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One-third of the excess death rate in 15–54 year olds in Scotland due to problem drug use

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How does problem drug use contribute to excess death rate in Scotland compared with England?


1033 drug users, aged 15–54 years, starting a new treatment episode and recruited into the Drug Outcomes Research in Scotland study (88% had used heroin in the 3 months prior to recruitment).


33 drug treatment agencies, Scotland. Recruitment from 2001 to 2002.

Prognostic factors:

Problem drug use. The number of deaths in the study population (Scottish problem drug users) was determined and used to calculate a crude death rate per 1000 person years. The standardised mortality ratio (SMR) was calculated by dividing this rate by the rate for the European standard population. The SMR was combined with data on the prevalence of problem drug use in Scotland and England to estimate the total number of deaths in drug users in each country. The SMR for the drug users was also used for England as age and gender breakdown of English drug users was not available. These data were used to calculate how …

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  • Source of funding: Robertson Trust and Scottish Executive, Scotland, UK.


  • Competing interests: None.