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All-cause and cause-specific mortality among people with regular or problematic cocaine use: a systematic review and meta-analysis

Peacock, A ORCID: 0000-0002-5705-2026, Tran, LT, Larney, S, Stockings, E, Santo Jr, T, Jones, H, Santomauro, D and Degenhardt, L 2020 , 'All-cause and cause-specific mortality among people with regular or problematic cocaine use: a systematic review and meta-analysis' , Addiction, vol. 116, no. 4 , pp. 725-742 , doi: 10.1111/add.15239.

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Abstract

Aims: To estimate pooled all-cause and cause-specific mortality risk for people with regular or problematic cocaine use.Methods: Systematic review and meta-analysis of prospective or retrospective cohort studies or clinical trials (n ≥30) of people with regular or problematic cocaine use with data on all-cause or cause-specific mortality. Of 2808 papers, 28 were eligible and reported on 21 cohorts, with a total 170 019 individuals. Cohorts identified based on acute care for drug poisoning or other severe health presentation were excluded. Title/abstract screening was conducted by one reviewer; a second reviewer independently checked 10% of excluded studies. Two reviewers conducted full-text screening. Data were extracted by one reviewer and checked by a second. A customized review-specific study reporting quality/risk of bias tool was used. Data on crude mortality rates (CMR) and standardized mortality ratios were extracted for both all-cause and cause-specific mortality. Standardized mortality ratios were imputed where not provided by the author using extracted data and information from the Global Burden of Disease Study 2017. Data were pooled using a random-effects model.Results: The pooled all-cause crude mortality rate was 1.24 per 100 person-years [95% confidence interval (CI) = 0.86, 1.78; n = 16 cohorts], but with considerable heterogeneity (I2 = 98.8%). The pooled all-cause standardized mortality ratio (SMR) was 6.13 (95% CI = 4.15, 9.05; n = 16 cohorts). Suicide (SMR = 6.26, 95% CI = 2.84, 13.80), accidental injury (SMR = 6.36, 95% CI = 4.18, 9.68), homicide (SMR = 9.38, 95% CI 3.45-25.48) and AIDS-related mortality (SMR = 23.12, 95% CI = 11.30, 47.31) were all elevated compared with age and sex peers in the general population.Conclusions: There are elevated rates of mortality among people with regular or problematic cocaine use for traumatic deaths and deaths attributable to infectious disease.

Item Type: Article
Authors/Creators:Peacock, A and Tran, LT and Larney, S and Stockings, E and Santo Jr, T and Jones, H and Santomauro, D and Degenhardt, L
Keywords: cardiovascular, cocaine, homicide, infectious disease, injury, mortality, suicide
Journal or Publication Title: Addiction
Publisher: Blackwell Publishing Ltd
ISSN: 0965-2140
DOI / ID Number: 10.1111/add.15239
Copyright Information:

Copyright 2020 Society for the Study of Addiction

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