Increased risk of death for middle aged who dabble in hard drugs
By Liz Lockhart
Young adults who experiment with hard drugs usually stop this when they reach adult roles and responsibilities (all but around 10%). Those who continue using hard drugs such as cocaine, amphetamines and opiates into their 50s are five times more likely to die earlier than those who do not, according to a new study.
The study was conducted by the University of Alabama at Birmingham(UAB) and is published only in the Journal of General Internal Medicine. The lead author of the study is Stefan Kertesz M.D. an associate professor in the UAB Division of Preventive Medicine.
The National Survey on Drug Use and Health suggests that 9.4% of Americans aged between 50 and 59, and 7% of adults aged between 35 and 49 reported the use of a drug other than marijuana at some point in the past year.
Kertesz and colleagues set out to discover if lifelong hard-drug use shortens life in order to better enable primary care doctors to advise patients who use drugs recreationally. ‘While government guidelines have not endorsed screening for drugs in primary care, many doctors are challenged when they discover patients continue to dabble with them. In primary care practice we often hear from stable patients who report using some cocaine, irregularly, perhaps on weekends. It’s an underappreciated but very common situation,’ Kertesz says.
‘The typical question physicians have to ask is ‘If this patient doesn’t have addiction, what advice can I give other than noting that it’s unwise to break the law?’ After all, we are supposed to be doctors, not law enforcement,’ he adds.
Kertesz and his team from other universities studied data from the Coronary Artery Risk Development in Young Adults Study(CARDIA) for their analysis. CARDIA is a long-term research project involving more than 5,000 black and white men and women from Birmingham, Chicago, Minneapolis and Oakland. It is designed to examine the development and determinants of cardiovascular disease and its risk factors. Participants were recruited aged between 18 and 30 and were followed from 1985 to 2006.
The research team concentrated on the reported use of hard drugs by 4,301 of the CARDIA participants. They compared individuals who ceased drug use early to those who continued. They calculated the likelihood of premature death among these groups.
Kertesz says ‘Fourteen percent of the people in the study reported recent hard-drug use at least once and of these, half continued using well into middle age. But most of the drug users in our study were not addicts. They were dabblers who used just a few days a month.’
The researchers found that older hard-drug users were more likely to report being raised in economically challenged circumstances in a family that was abusive, neglectful or unsupportive. They also found that those who were heavy drug users into young adulthood and continued at lower levels into middle age were roughly five times more likely to die than people who did not use drugs.
Kertesz said ‘We can’t assume that drugs caused death as in an overdose. Rather what we found is that middle-age adults who continue to dabble in hard drugs represent a group that is at risk of bad outcomes, which could include death from trauma, heart disease or other causes that are not a direct result of the drug use, at a higher rate than people who stopped using drugs.’
The team’s findings are a reminder of the vulnerability of people who continue to use drugs, furthermore, they often have grown up under economic and psychosocial stress from childhood onwards. They continue to smoke and drink and they remain at elevated risk of premature death, Kertesz added.
‘Based on the data we hope to offer better advice to primary care doctors struggling with the rising tide of drug-taking by adults who have not left behind many of the bad habits they learned in young adulthood,’ he concluded.