33-Year Study Emphasizes Lethal Consequences of Heroin Addiction

After following a cohort of heroin addicts for more than 33 years, researchers from the UCLA Drug Abuse Research Center found that nearly half of the original group of 581 men first interviewed in 1964 had died by 1997, when they would have been between 50 and 60 years of age. The study also found that about 40 percent of the 242 survivors reported past year heroin use and many reported other illicit drug use.

The study is published in the May 14, 2001, issue of the Archives of General Psychiatry.

"These findings highlight the drastic effects of heroin addiction," says Alan I. Leshner, Ph.D., director, National Institute on Drug Abuse (NIDA). "In addition to risking an early death, this long-term study shows that heroin users often suffer from hepatitis, HIV, sexually transmitted diseases and other health problems, and many have criminal justice histories. The study emphasizes the pervasive public health and public safety consequences of heroin use and the need for comprehensive approaches to deal with it."

The UCLA researchers, led by Dr. Yih-Ing Hser, followed 581 male heroin addicts who had been admitted to the California Civil Addict Program (CAP) during the years 1962 through 1964. CAP was a compulsory drug treatment program for heroin-dependent criminal offenders committed under court order. The average age of participants upon admission to CAP was 25.4 years. More than 60 percent had started using heroin before the age of 20.

The researchers conducted three face-to-face interviews with participants at 10-year intervals: the first set of interviews was conducted in 1974-1975, the second set in 1985-1986 and the third set in 1996-1997.

The men were an average of 57.4 years old in 1996-1997. Of the 242 subjects interviewed at that time, 20.7 percent tested positive for opiates, 66.9 percent reported current tobacco use, 22.1 percent drank alcohol every day, and many reported other illicit drug use in the past year (marijuana, 35.5 percent; cocaine, 19.4 percent; crack, 10.3 percent; and amphetamines, 11.6 percent).

Some other highlights of the 33-year study include:

Deaths: A total of 13.8 percent of the original 581 subjects had died by the time of the first interview; 27.7 percent had died by the second interview; and 48.9 percent had died by the last interview.

Heroin use: At the first interview, 37.8 percent of the surviving sample had opiate-free urine tests; 41 percent were opiate free at the second interview; and 55.8 percent were opiate free at the last interview.

Cause of death: Among the 284 confirmed deaths over the 33-year follow-up period, the most common cause of death (21.6 percent) was drug overdose. The next most common causes of death were chronic liver disease (15.2 percent), cancer (11.7 percent), and cardiovascular diseases (11.7 percent). Fifty-five deaths (19.5 percent) were due to homicide, suicide, or accident. Three subjects died of AIDS.

Criminal justice involvement: Of the final sample, 20.3 percent of participants had been incarcerated during the year prior to the 1996-1997 interview. In addition, 13.7 percent had been engaged in drug dealing and 7.4 percent in property crimes.

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