Citation

Teesson M, Marel C, Darke S, Ross J, Slade T, Burns L, Lynskey M, Memedovic S, White J, Mills KL. Addiction 2015; 110(6): 986-993.

Affiliation

National Drug and Alcohol Research Centre, University of New South Wales, Australia; NHMRC Centre for Research Excellence in Mental Health and Substances Use, Australia.

Copyright

(Copyright © 2015, John Wiley and Sons)

DOI

10.1111/add.12860

PMID

25619110

Abstract

AIMS: To determine the long-term mortality, remission, criminality and psychiatric comorbidity over 11 years among heroin dependent Australians.

DESIGN: Longitudinal cohort study. SETTING: Sydney, Australia PARTICIPANTS: 615 participants were recruited and completed baseline interviews between 2001-2002. Participants completed follow-up interviews at 3-, 12-, 24- and 36 months post baseline, and again at 11 years post-baseline. 431 (70.1%) of the original 615 participants completed the 11 year follow-up. MEASUREMENTS: Participants were administered the Australian Treatment Outcome Study (ATOS) structured interview, addressing demographics, treatment history, drug use, heroin overdose, criminality, health and mental health at all interviews. Overall, 96.1% of the cohort completed at least one follow-up interview.

FINDINGS: At 11-years 63 participants (10.2%) were deceased. The proportion of participants who reported using heroin in the preceding month decreased significantly from baseline (98.7%) to 36-month follow-up (34.0%; OR 0.01; 95%CI: 0.00, 0.01) with further reductions evident between 36-months and 11-years (24.7%). However, one-in-four continued to use heroin at 11-years, and close to one-half (46.6%) were in current treatment. The reduction in current heroin use was accompanied by reductions in risk-taking, crime, and injection-related health problems, and improvements in general physical and mental health. The relationship with treatment exposure was varied. Major depression was consistently associated with poorer outcome.

CONCLUSIONS: In an 11-year follow-up of patients undergoing treatment for heroin dependence, 10% had died, almost half were still in treatment; the proportion still using heroin fell to a quarter with major depression being a significant predictor of continued use. This article is protected by copyright. All rights reserved.

Language: en