among treated opioid dependent patients
T2 - Drug and alcohol dependence
TI - Gender differences in mortality among treated opioid dependent patients
U1 - Opioids & Substance Use
U2 - 26282107
U3 - 10.1016/j.drugalcdep.2015.07.010
VL - 155
VO - 1879-0046; 0376-8716
Y1 - 2015
ER -