@article{ref1,
title="Mortality risk among heroin abusers: clients and non-clients of public treatment centers for drug addiction",
journal="Substance use and misuse",
year="2015",
author="Pavarin, Raimondo Maria",
volume="50",
number="13",
pages="1690-1696",
abstract="In Europe, the prevalence of problematic heroin consumption is declining but, in spite of the constant rise in the number of treated patients, many of them do not turn to a public treatment center (PTC) for their drug addiction. The aim of this study is to study the mortality risk separately for heroin abusers PTC clients and non-PTC clients (i.e. those never treated at a PTC). <br><br>METHODS: Cohort study on 959 subjects resident in the metropolitan area of Bologna who went to a health service (i.e. hospital, emergency unit) or to a PTC following problems due to heroin abuse for the first time between 01/01/2004 and 31/12/2009. Standardized mortality ratios (SMRs) were calculated, and regression analysis using the Poisson method was used. <br><br>RESULTS: Elevated and statistically significant SMRs were found in both genders, irrespective of the contact facility, being higher for PTC clients. Among non-PTC clients 28% of deaths overall were from AIDS or infectious diseases (6% PTC clients), 17% from opiate overdose (6% PTC clients) and 14% from violent causes (6% PTC clients). Multivariate analysis showed a higher mortality risk for patients who used both heroin and cocaine and for concomitant abuse of benzodiazepines. <br><br>CONCLUSIONS: The characteristics of patients never before treated for addiction prompts a reflection on the presence of a hidden group of patients who are hard to reach, who have a high mortality risk and who turn to health care treatment facilities only in the event of an emergency.<p /> <p>Language: en</p>",
language="en",
issn="1082-6084",
doi="10.3109/10826084.2015.1027932",
url="http://dx.doi.org/10.3109/10826084.2015.1027932"
}