Deaths, HIV infection, abstinence, and other outcomes in a cohort of injecting drug users followed up for 10 years.

Abstract

OBJECTIVE--To trace, follow up, and interview a group of patients known to be injecting drug users in order to establish current drug taking and other features related to drug use over 10 years. DESIGN--Descriptive follow up study of a cohort of injecting drug users established between 1982 and 1985. SETTING--General practice based patient population study initially, with later tracing of subjects throughout the United Kingdom through NHS Central Registries and current general practitioners. SUBJECTS--203 injecting drug users recruited up to December 1985. MAIN OUTCOME MEASURES--Survival, cause of death, abstinence, or continued drug use; HIV status; and demographic variables. RESULTS--Of the 203 injecting drug users recruited into the study, over half were known to be HIV positive and 42 died of various causes (increasingly AIDS). From the start of follow up in 1990, 163 (91%) of the 180 survivors were traced, of whom 116 (71%) were interviewed. Dramatic changes had occurred in drug taking, with a move away from injecting towards oral drug use. A few patients, however, continued to inject. 90 (78%) of those interviewed had been in prison, of whom 37 (41%) had injected drugs while in prison. CONCLUSIONS--The pattern of deaths had changed from being largely due to overdose in the early 1980s to predominantly AIDS related in later years. The reduction in deaths due to overdose may have been connected with but was not always causally related to a new approach by legal, social, and medical services. Drug use continues in a modified form in a large proportion of patients followed up. As a group, drug users require long term support for a multiplicity of problems.