Abstract

IntroductionThe aim was to analyse whether age at first drug offense predicts premature mortality and morbidity due to substance use and violence among adolescents and young adults.MethodsA prospective longitudinal register‐linkage study based on a total population sample from Finland including individuals born between 1987 and 1992 and aged 15–25 years during follow‐up in 2002–2017 (n = 386 435). Age‐specific rates of deaths and health‐care admissions (morbidity) during a 5‐year follow‐up were calculated from the first drug offense. Cox regression models were used to estimate differences in mortality and morbidity at ages 21–25.ResultsOf all 15‐ to 20‐year‐olds, 1.4% (n = 5540) have had a police contact. The 5‐year mortality rates (per 1000 person‐years) among those with first drug offense at ages 15–16 was 2.92 [95% confidence interval (CI) 1.56–6.18], and 5.26 (CI 4.00–7.07) and 5.05 (CI 4.06–6.38) at ages 17–18, and 19–20, respectively. The rates of morbidity varied between 61.20 (CI 52.43–71.76) and 87.51 (CI 82.11–93.33). Both mortality and morbidity rates were over 10 times higher than among the general population. In models adjusted for family background, first police contact at an early age (15–16) did not increase the risk of mortality at ages 21–25 compared with first police contact at ages 17–18 (hazard ratio 1.55, CI 0.77–3.09) or 19–20 (hazard ratio 1.52, CI 0.78–2.98). The results were similar for morbidity.Discussion and ConclusionsAdolescents with drug‐related police contacts have high risk of mortality and morbidity due to substance use and violence regardless of age of first contact.

Highlights

  • The aim was to analyse whether age at first drug offense predicts premature mortality and morbidity due to substance use and violence among adolescents and young adults

  • Evidence of this relationship is limited and the only empirical research supporting this assumption is a study by Clark and colleagues [6], where they analysed the association between early onset drug use before age 18 and premature mortality based on a longitudinal sample of 870 adolescents with substance use disorders from clinical programs and community sources finding 21 deaths before the age of 25

  • This study investigates the association between early drug use-related police contact and the risk for mortality and morbidity due to substance use and violence by employing Finnish administrative register data including all deaths and health-care admissions of mental and behavioural disorders due to psychoactive substance use, poisoning by drugs, medications, alcohol, intentional self-harm and assaults based on the International Classification of Diseases (ICD-10)

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Summary

Introduction

The aim was to analyse whether age at first drug offense predicts premature mortality and morbidity due to substance use and violence among adolescents and young adults. Adolescent onset drug use has been shown to be associated with increased risk of premature mortality [6] Evidence of this relationship is limited and the only empirical research supporting this assumption is a study by Clark and colleagues [6], where they analysed the association between early onset drug use before age 18 and premature mortality based on a longitudinal sample of 870 adolescents with substance use disorders from clinical programs and community sources finding 21 deaths before the age of 25.

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