Mortality risk among recent-onset injection drug users in five U.S. cities

David Vlahov, Cunlin Wang, Danielle Ompad, Crystal M. Fuller, Wendy Caceres, Lawrence Ouellet, Peter Kerndt, Don C Des Jarlais, Richard S. Garfein

Research output: Contribution to journalArticlepeer-review


To quantify the risk of death among recent-onset (< 5 years) injection drug users, we enrolled 2089 injection drug users (IDUs) age ≤ 35 years (minimum age = 18 years) between 1997 and 1999. Median age was 24 years, 62.4% were male, 54.5% were non-Hispanic White, mean duration of injecting was 3 years, and 45.4% injected daily within the prior 6 months. Using the National Death Index, we identified 68 deaths over a follow-up period through December 2002 with a mortality rate of 7.10/1000 person years. Using age-, sex-, and race-adjusted data to the census and mortality, we calculated standardized mortality ratios (SMRs) over time. The adjusted SMR (with national data as the reference) for IDUs was 3.66 for 1997, which increased to 9.78 by 1998, decreased slightly to 7.08 by 1999, and continuously declined to 2.54 by 2002. These data confirm considerable excess mortality among recent onset injection drug users compared to non-IDU peers in the general population and indicate need for interventions such as increased quality and accessibility to drug abuse** treatment and overdose prevention to prevent premature death among young IDUs.

Original languageEnglish (US)
Pages (from-to)413-428
Number of pages16
JournalSubstance Use and Misuse
Issue number3-4
StatePublished - Feb 2008


  • HIV infection
  • Injection drug use (IDU)
  • Mortality
  • Overdose
  • Standard mortality ratio
  • Substance use

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health
  • Medicine (miscellaneous)


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