TY - JOUR PY - 2021// TI - Causes of death among U.S. Veterans with a prior nonfatal opioid overdose JO - Drug and alcohol dependence A1 - Bossarte, Robert M. A1 - Brumage, Michael A1 - Lilly, Christa A1 - Karras, Elizabeth A1 - Warfield, Sara SP - e108484 EP - e108484 VL - 219 IS - N2 - BACKGROUND: For over a decade, there has been a surge in opioid-related morbidity and mortality among Veterans. To better understand the impact of the growing epidemic, it is important to identify the cause-specific mortality rates among Veterans with a prior nonfatal opioid overdose.

METHODS: We followed 8370 Veterans who received medical care for a nonfatal opioid overdose between 2011 through 2015.Mortality records were linked to clinical records from the Veterans Health Administration (VHA). We compared the mortality rates among those with a nonfatal opioid overdose to a 5 % stratified random sample of patients accessing services during the same time period. SMRs were calculated using age-adjusted cause-specific mortality rates for the l U.S. population obtained from the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER).

RESULTS: The crude mortality for Veterans with a history of a nonfatal overdose was 370.6 per 10,000 person years. Those with a prior nonfatal overdose had a higher risk of substance-related mortality (aHR [adjusted Hazard Ratio] 5.0), including a higher risk of death from drugs (aHR 6.9) and alcohol (aHR 2.7). Similarly, cause-specific mortalities assessed between Veterans and the U.S. population, SMRs were also highest for deaths associated with substances (114.0).

CONCLUSION: Veterans with a prior nonfatal overdose experienced substantially higher mortality rates compared to other Veterans or the general U.S. POPULATION: Causes of death related to substance use and mental health were significantly higher than other causes of death, highlighting the importance of integrated treatment and substance use services.

Language: en

LA - en SN - 0376-8716 UR - http://dx.doi.org/10.1016/j.drugalcdep.2020.108484 ID - ref1 ER -