Mortality among Older Adults with Opioid Use Disorders in the Veteran's Health Administration, 2000-2011
BACKGROUND:
The
population of people with opioid use disorders (OUD) is aging. There has been
little research on the effects of aging on mortality rates and causes of death
in this group. We aimed to compare mortality in older (≥ 50 years of age)
adults with OUD to that in younger (<50 years) adults with OUD and older
adults with no history of OUD. We also examined risk factors for specific
causes of death in older adults with OUD.
METHODS:
Using
data from the Veteran's Health Administration National Patient Care Database
(2000-2011), we compared all-cause and cause-specific mortality rates in older
adults with OUD to those in younger adults with OUD and older adults without
OUD. We then generated a Cox regression model with specific causes of death
treated as competing risks.
RESULTS:
Older
adults with OUD were more likely to die from any cause than younger adults with
OUD. The drug-related mortality rate did not decline with age. HIV-related and
liver-related deaths were higher among older OUD compared to same-age peers
without OUD. There were very few clinically important predictors of specific
causes of death.
CONCLUSION:
Considerable
drug-related mortality in people with OUD suggests a need for greater access to
overdose prevention and opioid substitution therapy across the lifespan.
Elevated risk of liver-related death in older adults may be addressed through
antiviral therapy for hepatitis C virus infection. There is an urgent need to explore
models of care that address the complex health needs of older adults with OUD.
- 1National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia; Alpert Medical School, Brown University, Providence, RI, USA. Electronic address: s.larney@unsw.edu.au.
- 2Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA; Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI, USA.
- 3School of Social and Community Medicine, University of Bristol, Bristol, UK.
- 4National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia; School of Population and global Health, University of Melbourne, Melbourne, Victoria, Australia.
- Drug Alcohol Depend. 2015 Feb 1;147:32-7. doi: 10.1016/j.drugalcdep.2014.12.019. Epub 2014 Dec 30.
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