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This study aimed to quantify all\u2010cause and cause\u2010specific mortality following SUD treatment in Chile compared with the general population and assess variation across key clinical and demographic subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>National\u2010level registry\u2010based retrospective data linkage cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Publicly funded SUD psychosocial treatments offered by the Chilean National Drug Agency, linked with official national mortality records from 2010 to 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>70064 adults aged 18\u201364\u2009years (24% women, median age 35 at treatment entry) were followed after their first treatment episode until death or 31 December 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>\n                      Primary outcome was all\u2010cause mortality. Secondary outcomes were cause\u2010specific mortality by the\n                      <jats:italic>International Classification of Diseases<\/jats:italic>\n                      , 10th revision, underlying and external causes. We estimated age\u2013sex\u2013calendar year directly standardized rates (DSR), and standardized mortality ratios (SMR) compared with the expected rate for the (sub)population. We also stratified rates and ratios by sex (men\/women), attained age (18\u201329, 30\u201344, 45\u201359, 60+), setting (ambulatory\/residential), primary substance (alcohol; illicit: predominantly cocaine paste base, marijuana and cocaine hydrochloride) and treatment compliance (not completed\/completed). Additionally, we estimated rates and SMRs for underlying and external causes of mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Over a median 4.9\u2010year follow\u2010up (353\u2009826 person\u2010years), 2996 deaths occurred [DSR\u2009=\u200910.6, 95% confidence interval (CI) = 8.6\u201313.1]. Overall SMR was 3.65 (95% CI = 3.52\u20133.79). Excess risk was particularly pronounced for women (SMR\u2009=\u20095.57, 95% CI = 5.14\u20136.03), patients admitted due to alcohol use disorder (SMR\u2009=\u20094.59, 95% CI = 4.33\u20134.86), in residential care (SMR\u2009=\u20094.91, 95% CI = 4.45\u20135.42) and treatment noncompletion (SMR\u2009=\u20094.04, 95% CI = 3.85\u20134.24). Cause\u2010specific mortality revealed elevated external\u2010cause excess risk for SUD patients, including intentional self\u2010harm (SMR\u2009=\u20096.67, 95% CI = 6.05\u20137.36), unintentional injuries (SMR\u2009=\u20095.37, 95% CI = 4.79\u20136.02) and assaults (SMR\u2009=\u20094.98, 95% CI = 4.16\u20135.96). Notable excess risk was also observed for non\u2010external mortality causes: digestive system (SMR\u2009=\u20098.20, 95% CI = 7.62\u20138.83), symptoms and signs (SMR\u2009=\u20095.18, 95% CI = 4.29\u20136.26) and respiratory diseases (SMR\u2009=\u20095.18, 95% CI = 4.47\u20135.99) were greater than expected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In Chile, patients with a history of publicly funded substance\u2010use disorder treatment appear to have an all\u2010cause mortality up to 3.7 times higher than the general population, driven predominantly by digestive and respiratory causes, as well as self\u2010harm, unintentional injuries and assaults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.70420","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T09:54:31Z","timestamp":1775814871000},"page":"2060-2070","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Excess mortality following discharge from substance use disorder treatment in Chile"],"prefix":"10.1111","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5166-9121","authenticated-orcid":false,"given":"Andr\u00e9s","family":"Gonz\u00e1lez\u2010Santa Cruz","sequence":"first","affiliation":[{"name":"Doctoral Program in Public Health, Institute of Population Health, Faculty of Medicine Universidad de Chile  Santiago Chile"},{"name":"Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP)  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3016-890X","authenticated-orcid":false,"given":"Alvaro","family":"Castillo\u2010Carniglia","sequence":"additional","affiliation":[{"name":"Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP)  Santiago Chile"},{"name":"Departamento Nacional de Salud P\u00fablica, Facultad de Medicina Universidad San Sebasti\u00e1n  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1606-401X","authenticated-orcid":false,"given":"Jay S.","family":"Kaufman","sequence":"additional","affiliation":[{"name":"Doctoral Program in Public Health, Institute of Population Health, Faculty of Medicine Universidad de Chile  Santiago Chile"},{"name":"Department of Epidemiology, Biostatistics and Occupational Health McGill University  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajp.2023.103677"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.13279"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32279-7"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102985"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-069861"},{"key":"e_1_2_10_7_1","unstructured":"Organization for Economic Co\u2010operation and Development[OECD] World Bank. 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