Two-thirds of drug users in study dead


ALMOST TWO-THIRDS of a group of intravenous drug-users have died in the 25 years since they enlisted in a unique medical study, research just published has found.

Eighty-two users of intravenous heroin from south inner Dublin were identified by doctors in 1985, before HIV testing was available.

Followed up over a 25-year period, the latest review has found that 51 people in the original cohort had died by 2010, half of them due to HIV disease. Those who died had an average age of 36.

The researchers, led by Dr Fergus O’Kelly of the department of public health and primary care at Trinity College Dublin, said the study group showed high levels of HIV infection (63 per cent), which was the principal cause of death over the follow-up period.

“HIV-related mortality peaked in this study cohort in the early to mid-1990s . . . a reflection of the development of untreated HIV from the early epidemic of the 1980s,” they said.

“The injecting cohort had a mortality rate 11 times that of the non-drug-using cohort [62 per cent compared to 5.5 per cent].”

This reflects international experience where deaths in opiate-users are about 13 times those in a matched group of non-addicts.

One-third of survivors in the study are HIV-positive, are over 45 years of age and attend St James’s University Hospital for treatment. These patients also have a significant number of co-morbid diseases.

When treated early, HIV has become a chronic rather than a fatal disease. Patients take a cocktail of anti-retroviral and other drugs which do not cure the disease but keep it and possible complications under control.

Writing in the current issue of the Irish Journal of Medical Science, the authors conclude that the lifestyle of intravenous drug-users has hazardous consequences resulting in high levels of morbidity and mortality.

“A relatively stable picture of HIV associated with intravenous drug-users is now emerging in Ireland, as is the case throughout most of the EU.

“HIV is a more manageable chronic disease, posing challenges for primary care in its treatment of former and existing intravenous drug-users who are ageing and now have other chronic diseases.”