Citation

Rönkä S, Karjalainen K, Martikainen P, Makela P. Drug Alcohol Depend. 2017; 181: 37-43.

Affiliation

National Institute for Health and Welfare, PO Box 30, FI-00271 Helsinki, Finland.

Copyright

(Copyright © 2017, Elsevier Publishing)

DOI

10.1016/j.drugalcdep.2017.09.005

PMID

29032023

Abstract

BACKGROUND: We investigated the association between social determinants and a broad selection of drug-related deaths in a general population.

METHODS: We conducted a follow-up of an 11% random sample of working-age Finnish residents for 1996-2007 linked with an oversampling of deaths and population registration data on social characteristics. We defined total drug-related deaths as those from psychoactive substance use disorders and drug-induced poisonings (drug-induced deaths) as well as drug-related accidents, homicides, illnesses, and suicides.

RESULTS: The number of drug-related deaths was three times that of drug-induced deaths. We found the highest hazard ratios (HRs) for total drug-related mortality for long-term unemployment (4.9; 95% confidence interval [CI], 4.3-5.6), short-term unemployment (3.9; 95% CI, 3.5-4.4), and retirement (5.8; 95% CI, 5.1-6.8). The HRs were highest for mortality related to psychoactive substance use disorders and lowest for mortality related to drug-related suicides. The differences were large for both sexes.

CONCLUSIONS: Drug-related mortality was associated with social disadvantage; however, the strength of the association varied by drug-related cause of death. Primary and secondary prevention of drug use should particularly target disadvantaged groups.

Copyright © 2017 Elsevier B.V. All rights reserved.

Language: en

Keywords

Cox regression; Drugs; Mortality; Register-based study; Social determinants