Background

People who are dependent on opioids have substantially increased risk of premature death, but there are few estimates of life expectancy.

Methods

We calculated age-specific mortality rates in a cohort of people who had at least one prescription of an opioid agonist (methadone or buprenorphine) between 2001 and 2018 in New South Wales, Australia. We estimated life expectancy at age 18 based on life tables. We also estimated the potential years of life lost before age 75, decomposed by cause of death.

Results

The cohort included 47,197 people, with a median of 9.8 years of follow-up. 5,097 participants died, and the standardised mortality ratio (compared to the general population of New South Wales) was 6.06 (95% CI 5.90-6.23). Life expectancy at age 18 was 47.5 years (95% CI 42.9-50.5) for men and 50.7 years (95% CI 45.4-54.8) for women; deficits of 14.7 and 15.8 years respectively when compared to the general population. The largest cause of death was non-communicable physical diseases, which accounted for 47% of deaths in life tables for men and 42% for women. Drug-related deaths accounted for 16% of deaths for men and 19% for women, but due to the young age at which these deaths occur, they contributed approximately one third of potential years of life lost.

Conclusion

In common with people with serious mental illnesses, people who are dependent on opioids have substantially reduced life expectancy. In both populations most excess deaths relate to non-communicable physical diseases.

中文翻译：

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依赖阿片类药物的人的预期寿命：澳大利亚新南威尔士州的一项队列研究。

背景

依赖阿片类药物的人过早死亡的风险大大增加，但是预期寿命却很少。

方法

我们计算了2001年至2018年之间在澳大利亚新南威尔士州至少使用一种阿片类激动剂（美沙酮或丁丙诺啡）处方的人群的特定年龄死亡率。我们根据寿命表估算了18岁时的预期寿命。我们还估计了75岁之前因死亡原因分解的潜在生命年限。

结果

该队列包括47197人，中位随访时间为9.8年。5,097名参与者死亡，标准死亡率（与新南威尔士州的总人口相比）为6.06（95％CI 5.90-6.23）。男性的18岁预期寿命为47.5岁（95％CI 42.9-50.5），女性为50.7岁（95％CI 45.4-54.8）；与总人口相比，赤字分别为14.7年和15.8年。造成死亡的最大原因是非传染性身体疾病，占男性生命表中死亡的47％，女性占42％。与毒品有关的死亡占男性死亡的16％，女性死亡的19％，但是由于这些死亡发生的年龄较小，因此造成了大约三分之一的潜在生命损失。

结论

与患有严重精神疾病的人一样，依赖阿片类药物的人的预期寿命大大降低。在这两个人群中，大多数超额死亡与非传染性身体疾病有关。