Drug Use Severity, Mortality, and Cause of Death in Primary Care Patients with Substance Use Disorders

Abstract

This article examines the association between drug use severity and mortality in primary care patients with substance use disorders. In 848 individuals with known vital status, severity was low in 32%, intermediate in 38%, or substantial/severe in 30%. Two-year survival was 93% in the low group, 96% in the medium group, and 92% in the high group (p = .19). The age-adjusted risk of death for the high-severity group was twice that of the medium-risk group (hazard ratio = 2.00, 95% confidence interval = [1.02, 3.93]). Individuals in the high group were more likely to die from accidents than those in the low- or medium-severity groups (50% vs. 20%, p = .021). Compared with low- and medium-severity groups, age at death was 5 years younger in the high-severity group (52 ± 9 vs. 57 ± 6, p = .017). Premature death due to accidental causes in persons with substance use disorders is a persistent yet complex problem.