Even Occasional Cocaine, Opioid, or Amphetamine Use Persisting into Middle Age Increases Mortality
This secondary analysis of a prospective cohort study examined the impact of drug use on mortality over 18 years in a randomly selected sample of 4301 healthy adults aged 18–30 years from 4 US cities. Eligible persons completed questionnaires regarding cocaine, amphetamine, and recreational opioid use in 1987/1988 and again during at least 1 subsequent in-person examination through 2006. Trajectory analysis classed participants into 4 groups based on their pattern of drug use: 85.8% reported no use at any examination (nonusers); 7.9% matured out of early infrequent use (early occasional users); 3.7% started with infrequent use that persisted or increased over time (persistent occasional users); and 2.6% started with frequent use that diminished over time (early frequent/later occasional users).
- All-cause mortality was 4.6% over 18 years of follow-up.
- Unadjusted mortality was higher among persistent occasional users (8.1%) and early frequent/later occasional users (6.4%) compared with early occasional users (5%) and nonusers (3.1% [p=0.003]).
- In proportional hazard models adjusted for multiple demographic, behavioral, and health-related factors, risk of death was higher for early frequent/later occasional users (hazard ratio [HR], 4.9) and was borderline significantly higher for persistent occasional users (HR, 3.3; p=0.06) compared with nonusers.