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. 2020 Mar 31;368:m772. doi: 10.1136/bmj.m772

Table 2.

All cause and drug related mortality among recipients of opioid agonist treatment (OAT) according to key patient strata: British Columbia, Canada, 1 January 1996 to 30 September 2018

Characteristic Person years of follow-up All cause Drug related*
No of deaths CMR† (95% CI) SMR (95% CI) No of deaths CMR† (95% CI)
Overall 400 817 7030 17.5 (17.1 to 18.0) 7.2 (7.1 to 7.4) 2184 5.4 (5.2 to 5.7)
Female sex 142 864 2274 15.9 (15.3 to 16.6) 9.9 (9.5 to 10.3) 668 4.7 (4.3 to 5.0)
Male sex 257 906 4756 18.4 (17.9 to 19.0) 6.4 (6.2 to 6.6) 1516 5.9 (5.6 to 6.2)
OAT status:
 On OAT 202 315 2197 10.9 (10.4 to 11.3) 4.6 (4.4 to 4.8) 429 2.1 (1.9 to 2.3)
  Buprenorphine/naloxone 13 190 87 6.6 (5.3 to 8.1) 2.9 (2.3 to 3.6) 26 2.0 (1.3 to 2.9)
  Methadone 188 113 2085 11.1 (10.6 to 11.6) 4.7 (4.5 to 4.9) 398 2.1 (1.9 to 2.3)
 Off OAT 198 502 4833 24.3 (23.7 to 25.0) 9.7 (9.5 to 10.0) 1755 8.8 (8.4 to 9.3)
  Buprenorphine/naloxone 23 712 570 24.0 (22.1 to 26.1) 11.3 (10.4 to 12.2) 269 11.3 (10.0 to 12.8)
  Methadone 174 431 4237 24.3 (23.6 to 25.0) 9.5 (9.3 to 9.8) 1482 8.5 (8.1 to 8.9)
Age group:
 <20 years x x 5.3 (3.0 to 8.7) 15.0 (8.6 to 24.4) x 3.0 (1.4 to 5.7)
 20-24 years 22 579 187 8.3 (7.1 to 9.6) 13.1 (11.3 to 15.1) 106 4.7 (3.8 to 5.7)
 25-34 years 107 219 986 9.2 (8.6 to 9.8) 10.8 (10.2 to 11.5) 495 4.6 (4.2 to 5.0)
 35-44 years 122 003 1510 12.4 (11.8 to 13.0) 9.5 (9.0 to 10.0) 646 5.3 (4.9 to 5.7)
 45-54 years 95 300 1981 20.8 (19.9 to 21.7) 7.5 (7.2 to 7.9) 620 6.5 (6.0 to 7.0)
 >54 years 50 670 2350 46.4 (44.5 to 48.3) 5.3 (5.1 to 5.5) 308 6.1 (5.4 to 6.8)
Alcohol use disorder‡:
 No 293 181 4175 14.2 (13.8 to 14.7) 5.8 (5.7 to 6.0) 1293 4.4 (4.2 to 4.7)
 Yes 107 636 2855 26.5 (25.6 to 27.5) 11.1 (10.7 to 11.5) 891 8.3 (7.7 to 8.8)
Substance use disorder§:
 No 68 692 889 12.9 (12.1 to 13.8) 3.8 (3.6 to 4.1) 48 0.7 (0.5 to 0.9)
 Yes 332 125 6141 18.5 (18.0 to 19.0) 8.3 (8.1 to 8.5) 2136 6.4 (6.2 to 6.7)
Mental ill health¶:
 No 75 448 1240 16.4 (15.5 to 17.4) 6.5 (6.2 to 6.9) 332 4.4 (3.9 to 4.9)
 Yes 325 369 5790 17.8 (17.3 to 18.3) 7.4 (7.2 to 7.6) 1852 5.7 (5.4 to 6.0)
Chronic pain**:
 No 122 329 1796 14.7 (14.0 to 15.4) 7.6 (7.2 to 7.9) 597 4.9 (4.5 to 5.3)
 Yes 278 489 5234 18.8 (18.3 to 19.3) 7.1 (6.9 to 7.3) 1587 5.7 (5.4 to 6.0)
Hepatitis C virus:
 Unknown/no†† 366 602 5098 13.9 (13.5 to 14.3) 6.0 (5.8 to 6.1) 1824 5.0 (4.7 to 5.2)
 Yes 34 215 1932 56.5 (54.0 to 59.0) 16.5 (15.8 to 17.2) 360 10.5 (9.5 to 11.7)
HIV:
 Unknown/no†† 378 852 6043 16.0 (15.6 to 16.4) 6.5 (6.4 to 6.7) 1933 5.1 (4.9 to 5.3)
 Yes 21 966 987 44.9 (42.2 to 47.8) 20.7 (19.4 to 22.0) 251 11.4 (10.1 to 12.9)

CMR=crude mortality rate; SMR: standardised mortality ratio; x=suppressed due to cell size <10.

*

Drug misuse or accidental drug poisoning (see appendix table A4).

Per 1000 person years.

See appendix table A5 for ICD-9/ICD-10 codes used to identify concurrent chronic conditions.

§

Any indication of non-opioid and non-alcohol drug use, poisoning (accidental or intentional), or substance use counselling or rehabilitation.

Any indication of depression, anxiety, psychotic illness, personality disorders, attention-deficit/hyperactivity disorders, or bipolar disorders.

**

Non-cancer chronic pain.

††

Data linkage to provincial HIV and hepatitis C virus testing databases not available.