Mortality and morbidity between injecting drug users in Amsterdam (n=624) and Baltimore (n=2,185) are compared to generate a hypothesis about the role of different health care systems and drug user policies (universal care and harm reduction versus episodic care and criminalization, respectively).
Overdose/suicide mortality was twofold higher in Amsterdam ; no sufficient explanation was found.
Other independent « risk factors » for overdose/suicide mortality were recent injecting, polydrug use, and HIV-seropositivity (especially with CD4 count<200/mm3).
High dose methadone maintenance was associated with lower mortality.
Incidence of hospitalizations and emergency room visits was substantially lower in Amsterdam, suggesting that higher accessibility to primary care in Amsterdam lowers (inpatient) hospital visits and presumably societal costs.
Mots-clés Pascal : Toxicomanie, Overdose, SIDA, Virose, Infection, Mortalité, Etude comparative, Maryland, Etats Unis, Amérique du Nord, Amérique, Pays Bas, Europe, Système santé, Santé mentale, Immunopathologie, Immunodéficit
Mots-clés Pascal anglais : Drug addiction, Overdose, AIDS, Viral disease, Infection, Mortality, Comparative study, Maryland, United States, North America, America, Netherlands, Europe, Health system, Mental health, Immunopathology, Immune deficiency
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0276439
Code Inist : 002B18H05B. Création : 16/11/1999.