Death Risk for New Injection Drug Users is Substantially Higher Than Among Their Peers, According to New Academy Research

NEW YORK CITY, Aug. 9 ??? Youths and young adults who have recently begun injecting drugs like heroin and cocaine face a death risk at least three times higher than their peers, according to new research led by The New York Academy of Medicine. The study appears in the latest issue of the international peer-reviewed journal Addiction.

While it is obvious that drug use is dangerous, little information has been available until now about the extent of death risk faced by new injection drug users (IDUs), defined as those who have been injecting drugs for two years or less. Most past research examining mortality among IDUs has focused on the risk among long-term users who have been injecting drugs for about 10 years.

This study is one of the first to clarify that risk of death rises significantly soon after people begin injecting, said principal investigator David Vlahov, Ph.D., Director of the Academy Center for Urban Epidemiologic Studies. New users are not spared from early risk, as might be assumed.

???There is no window of safety,??? said Vlahov, an Adjunct Professor of Epidemiology in the Johns Hopkins Bloomberg School of Public Health in Baltimore. ???When adolescents and young adults start to inject, they may think that death risk applies only to older, longer-term, ???broken down??? drug users. But they face dangerous consequences from the start.???

Vlahov and colleagues at Johns Hopkins recruited 256 new injection drug users in Baltimore through street outreach in 1988-89 and followed them for 12 years. Study participants had a median age of 30 at the start of the study, and most were African-American men. After only three years of injecting, IDUs faced a death risk three times higher than what would be expected among the general population of their peers in the same age, gender and race groups. After a decade of injecting, IDUs faced a death risk eight times higher than expected among their peers. Causes of death included AIDS, overdose, heart disease, firearms and medical complications of drug use.

The fact that mortality risk rises very soon after initiating injection is consistent with data showing that blood-borne infections and risky behaviors also rapidly increase among new IDUs. Health leaders should use this information to better plan for acute and chronic care needs of populations containing many IDUs, the authors conclude. Substance abuse prevention and rehabilitation efforts also need to be increased to prevent premature deaths. Previous research has shown that users of inhaled drugs like cocaine or crack are most likely to start injecting, so it is particularly important to reach out to heavily drug-using communities to prevent transition into injection. It is also essential that new IDUs are referred to drug treatment programs as soon as possible.

Addiction is a monthly journal published by the Society for the Study of Addiction, founded in 1884 and available online at www.addictionjournal.org. The New York Academy of Medicine is a non-profit institution founded in 1847 that is dedicated to enhancing the health of the public through research, education and advocacy, with a particular focus on urban populations, especially the disadvantaged. Visit the Academy online at www.nyam.org.

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Posted on August 9, 2004

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