Mortality among regular or dependent users of heroin and other opioids: a systematic review and meta-analysis of cohort studies: Mortality among opioid users
Abstract
Aims To review the literature on mortality among dependent or regular users of opioids across regions, according to specific causes, and related to a number of demographic and clinical variables. Methods Multiple search strategies included searches of Medline, EMBASE and PsycINFO, consistent with the methodology recommended by the Meta-analysis of Observational Studies in Epidemiology (MOOSE) group; grey literature searches; and contact of experts for any additional unpublished data from studies meeting inclusion criteria. Random-effects meta-analyses were conducted for crude mortality rates (CMRs) and standardized mortality ratios (SMRs), with stratified analyses where possible. Meta-regressions examined potentially important sources of heterogeneity across studies. Results Fifty-eight prospective studies reported mortality rates from opioid-dependent samples. Very high heterogeneity across studies was observed; pooled all-cause CMR was 2.09 per 100 person-years (PY; 95% CI; 1.93, 2.26), and the pooled SMR was 14.66 (95% CI: 12.82, 16.50). Males had higher CMRs and lower SMRs than females. Out-of-treatment periods had higher mortality risk than in-treatment periods (pooled RR 2.38 (CI: 1.79, 3.17)). Causes of death varied across studies, but overdose was the most common cause. Multivariable regressions found the following predictors of mortality rates: country of origin; the proportion of sample injecting; the extent to which populations were recruited from an entire country…
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Medications for opioid use disorder (MOUD) are a tool that helps reduce opioid-related overdose mortality.
“Evidence shows that medications for opioid use disorder (MOUD) are a tool that helps reduce opioid-related overdose mortality.2,3,4”
From Economic Evaluation of Extended-Release Buprenorphine for Persons With Opioid Use Disorder (2023) · cites this paper as [3]
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- Authors
- Degenhardt, L., Bucello, C., Mathers, B., Briegleb, C., Ali, H., Hickman, M., & McLaren, J.
- Affiliations
- Burnet Institute (AU)
- UNSW Sydney (AU)
- Corresponding author
- Degenhardt, Louisa
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2010-11-04
- Volume
- 106
- Issue
- 1
- Pages
- 32-51
- ISSN
- 0965-2140 (ISSN-L)
- OpenAlex
- W1958535246
- Cited by
- 856
- References
- 8
- Citations by year
- 2026: 21 · 2025: 22 · 2024: 36 · 2023: 91 · 2022: 57 · 2021: 74 · 2020: 71 · 2019: 72 · 2018: 64 · 2017: 53 · 2016: 58 · 2015: 76 · 2014: 65 · 2013: 46 · 2012: 32
- FWCI
- 4.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- Bristol Research (University of Bristol) (publishedVersion)
- Funders
- Economic and Social Research Council (ES/G007543/1)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- opioid use disorder, heroin use, mortality, standardized mortality ratio, opioid overdose, addiction treatment, intravenous drug use, sex differences, causes of death, mortality risk factors, international variation
- MeSH terms
- Adult, Analgesics, Opioid, Asia, Cause of Death, Europe, Female, Humans, Male, Opioid-Related Disorders, North America, Recurrence, Time Factors, HIV Infections, Substance Abuse, Intravenous, Australasia, Young Adult, Drug Overdose
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