People hooked on to illicit opioids are not only at the risk of dying from a drug overdose but also face increased chances of death from communicable and non-communicable diseases, injuries and suicide.
Suicide related mortality was eight times higher among opioid abusers as against general populations. The rate of unintentional injury was increased sevenfold, while intrapersonal violence, in spite of being quite infrequent, went up by 9 times.
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"People might be surprised that although overdose was the most common cause of death, it's far from the only cause of death that people using opioids outside a prescription experience at excessive rates," Sarah Larney, the lead author of the study told CNN.
Larney who is a senior research fellow at the University of New South Wales' National Drug and Alcohol Research Centre in Australia further said: "Smoking-related illnesses such as cancer and cardiovascular diseases are common. Trauma is another major factor. People are exposed to car accidents, assaults and other causes of injuries at greater than usual rates, and suicide is also much more common than in the broader population."
"It's really clear that although overdose prevention is critical, we also need to look at the range of poor outcomes that people are experiencing, and work to reduce other causes of excess mortality such as suicide, chronic diseases and infectious diseases."
This research was a systematic review and meta-analysis of 124 studies carried out previously, with a few dating back to 2009. Data pertaining to illegal opioid usage was collected and analyzed for 28 different countries and was compared against the general population of similar sex and age group.
The findings showed that men had a higher likelihood of dying from opioid consumption as against women. Liver related deaths were more prevalent in the male population while women were found to be at a higher risk of excess mortality from AIDS. Also, older individuals were more vulnerable than younger ones.
Expressing her concern over AIDS-related mortality, Larney added: "Another surprise is that we didn't see any evidence that deaths due to AIDS are reducing over time in this population. In the other population groups living with HIV, deaths due to AIDS are decreasing due to better treatments, and better access to treatments among marginalized populations".
"People who inject drugs are the only group where we don't see this. People who inject opioids and other drugs who are living with HIV still have very limited access to care, and as a result, are dying of treatable chronic disease."
While being quite exhaustive, the study wasn't devoid of limitations. For instance, there were variations in the manner the cause of death was defined. Also, the study majorly focuses n high-income countries, so it's not clear at this moment that its findings would apply to low and middle-income nations.
As expected, poisoning was the biggest cause of death among illicit opioid users, responsible for 31.5 percent of the deaths. Noncommunicable and communicable diseases accounted for 24.1 and 19.7 percent, respectively. Trauma led to 18.1 percent of the deaths.
As a solution, Larney expressed told CNN: "To me the most important message to take from this study is that we need to think beyond the drug. People using opioids are people first and foremost, and have complex health and social needs."
"Making sure people have access to essential medicines to treat HIV and hepatitis C; encouraging smoking cessation through access to nicotine replacement therapies; and ensuring access to nutritious food and safe shelter would all go towards reducing the death toll in this population."
Presently, around 130 people die in USA alone each day from opioid overdose, which is put into the category of "death of despair", which also includes suicides, liver disease, and drug overdose.
