{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T17:05:53Z","timestamp":1770483953760,"version":"3.49.0"},"reference-count":33,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2011,10,17]],"date-time":"2011-10-17T00:00:00Z","timestamp":1318809600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2011,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p><jats:bold>Aims\u2003<\/jats:bold> Hepatitis C (HCV) infection is highly prevalent among injection drug users (IDUs) and likely to cause significant mortality over time, but little research attention has focused upon the magnitude of this risk, particularly among ageing users. This study examined trends over time in mortality attributed to liver disease, and in particular contrasting this with other more commonly studied causes of death [acquired immune deficiency syndrome (AIDS), suicide and overdose] among an ageing cohort of heroin\u2010dependent people in Australia.<\/jats:p><jats:p><jats:bold>Design\u2003<\/jats:bold> Data linkage study of methadone treatment entrants with the National Deaths Index.<\/jats:p><jats:p><jats:bold>Setting\u2003<\/jats:bold> A cohort entering methadone treatment for heroin dependence in New South Wales, Australia, 1980\u201385.<\/jats:p><jats:p><jats:bold>Participants\u2003<\/jats:bold> A total of 2489 people entering methadone treatment for heroin dependence and 54\u2003847 person\u2010years (PY) of follow\u2010up.<\/jats:p><jats:p><jats:bold>Measurements\u2003<\/jats:bold> Linkage of data on all methadone entrants between 1980 and 1985 with data from the Australian National Deaths Index, linked using probabilistic record linkage software.<\/jats:p><jats:p><jats:bold>Findings\u2003<\/jats:bold> There were 8.2 deaths per 1000 PY [95% confidence interval (CI) 7.5\u20139.0], with standardized mortality ratios (SMRs) of 4.6 (95% CI 4.2\u20135.0). Almost one in five (17%) of deaths were from underlying liver\u2010related causes, most commonly viral hepatitis. The overall mortality rate for any liver cause was 1.4 deaths per 1000 PY (95% CI 1.1\u20131.7), 17 times higher than to the general population (95% CI 13.4\u201321.3), with relative elevations more marked for females (SMR 27.9; 95% CI 17.7\u201341.9) than males (SMR 14.5; 95% CI 10.8\u201319.0). Liver mortality increased over time, becoming the most common cause of death by the end of follow\u2010up.<\/jats:p><jats:p><jats:bold>Conclusions\u2003<\/jats:bold> Liver disease has become the most common cause of mortality among ageing opioid\u2010dependent people in an ageing Australian cohort. There is an imperative to reduce the long\u2010term risks of HCV and other risks to the liver, including alcohol consumption, which are typically not the major clinical focus for this group.<\/jats:p>","DOI":"10.1111\/j.1360-0443.2011.03575.x","type":"journal-article","created":{"date-parts":[[2011,7,12]],"date-time":"2011-07-12T21:06:10Z","timestamp":1310504770000},"page":"2186-2192","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["The increasing mortality burden of liver disease among opioid\u2010dependent people: cohort study"],"prefix":"10.1111","volume":"106","author":[{"given":"Amy","family":"Gibson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah","family":"Randall","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louisa","family":"Degenhardt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2011,10,17]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2010.03140.x"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511543692"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61311-2"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0376-8716(97)00117-8"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2007.01.016"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61097-0"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyg101"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2005.03882.x"},{"key":"e_1_2_7_10_2","volume-title":"Hepatitis C Virus Projections Working Group: Estimates and Projections of the Hepatitis C Virus Epidemic in Australia 2006","author":"Ministerial Advisory Committee on AIDS Sexual Health and Hepatitis: Hepatitis C Sub\u2010Committee","year":"2006"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.317.7156.424"},{"key":"e_1_2_7_12_2","first-page":"21","volume-title":"Hepatitis C and Injecting Drug User: Impact, Costs and Policy Options","author":"Limberg W.","year":"2004"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1746.2002.02730.x"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_2_7_15_2","volume-title":"2005 Causes of Death, Australia","author":"Australian Bureau of Statistics","year":"2007"},{"key":"e_1_2_7_16_2","volume-title":"Information Paper: ABS Causes of Death Statistics: Concepts, Sources and Methods","author":"Australian Bureau of Statistics","year":"2006"},{"key":"e_1_2_7_17_2","volume-title":"The Health of the People of New South Wales\u2014Report of the Chief Health Officer","author":"Population Health Division","year":"2006"},{"key":"e_1_2_7_18_2","volume-title":"Drug Induced Deaths, Australia, 1991\u20132001","author":"Australian Bureau of Statistics","year":"2003"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69374-4"},{"key":"e_1_2_7_20_2","volume-title":"Mortality among People Who Use Illicit Drugs: A Toolkit for Classifying Major Causes of Death","author":"Randall D.","year":"2009"},{"key":"e_1_2_7_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2009.05.021"},{"key":"e_1_2_7_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2008.03.006"},{"key":"e_1_2_7_23_2","unstructured":"DegenhardtL. 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