Mortality Rates Among Substance Use Disorder Participants in Clinical Trials: Pooled Analysis of 22 NIDA CTN Studies
Most substance use disorders (SUD) treatment trials are too short and small to reliably estimate the incidence of rare events like death. Our aim is to estimate the mortality rate among a SUD treatment-seeking population by pooling participants from multiple trials conducted through the NIDA-sponsored National Drug Abuse Treatment Clinical Trials Network (CTN).
This study is a pooled analysis of mortality among 9,866 participants in 22 SUD CTN treatment trials. Age- and gender-standardized mortality rate(s) (SM rate(s)), and age- and gender-standardized mortality ratio(s) (SM ratio(s)) were calculated among CTN participants relative to the U.S. general population.
The age- and gender-SM rate among CTN participants was 1403 (95% CI: 862-2074) per 100,000 person years (PY) compared to 542 (95% CI: 541-543) per 100,000 PY among the 2005 US population. The age-SM rates of female and male CTN participants were 1141 (95% CI: 465-2080) and 1672 (95% CI: 869-2738) per 100,000 PY compared to 444 (95% CI: 443-446) and 642 (95% CI: 640-643) per 100,000 PY of the female and male US population. The age- and gender-SM ratio of the CTN participants was 4 times that of the US population (SM-ratio= 4.02 (95% CI: 2.97-5.32). The age-SM ratio for female CTN participants was over 5 times (SM-ratio=5.35, 95% CI: 3.31-8.19)) and male CTN participants was over 3 times (SM-ratio=3.39, 95% CI: 2.25-4.90) higher than their gender comparable peers in the US population.
Age and gender-standardized mortality rates and ratios among NIDA CTN SUD treatment-seeking trial participants are higher than the comparable US population. Mortality rates among CTN participants with varied types of substance use are similar to those reported in large US and non-US cohorts of opioid users during or following SUD treatment.