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Drugnet Europe News from the European Monitoring Centre for Drugs and Drug Addiction — April–June 2007

Estimating the total burden of drug-related mortality

The EMCDDA’s key indicator on drug-related deaths collects information predominantly on drug-induced deaths (also described as poisonings or fatal overdoses). Increasingly, however, the EU Member States are supplementing this information with data from mortality studies of problem-drug-user cohorts that record all causes of death in these groups.

overdose victim

Several causes of death, besides fatal overdose, are found to be considerably higher in problem drug users than among their peers. These include diseases (e.g. HIV/AIDS, liver disease); trauma (e.g. accidents, homicide) and suicide. It was estimated that in the 1990s and early 2000s, 10–20 % of mortality among young adults in several European cities studied could be attributed, directly or indirectly, to opioid use (1).

Two innovative approaches, applied to date in only a few studies, involve estimating the total burden of mortality related to drugs by:

  • applying the information from cohort studies to national estimates of the prevalence of problem drug use (2); or
  • estimating drug-attributable fractions (3) and applying them to general mortality registries.

Using these methods, the EMCDDA launched a project with Czech experts in 2007 to analyse data availability and the methodological possibilities for estimating the overall mortality of problem drug users in the EU. The project, running until the end of the year, will culminate in a report that will provide the basis for possible work on this issue at EU level in the future.

Danica Klempová and Julián Vicente

(1) Bargagli, A. M., Faggiano, F., Amato, L., Salamina, G. et al. (2006), 'VEdeTTE, a longitudinal study on effectiveness of treatments for heroin addiction in Italy: study protocol and characteristics of study population', Substance use misuse 41, pp. 1861–79.
(2) Cruts, G., Buster, M., Vicente, J., Deerenberg, I. and Van Laar, M. (in press), 'Estimating the total mortality among problem drug users', Substance use and misuse 43.
(3) The proportion of deaths due to different causes (e.g. AIDS, accidents) that could be attributed to problem drug use.

Drugnet Europe is the EMCDDA's newsletter launched in September 1996. The newsletter provides regular and succint information on the Centre's projects and activities to a broad readership.

Page last updated: Wednesday, 30 April 2008