Table 2. Findings From Observational Studies on the Pooled All-Cause and Cause-Specific Crude Mortality Rates, and Mortality Rate Ratios Among People With Opioid Dependence According to Time Spent During and Out of OAT.
| Variable | References | No. of cohortsa | No. of people | CMR with treatment | CMR without treatment | Rate ratio with OAT/without OAT | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PY | Deaths | Pooled CMR per 1000 PY (95% CI) | I2, % | PY | Deaths | Pooled CMR per 1000 PY (95% CI) | I2, % | Rate ratio (95% CI) | I2, % | ||||
| All-cause | 34-36, 38, 39, 41-45, 48-50, 52-59, 61-69 | 30 | 562 714 | 869 497 | 7438 | 11.00 (9.20-13.16) | 97.8 | 1 004 979 | 16 349 | 23.97 (19.92-28.83) | 99.1 | 0.47 (0.42-0.53) | 88.6 |
| All injury and poisoning | 36, 43-45, 49, 50, 52, 54, 55, 57-59, 61, 63, 65, 69, 70 | 17 | 179 184 | 563 194 | 2014 | 4.73 (3.80-5.90) | 93.9 | 607 523 | 5677 | 15.31 (11.70-20.03) | 98.6 | 0.34 (0.27-0.42) | 90.2 |
| Drug-induced deaths | 34, 36-40, 42-45, 50, 51, 53-55, 57-59, 63, 65, 67, 69, 70 | 22 | 364 971 | 908 947 | 2351 | 3.03 (2.52-3.63) | 92.8 | 808 982 | 5412 | 7.90 (6.07-10.28) | 98.7 | 0.41 (0.33-0.52) | 92.0 |
| Unintentional drug-induced deaths | 44, 45, 50, 54, 55, 57-59, 63, 69, 70 | 11 | 166 044 | 509 209 | 1026 | 2.14 (1.78-2.56) | 78.2 | 577 366 | 3674 | 7.32 (4.89-10.94) | 99.1 | 0.35 (0.27-0.46) | 89.3 |
| Unintentional opioid deaths | 44, 45, 50, 54, 55, 57-59, 63, 65, 68-70 | 13 | 185 166 | 511 428 | 772 | 1.96 (1.32-2.91) | 95.2 | 590 416 | 3203 | 7.14 (4.55-11.20) | 99.2 | 0.31 (0.23-0.43) | 88.1 |
| Suicide | 36, 43-45, 50, 53-55, 57-59, 63, 69, 70 | 14 | 175 032 | 542 285 | 293 | 0.79 (0.53-1.17) | 86.1 | 598 393 | 723 | 1.36 (1.03-1.80) | 85.2 | 0.48 (0.37-0.61) | 37.0 |
| Violence | 44, 45, 50, 53-55, 57-59, 63, 65, 69, 70 | 13 | 167 885 | 493 943 | 89 | 0.30 (0.10-0.86) | 95.1 | 528 904 | 150 | 0.58 (0.22-1.55) | 96.4 | 0.72 (0.39-1.33) | 66.3 |
| Motor vehicle and transport injuries | 44, 45, 50, 54, 55, 57-59, 63, 70 | 10 | 110 697 | 306 359 | 115 | 0.63 (0.27-1.48) | 91.1 | 385 455 | 133 | 0.39 (0.24-1.97) | 94.7 | 0.90 (0.56-1.45) | 31.1 |
| Falls, fires, burns, drownings | 44, 45, 50, 54, 55, 57-59, 63, 70 | 10 | 110 697 | 301 278 | 26 | 0.16 (0.07-0.39) | 68.9 | 372 786 | 37 | 0.17 (0.08-0.37) | 75.4 | 0.88 (0.52-1.48) | 0.0 |
| All liver-related | 44, 45, 49, 50, 53-55, 57-59, 61, 63, 69, 70 | 14 | 169 002 | 519 613 | 597 | 1.19 (0.80-1.77) | 91.3 | 589 295 | 702 | 1.16 (0.78-1.72) | 94.2 | 0.89 (0.67-1.19) | 57.7 |
| Viral hepatitis | 43-45, 49, 50, 54, 55, 57-59, 61, 63, 69, 70 | 14 | 169 553 | 521 162 | 340 | 0.75 (0.44-1.27) | 93.2 | 583 020 | 262 | 0.45 (0.29-0.71) | 87.8 | 1.35 (1.15-1.60) | 0.0 |
| All alcohol-related | 43-45, 49, 50, 54, 55, 57-59, 61, 63, 65, 69, 70 | 15 | 171 097 | 525 967 | 174 | 0.34 (0.13-0.87) | 96.4 | 579 300 | 296 | 0.67 (0.34-1.30) | 95.9 | 0.59 (0.49-0.72) | 0.0 |
| Cancer | 43-45, 49, 50, 54, 55, 57-59, 61, 63, 69, 70 | 14 | 169 553 | 524 023 | 522 | 0.97 (0.57-1.66) | 95.1 | 591 466 | 958 | 0.99 (0.56-1.74) | 97.5 | 0.72 (0.54-0.98) | 63.2 |
| Cardiovascular disease | 43-45, 49, 50, 54, 55, 57-59, 61, 63, 69, 70 | 14 | 169 553 | 524 023 | 429 | 0.82 (0.55-1.22) | 88.8 | 592 224 | 677 | 1.14 (0.74-1.76) | 93.9 | 0.69 (0.60-0.79) | 4.1 |
| Chronic respiratory disease | 44, 45, 49, 50, 54, 55, 57-59, 61, 63, 69, 70 | 13 | 168 705 | 497 738 | 176 | 0.35 (0.16-0.74) | 92.3 | 581 398 | 199 | 0.28 (0.14-0.58) | 92.1 | 0.95 (0.78-1.17) | 0.0 |
| Digestive disorders | 44, 45, 49, 50, 54, 55, 57-59, 61, 63, 69, 70 | 13 | 168 705 | 502 819 | 74 | 0.20 (0.11-0.34) | 72.1 | 551 954 | 106 | 0.30 (0.18-0.52) | 84.7 | 0.72 (0.41-1.26) | 50.0 |
| HIV related | 43-45, 49, 50, 53-55, 57-59, 61, 63, 69, 70 | 15 | 169 850 | 493 493 | 383 | 1.51 (0.38-6.02) | 99.3 | 565 738 | 307 | 1.14 (0.38-3.40) | 98.5 | 1.14 (0.75-1.74) | 72.9 |
| Influenza and pneumonia | 43-45, 49, 50, 53-55, 57-59, 61, 63, 69, 70 | 15 | 169 850 | 512 728 | 101 | 0.20 (0.09-0.44) | 87.9 | 572 650 | 115 | 0.29 (0.17-0.62) | 88.1 | 0.92 (0.70-1.20) | 0.0 |
| Injection-related injuries and diseases | 44, 45, 49, 50, 54, 55, 57-59, 61, 63, 69, 70 | 13 | 168 705 | 500 359 | 144 | 0.36 (0.19-0.69) | 87.9 | 585 263 | 178 | 0.41 (0.20-0.84) | 93.0 | 0.90 (0.72-1.12) | 0.0 |
| Endocarditis | 44, 45, 49, 50, 54, 55, 57-59, 61, 63, 69, 70 | 13 | 168 705 | 487 813 | 74 | 0.23 (0.10-0.52) | 88.9 | 565 575 | 102 | 0.25 (0.09-0.69) | 94.9 | 0.80 (0.59-1.08) | 0.0 |
| Bacteremia or sepsis | 44, 45, 49, 50, 53-55, 57-59, 61, 63, 69, 70 | 14 | 169 002 | 499 274 | 43 | 0.09 (0.05-0.18) | 64.1 | 558 128 | 51 | 0.17 (0.08-0.36) | 81.8 | 0.93 (0.62-1.40) | 0.0 |
| Skin or soft-tissue infections | 44, 45, 49, 50, 54, 55, 57-59, 61, 63, 69, 70 | 13 | 168 705 | 486 728 | 23 | 0.06 (0.02-0.17) | 80.5 | 546 515 | 23 | 0.08 (0.02-0.27) | 87.0 | 1.17 (0.65-2.09) | 0.0 |
Abbreviations: CMR, crude mortality rates; OAT, opioid agonist treatment; PY, person-years of follow-up.