The relationship between notification to the Home Office Addicts Index and deaths of notified addicts

Aims: This paer examines (a) the relationship between notifications to the Home Office Addicts Index and deaths of notified addicts, and (b) the survival rates of such addicts. Design and participants: Data came from the Home Office Addicts Index covering (a) notifications of opiate and cocaine addicts seeking treatment in the UK between 1966 and 1996, and (b) deaths of notified addicts between 1967 and 1996. Measurement: Date of first notification; date of death; numbers of notifications in different times. Findings: The proportion of addicts dying compared to the number of new notifications 20 years earlier rose from 2 to 7 in 10 between 1988 and 1993. There is constancy in the relationship between numbers of death and new notifications for up to 10 years before death. The proportion of the cumulative notified population dying between 1985 and 1993 remained consistent at 0.6% or 0.7%. The average length of time between first notification and death increased by six months between 1985–90 and 1991–96. Whilst the absolute number of deaths rose between 1984 and 1993, the proportion of newly notified addicts dying each year fell from 2.1% to 0.5%. Conclusions:An increase in notifications was directly associated with a proportionate increase in addict deaths. One can expect the number of serious-end drug users who die to increase with time, especially given the continuing role played by opiates – chiefly heroin and methadone – and increasingly cocaine in drugrelated deaths. At the same time, one can expect such individuals to survive for longer periods than did addicts in past decades.