Journal of Behavioral Medicine

, Volume 27, Issue 6, pp 607–622

Health Conditions Among Aging Narcotics Addicts: Medical Examination Results

  • Yih-Ing Hser
  • Lillian Gelberg
  • Valerie Hoffman
  • Christine E. Grella
  • William McCarthy
  • M. Douglas Anglin
Article

Abstract

The study examined health conditions among an aging cohort of male narcotics addicts. This prospective cohort study (1964–1998) included interviews and medical testing for 108 surviving subjects who had been admitted to the California Civil Addict Program during the years 1962 through 1964. Medical testing results were: 51.9% had high blood pressure, 22.4% showed hyperlipidemia, 13.3% had elevated levels of blood glucose, 33.6% had abnormal pulmonary function, half of the sample had abnormal liver function, and 94.2% tested positive for hepatitis C, 85.6% for hepatitis B, 3.8% for syphilis, and 27.3% for TB. The study empirically demonstrated poor health conditions and high morbidity among surviving narcotics addicts.

heroin addicts morbidity health conditions long-term follow-up 

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REFERENCES

  1. Alter, M. J., Kruszon-Moran, D., Nainan, O. V., McQuillan, G. M., Gao, F., Moyer, L. A., Kaslow, R. A., and Margolis, H. S. (1999). The prevalence of hepatitis Cvirus infection in the United States, 1988 through 1994. N. Engl. J. Med. 341: 556–562.PubMedGoogle Scholar
  2. Alter, M. J., and Moyer, L. A. (1998). The importance of preventing hepatitis C virus infection among injection drug users in the United States. J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. 18: S6–S10.PubMedGoogle Scholar
  3. Aylett, P. (1978). Respiratory function in heroin and methadone addicts. Br. J. Addict. Alcohol Other Drugs 73: 171–174.PubMedGoogle Scholar
  4. Banner, A. S., Rodriguez, J., Sunderrajan, E. V., Agarwal, M. K., and Addington, W. W. (1979). Bronchiectasis: Acause of pulmonary symptoms in heroin addicts. Respiration 37: 232–237.PubMedGoogle Scholar
  5. Buster, M., Rook, L., van Brussel, G. H., van Ree, J., and van den Brink, W. (2002). Chasing the dragon, related to the impaired lung function among heroin users. Drug Alcohol Depend. 68: 221–228.PubMedGoogle Scholar
  6. Camargo, G., and Colp, C. (1975). Pulmonary function studies in ex-heroin users. Chest 67: 331–334.PubMedGoogle Scholar
  7. Centers for Disease Control and Prevention (CDC) (1988–94a ). Serum High Density Lipopro-tein (HDL) Cholesterol of Males 4 Years of Age and Older by Age: Mean and Selected Percentiles, United States, 1988–94. NHANES III. Retrieved April 3, 2003 from http://www. cdc.gov/nchs/data/nhanes/hdlmale.pdfGoogle Scholar
  8. Centers for Disease Control and Prevention (CDC) (1988–94b). Serum Total Choles-terol of Males 4 Years of Age and Older by Age: Mean and Selected Percentiles, United States, 1988–94. NHANES III. Retrieved April 3, 2003 from http://www.cdc.gov/ nchs/data/nhanes/cholmal.pdfGoogle Scholar
  9. Centers for Disease Control and Prevention (CDC) (1998). National HIV Prevalence Surveys, 1997 Summary, National Center for HIV, STD, and TB Prevention, Division of HIV/AIDS Prevention. Retrieved April 3, 2003, from http://www.cdc.gov/hiv/pubs/hivser97.htmGoogle Scholar
  10. Centers for Disease Control and Prevention (CDC) (1999). Reported Tuberculosis in the United States, 1999, Division of Tuberculosis Elimination, National Center for HIV, STD and TB Prevention, Department of Health and Human Services, Atlanta, GA.Google Scholar
  11. Centers for Disease Control and Prevention (CDC) (2000a). 1999 Diabetes Surveillance Re-port. National Diabetes Fact Sheet: General Information and National Estimates on Diabetes in the United States. Retrieved April 3, 2003, from http://www.cdc.gov/diabetes/ statistics/survl99/index.htmGoogle Scholar
  12. Centers for Disease Control and Prevention (CDC) (2000b). Sexually Transmitted Disease Surveillance, 1999. Atlanta, Division of STDPrevention, Department of Health and Human Services, Atlanta, GA.Google Scholar
  13. Davis, R. M., Novotny, T. E., and Lynn, W. R. (1988). The Health Consequences of Smoking, Nicotine Addiction: A Report of the Surgeon General (DHHS Publication No. (CDC) 88-8406), Centers for Disease Control, Center for Health Promotion and Education, Office on Smoking and Health, Rockville, MD.Google Scholar
  14. Donahue, J. G., Nelson, K. E., Munoz, A., Vlahov, D., Rennie, L. L., Taylor, E. L., Saah, A. J., Cohn, S., Odaka, N. J., and Farzadegan, H. (1991). Antibody to hepatitis C virus among cardiac surgery patients, homosexual men, and intravenous drug users in Baltimore, Maryland. Am. J. Epidemiol. 134: 1206–1211.PubMedGoogle Scholar
  15. Escamilla, R., Pecoul, J., Hermant, C., Besombes, J. P., and Krempf, M. (1992). Respiratory function in heroin addicts with or without HIV infection. Rev. Mal. Respir. 9: 425–429.PubMedGoogle Scholar
  16. Esteban, J. I., Esteban, R., Viladomiu, L., Lopez-Talavera, J. C., Gonzalez, A., Hernandez, J. M., Roget, M., Vargas, V., Genesca, J., and Buti, M. (1989). Hepatitis C virus antibodies among risk groups in Spain. Lancet 2: 294–297.PubMedGoogle Scholar
  17. Facy, F. (1995). Epidemiological aspects of drug addiction: Morbidity and evaluation of care. Rev. Prat. 45: 1345–1350.PubMedGoogle Scholar
  18. Fingerhood, M. I., Jasinski, D. R., and Sullivan, J. T. (1993). Prevalence of hepatitis C in a chemically dependent population. Arch. Intern. Med. 153: 2025–2030.PubMedGoogle Scholar
  19. Flegal, K. M., Carroll, M. D., Kuczmarski, R. J., and Johnson, C. L. (1998). Overweight and obesity in the United States: Prevalence and trends, 1960–1994. Int. J. Obes. Relat. Metab. Disord. 22: 39–47.PubMedGoogle Scholar
  20. Gallo, D., George, J. R., Fitchen, J. H., Goldstein, A. S., and Hindahl, M. S. (1997). Evaluation of a system using oral mucosal transudate for HIV-1 antibody screening and confirmatory testing. OraSure HIV Clinical Trials Group. JAMA 277: 254–258.PubMedGoogle Scholar
  21. Gross, G. A. (1994). Drug and alcohol abuse and cholesterol levels . J. Am. Osteopath. Assoc. 94: 55–56, 61–62.PubMedGoogle Scholar
  22. Hankinson, J. L., Odencrantz, J. R., and Fedan, K. B. (1999). Spirometric reference values from a sample of the general U.S. population. Am. J. Respir. Crit. Care Med. 159: 179–187.PubMedGoogle Scholar
  23. Hass, D. (2000). Mycobacterial Diseases. Principles and Practice of Infectious Diseases, 5th ed., Orlando, FL.Google Scholar
  24. Haverkos, H. W. (1991). Infectious diseases and drug abuse. Prevention and treatment in the drug abuse treatment system. J. Subst. Abuse Treat. 8: 269–275.PubMedGoogle Scholar
  25. Haverkos, H. W., and Lange, W. R. (1990). Serious infections other than human immunodeficiency virus among intravenous drug abusers. J. Infect. Dis. 161: 894–902.PubMedGoogle Scholar
  26. Hays, R. D., Sherbourne, C. D., Spritzer, K., and Dixon, W. (1996). A Microcomputer Program (Sf36.exe) That Generates SAS Code for Scoring the SF-36 Health Survey. In Paper Presented at the Proceedings of the 22nd Annual SAS Users Group International Conference, San Diego, CA.Google Scholar
  27. Hennessey, K. A., Schulte, J. M., Cook, L., Collins, M., Onorato, I. M., and Valway, S. E. (1998). Tuberculin skin test screening practices among US colleges and universities. JAMA 280: 2008–2012.PubMedGoogle Scholar
  28. Henningfield, J. E., Clayton, R., and Pollin, W. (1990). Involvement of tobacco in alcoholism and illicit drug use. Br. J. Addict. 85: 279–291.PubMedGoogle Scholar
  29. Hser, Y. I., Anglin, D., and Powers, K. (1993). A 24-year follow-up of California narcotics addicts. Arch. Gen. Psychiatry 50: 577–584.PubMedGoogle Scholar
  30. Hser, Y. I., Boyle, K., and Anglin, M. D. (1998). Drug use and correlates among sexually transmitted disease patients, emergency room patients, and arrestees. J. Drug Issu. 28: 437–453.Google Scholar
  31. Hser, Y. I., Hoffman, V., Grella, C. E., and Anglin, M. D. (2001). A 33-year follow-up of narcotics addicts. Arch. Gen. Psychiatry 58: 503–508.PubMedGoogle Scholar
  32. Hser, Y. I., McCarthy, W. J., and Anglin, M. D. (1994). Tobacco use as a distal predictor of mortality among long-term narcotics addicts. Prev. Med. 23: 61–69.PubMedGoogle Scholar
  33. Kamimoto, L. A., Easton, A. N., Maurice, E., Husten, C. G., and Macera, C. A. (1999). Surveillance for five health risks among older adults—United States, 1993–1997. MMWR CDC Surveill. Summ. 48: 89–130.PubMedGoogle Scholar
  34. Kao, T. C., Schneider, S. J., and Hoffman, K. J. (2000). Co-occurrence of alcohol, smokeless tobacco, cigarette, and illicit drug use by lower ranking military personnel. Addict. Behav. 25: 253–262.PubMedGoogle Scholar
  35. Kreek, M. J., Des Jarlais, D. C., Trepo, C. L., Novick, D. M., Abdul-Quader, A., and Raghunath, J. (1990). Contrasting prevalence of delta hepatitis markers in parenteral drug abusers with and without AIDS. J. Infect. Dis. 162: 538–541.PubMedGoogle Scholar
  36. Laine, C., Hauck, W. W., Gourevitch, M. N., Rothman, J., Cohen, A., and Turner, B. J. (2001). Regular outpatient medical and drug abuse care and subsequent hospitalization of persons who use illicit drugs. JAMA 285: 2355–2362.PubMedGoogle Scholar
  37. Maddrey, W. C. (2000). Alcohol-induced liver disease. Clin. Liver Dis. 4:115–131.PubMedGoogle Scholar
  38. Mannino, D. M., Gagnon, R. C., Petty, T. L., and Lydick, E. (2000). Obstructive lung disease and low lung function in adults in the United States: Data from the National Health and Nutrition Examination Survey, 1988–1994. Arch. Intern. Med. 160: 1683–1689.PubMedGoogle Scholar
  39. Mannino, D. M., Homa, D. M., Akinbami, L. J., Ford, E. S., and Redd, S. C. (2002). Chronic obstructive pulmonary disease surveillance—United States, 1971–2000. Respir. Care 47: 1184–1199.PubMedGoogle Scholar
  40. McGinnis, J. M., and Foege, W. H. (1999). Mortality and morbidity attributable to use of addictive substances in the United States. Proc. Assoc. Am. Physicians 111: 109–118.PubMedGoogle Scholar
  41. McGlothlin, W. H., Anglin, D. M., and Wilson, B. D. (1977). An Evaluation of the California Civil Addict Program. NIDA Services Research Monograph Series, U.S. Department of Health, Education, and Welfare, Washington, DC.Google Scholar
  42. McHorney, C. A., Ware, J. E., and Raczek, A. E. (1993). The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med. Care 31: 247–263.PubMedGoogle Scholar
  43. McQuillan, G. M., Coleman, P. J., Kruszon-Moran, D., Moyer, L. A., Lambert, S. B., and Margolis, H. S. (1999). Prevalence of hepatitis B virus infection in the United States: The National Health and Nutrition Examination Surveys, 1976 through 1994. Am. J. Public Health 89: 14–18.PubMedGoogle Scholar
  44. National Center for Health Statistics (2000). Hypertension Among Persons 20 Years of Age and Over, According to Sex, Age, Race, and Hispanic Origin: United States, 1960–62, 1971–74, 1976–80, 1988–94, and 1999–2000. Health, United States, 2002 With Chartbook on Trends in the Health of Americans. Hyattsville, Maryland. Retrieved April 3, 2003, from http://www.cdc.gov/nchs/data/hus/tables/2002/02hus068.pdfGoogle Scholar
  45. National Institutes of Health (2000). The 10th Special Report to the U.S. Congress on Alcohol and Health, U.S. Department of Health and Human Services, Public Health Service.Google Scholar
  46. Retrieved April, 2003, from http://www.niaaa.nih.gov/publications/10report/intro.pdf Obesity Education Initiative Expert Panel (2000). Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, National Institutes of Health, National Heart, Lung, and Blood Institute, North American Association for the Study of Obesity, Silver Spring, MD.Google Scholar
  47. Overland, E. S., Nolan, A. J., and Hopewell, P. C. (1980). Alteration of pulmonary function in intravenous drug abusers. Prevalence, severity, and characterization of gas exchange abnormalities. Am. J. Med. 68: 231–237.PubMedGoogle Scholar
  48. Passariello, N., Giugliano, D., Ceriello, A., Chiariello, A., Sgambato, S., and D'Onofrio, F. (1986). Impaired insulin response to glucose but not to arginine in heroin addicts. J. Endocrinol. Invest. 9: 353–357.PubMedGoogle Scholar
  49. Passariello, N., Giugliano, D., Quatraro, A., Consoli, G., Sgambato, S., Torella, R., and D'Onofrio, F. (1983). Glucose tolerance and hormonal responses in heroin addicts: A possible role for endogenous opiates in the pathogenesis of non-insulin-dependent diabetes. Metabolism 32: 1163–1165.PubMedGoogle Scholar
  50. Patkar, A. A., Sterling, R. C., Gottheil, E., and Weinstein, S. P. (1999). Acomparison of medical symptoms reported by cocaine-, opiate-, and alcohol-dependent patients. Subst. Abuse 20: 227–235.Google Scholar
  51. Quaglio, G., Lugoboni, F., Talamini, G., Lechi, A., and Mezzelani, P. (2002). Prevalence of tuberculosis infection and comparison of multiple-puncture liquid tuberculin test and Mantoux test among drug users. Scand. J. Infect. Dis. 34: 574–576.PubMedGoogle Scholar
  52. Riordan, S. M., and Williams, R. (1998). Liver disease due to illicit substance use. Addict. Biol. 3: 47–53.Google Scholar
  53. Risdahl, J. M., Khanna, K. V., Peterson, P. K., and Molitor, T. W. (1998). Opiates and infection. J. Neuroimmunol. 83 pp: 4–18.PubMedGoogle Scholar
  54. Santolaria-Fernandez, F. J., Gomez-Sirvent, J. L., Gonzalez-Reimers, C. E., Batista-Lopez, J. N., Jorge-Hernandez, J. A., Rodriguez-Moreno, F., Martinez-Riera, A., and Hernandez-Garcia, M. T. (1995). Nutritional assessment of drug addicts. Drug Al-cohol Depend. 38: 11–18.Google Scholar
  55. Scheidegger, C., and Zimmerli, W. (1989). Infectious complications in drug addicts: Seven-year review of 269 hospitalized narcotics abusers in Switzerland. Rev. Infect. Dis. 11: 486–493.PubMedGoogle Scholar
  56. Schikler, K. N., Lane, E. E., Seitz, K., and Collins, W. M. (1984). Solvent abuse associated pulmonary abnormalities. Adv. Alcohol Subst. Abuse 3: 75–81.PubMedGoogle Scholar
  57. Schunemann, H. J., Grant, B. J., Freudenheim, J. L., Muti, P., Browne, R. W., Drake, J. A., Klocke, R. A., and Trevisan, M. (2001). The relation of serum levels of antioxidant vitamins C and E, retinol and carotenoids with pulmonary function in the general population. Am. J. Respir. Crit. Care Med. 163: 1246–1255.PubMedGoogle Scholar
  58. Standardization of Spirometry (1995). 1994 update, American Thoracic Society. Am. J. Respir. Crit. Care Med. 152: 1107–1136.Google Scholar
  59. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. (2003). Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 26: S5–S20.Google Scholar
  60. The Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) (2001). Executive summary of the third report of the National Cholesterol Education Program (NCEP). JAMA 285: 2486–2497.Google Scholar
  61. The Expert Panel on Detection, Evaluation, and Treatment of High Blood Pressure (1997). The sixth report of the Joint National Committee on Prevention. Arch. Intern. Med. 157: 2413–2446.Google Scholar
  62. Ware, YJ. E., and Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection(kelan). Med. Care 30: 473–483.PubMedGoogle Scholar
  63. Warner, K. E., Davis, R. M., Holbrook, J. H., Novotny, T. E., Ockene, J. K., and Rigotti, N. A. (1989). Reducing the Health Consequences of Smoking: 25 Years of Progress. A Report of the Surgeon General: 1989 Executive Summary (DHHS Publication No. (CDC) 89–8411), Centers for Disease Control, Center for Health Promotion and Education, Office on Smoking and Health, Rockville, MD.Google Scholar
  64. Wasley, A., and Alter, M. J. (2000). Epidemiology of hepatitis C: Geographic differences and temporal trends. Semin. Liver Ds.i 20: 1–16.Google Scholar
  65. Weller, I. V., Cohn, D., Sierralta, A., Mitcheson, M., Ross, M. G., Montano, L., Scheuer, P., and Thomas, H. C. (1984). Clinical, biochemical, serological, histological and ultrastructural features of liver disease in drug abusers. Gut 25: 417–423.PubMedGoogle Scholar
  66. Wolff, K., Farrell, M., Marsden, J., Monteiro, M. G., Ali, R., Welch, S., and Strang, J. (1999). A review of biological indicators of illicit drug use, practical considerations and clinical usefulness. Addiction 94: 1279–1298.PubMedGoogle Scholar
  67. Woodfield, D. G., Harness, M., and Rix-Trott, K. (1993). Hepatitis C virus infections in oral and injectable drug users. N.Z. Med. J. 106: 332–334.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2004

Authors and Affiliations

  • Yih-Ing Hser
    • 1
  • Lillian Gelberg
    • 1
  • Valerie Hoffman
    • 1
  • Christine E. Grella
    • 1
  • William McCarthy
    • 1
  • M. Douglas Anglin
    • 1
  1. 1.University of CaliforniaCalifornia

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