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- Title
Mortality after Discharge from Publicly-Funded Substance Abuse Treatment in Texas, 2006-2013.
- Authors
Maughan, Brandon; Shafer, Alan B.; Becker, Emilie A.
- Abstract
Background: Substance abuse is a leading cause of preventable morbidity and mortality. While there is prior literature on mortality associated with abuse of major drug classes, relatively less literature exists regarding risks of mortality experienced by patients after they complete substance abuse treatment. Methods: The study was a retrospective cohort record-linkage study of patients aged 18-64 who enrolled in and were discharged from substance abuse treatment provided by the Texas Department of State Health Services during 2006-2013. These records were matched to DSHS vital statistics death records. Patients were classified by type(s) of drugs patients reported using, including alcohol, central nervous system (CNS) depressants, marijuana, opioids and stimulants. Age was classified into five categories (18-24, 25-34, 35-44, 45-54 and 55-64 years). Crude mortality rates (CMRs) and standardized mortality ratios (SMRs) were calculated for deaths occurring up to 5 years after discharge. Manner of death was examined for each drug category. Results: The study sample included 199,225 patients, of whom 6537 (3.3%) died. Among patients who reported substance use disorder of a single drug type, the highest post-discharge SMRs were associated with opioids (7.1), CNS depressants (6.8) and alcohol (5.1), relative to the expected number of deaths in the general Texas population. High SMRs were observed among women ages 18-34 with opioid use disorder (range 14.3-17.7), women ages 25-34 with alcohol use disorder (SMR 12.3) and patients ages 25-34 with CNS depressant use disorder (14.7). Lower SMRs were observed for stimulants (3.0) and marijuana (2.4). Fifty-three percent of deaths were natural and 31 percent were accidental; drug overdoses caused most accidental deaths. Conclusions: Patients retain elevated risks of mortality after discharge from substance abuse treatment. Additional programs should be considered to reduce potentially avoidable deaths among those at highest risk, including young women with a history of abusing opioids, CNS depressants, or alcohol. Future research should examine manners and causes of deaths among these high-risk patient cohorts.
- Publication
Texas Public Health Journal, 2017, Vol 69, Issue 4, p16
- ISSN
2574-5859
- Publication type
Academic Journal