Pavarin RM, Cocaine consumption and death risk: a follow-up study on 347 cocaine addicts in the metropolitan area of Bologna, in Annali dell'Istituto superiore di sanità 2008, 44(1):91-98

This paper reports the results of the mortality rate in a retrospective cohort of cocaine addicts enrolled in treatment programs at the SerTs (Drug Addiction Services) of Bologna’s metropolitan area from 1989 to December 31, 2004 including 347 subjects, 89% males and 11% females, with an average age of 30.4 years at the time of enrolment (females 29.1 and males 30.6). 15.3% of the subjects had been at least once in jail, 29.4% were also using cannabis, 22.2% alcohol, 25% had a high school degree, 16% were married and 60% were employed. During the follow-up period, 7 deaths have been observed, all in the male population: one caused by AIDS, one by drug overdose, three by vascular diseases, two by injuries and poisonings. The mortality rate was 4.98 per 1000 person-years in both sexes, 5.38 by the males. The survival chance after 12 years from the first contact with the SerTs was of 89% (CI 66.8-96.7). The death risk goes down after two years from the first enrolment and drops remarkably only after two years from the last contact with the drug treatment service. The study confirms the excess of mortality for all causes of the cohort among males in comparison with the general population (SMR 4.75; CI 2.26-9.96). As to the specific death causes, the highest SMR was related to vascular diseases (SMR 14.85; CI 4.79-46.04), suicides (SMR 7.07; CI 1-50.16) and overdoses (SMR 9.95; CI 1.40-70.61). Males show a higher mortality rate, subjects older than 30 years at the first contact with SerTs, with at least one imprisonment, married, with problematic housing situation, unemployed, with concomitant alcohol abuse and low schooling level.