Theme: Epidemiology & Public Health Research Year: 2024
Background: People who inject drugs (PWID) experience high mortality rates. A recent study in Greece found all-cause mortality among PWID to be 16 times higher than that of the general population. This study aimed to investigate, for the first time in Greece, the causes of death among PWID for the period 2012-2020.
Methods: Between 2012 and 2021, three interventions were conducted in Athens and Thessaloniki for PWID, mainly people currently injecting and not enrolled in opioid agonist treatment programs (ARISTOTLE, ARISTOTLE HCV-HIV, and ALEXANDROS programs). Out of 5,363 unique PWID enrolled to these programs, it was possible to assess the vital status for 2,927 of them. Data on the causes of death were available for deaths recorded up to 2020 from the Hellenic Statistical Authority, based on the International Statistical Classification of Diseases and Related Health Problems (ICD-10).
Results: During 2012-2020, 252 deaths were recorded. The median age of death (25th-75th percentile) was 39.5 (35.0-47.5) years, 90.1% were male, and 96.0% were of Greek nationality. The main cause of death was injuries/poisoning and other consequences of external causes (50.2%) [including the overdose of psychoactive substances, mainly opioids (38.6%)], followed by cardiovascular diseases (15.7%), infections (12.9%) [of which 7.6% were HIV/AIDS], respiratory diseases (5.6%), digestive diseases (5.2%), neoplasms (4.8%), and other causes (5.6%).
Conclusion: Opioid overdose is the leading cause of death, while a significant proportion is attributed to cardiovascular disease and HIV infection. Addressing overdose prevention and HIV diagnosis/treatment are critical to reducing mortality in this vulnerable population.
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