Reducir la mortalidad relacionada con las drogas en Europa parece una cuestión de salud pública irresoluble Reducing drug related mortality in Europe - a seemingly intractable public health issue

Autores/as

  • Isabelle Giraudon European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). Lisbon, Portugal. Enviar correspondencia a: Isabelle Giraudon. Health consequences. Prevalence, consequences and data management unit. EMCDDA, Cais do Sodré, 1249-289 Lisbon, Portugal. Tel. (351) 211 21 03 39 - Fax (351) 213 58 44 41.
  • Julian Vicente European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). Lisbon, Portugal.
  • João Matias European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). Lisbon, Portugal.
  • Jane Mounteney European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). Lisbon, Portugal.
  • Paul Griffiths European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). Lisbon, Portugal.

DOI:

https://doi.org/10.20882/adicciones.111

Palabras clave:

mortalidad, sobredosis, VIH, usuarios de drogas, Europa mortality, overdose, HIV, drug users, Europe

Resumen

En base al análisis de los datos de más de 30 estudios de cohortes, se puede estimar que cada año mueren en Europa entre 10.000 y 20.000 usuarios de opiáceos. Generalmente las tasas de mortalidad anual se sitúan entre 10-20/1000, representando un exceso de mortalidad 10 a 20 veces superior al esperado para el grupo de edad. La mayoría de las muertes suceden entre hombres de alrededor de 35 años. Se pueden identificar cuatro grandes grupos de causas de muerte: sobredosis, enfermedades, suicidio y traumas. Mientras que la mortalidad relacionada con el VIH esta en disminución, otras causas de muerte han mostrado pocos signos de descenso en los últimos años. Particularmente preocupantes son las sobredosis, que representan 6.300 a 8.400 muertes cada año. El hecho de que las muertes no hayan disminuido es sorprendente, dada la expansión del tratamiento y otros servicios. Varios factores interrelacionados podrían ayudar a explicar este problema irresoluble, como son una creciente vulnerabilidad de una cohorte de usuarios que envejecen, el uso de alcohol y otras drogas, una salud altamente deteriorada, conductas de riesgo, la co-morbilidad, y la exclusión social y marginalización. Reducir la morbilidad general entre los usuarios de heroína continua siendo un tema clave para los servicios europeos de salud pública. Para conseguirlo es necesario profundizar en la comprensión y la actuación sobre los factores asociados, directa o indirectamente, a la mortalidad por el uso de drogas.
Drawing on an analysis of data from over 30 cohort studies, it can be estimated that between 10.000 and 20.000 opioid users die each year in Europe. Typically, annual mortality rates are between 10–20/1000, representing an excess mortality 10 to 20 times greater than expected. Most deaths occur among males in their mid-thirties. Four broad categories of cause of death can be identified: overdoses, diseases, suicide and trauma. While the long term trend in HIV related mortality among drug users is downwards, other causes of mortality have shown little sign of decreasing in recent years. Of particular concern are overdoses which account for 6300 to 8400 deaths reported annually. The fact that deaths have not decreased is surprising given the scaling up of treatment and other services. Opioid substitution treatment in particular is known to be protective and the numbers of those in substitution treatment in Europe has increased dramatically. A number of interrelated factors may help explain this intractable problem. These include: the possibility of an aging cohort becoming more vulnerable; the use of alcohol and other drugs; high levels of ill-health, risk behaviour, and co-morbidity; and social exclusion and marginalisation. Reducing overall morbidity among heroin users remains a key issue for Europe’s public health services. More efforts are required to better understand and target both the direct and indirect factors associated with mortality among problem drugs users, if this major health cost associated with drug consumption is to be reduced.

Biografía del autor/a

Isabelle Giraudon, European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). Lisbon, Portugal. Enviar correspondencia a: Isabelle Giraudon. Health consequences. Prevalence, consequences and data management unit. EMCDDA, Cais do Sodré, 1249-289 Lisbon, Portugal. Tel. (351) 211 21 03 39 - Fax (351) 213 58 44 41.

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Publicado

2012-03-01

Número

Vol. 24 Núm. 1 (2012)

Sección

Originales