Mortality among injecting drugs users - a follow-up study of injecting drug user cohorts.

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This study will follow-up injecting drug users that participated in research in the 1990s and 2000s to examine mortality rates in these groups over time. Identifying information from these studies will be cross-referenced with National Death Index data to determine participants that died and the dates of their death. This study will be the first in Australia to determine mortality rates over time in a defined cohort of injecting drug users outside drug treatment settings. Studying a defined group overcomes some of the problems associated with mortality rate estimates based simply on the number of injecting drug-related deaths. Although the number of deaths can be found, the number of people at risk of injecting drug-related death is unclear because of the hidden nature of drug use and the dynamic characteristics of drug use and drug markets. The examination of mortality trends among injecting drug users over time can provide insights regarding changes in drug use patterns and markets. For example, this study will examine changes in injecting drug use mortality across periods of high heroin availability in the late '90s and periods of interrupted heroin supply - the heroin 'drought' - from 2000 onwards. In addition, factors related to injecting drug-related mortality can be explored by comparing the characteristics of injecting drug users that died and those that survived, such as drug use and drug treatment histories, co-morbidities such as mental illness and socio-demographic backgrounds. This information can inform overdose prevention and harm reduction strategies by identifying individuals most at risk of injecting drug-related mortality. This study will also draw attention to the significant public health burden of injecting drug use. In addition, by comparing the results from this study with other similar studies from overseas, we can more reliably compare mortality among groups of Australian injecting drug users with their peers in other countries.