Chapter 7 - Mortality and trauma

Summary

Introduction

In this chapter we examine deaths attributable to trauma. Death from trauma among illicit drug users is understudied by comparison with overdose and human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), but, nonetheless, there are strong reasons for believing that it plays a role in premature mortality. Firstly, there are lifestyle factors surrounding illicit drug use that suggest that trauma may play a significant role in causing illicit drug user deaths. Illicit drugs are expensive, and highly sought after by dependent drug users. The scope for violence in such circumstances is high. High levels of crime and sex work performed to support drug use are well documented (Flynn et al., 2003; Gossop et al., 1998; Kaye et al., 1998), activities that carry a high trauma risk. At the psychological level, there is a strong association between antisocial personality disorder (ASPD), borderline personality disorder (BPD) and dependent drug use, diagnoses specifically associated with impulsivity, risk-taking and violent behaviours (American Psychiatric Association, 2000). In addition to the more direct results of the illicit drug using lifestyle, there is also a strong association between motor vehicle accident (MVA) trauma, other accidents and illicit drug use (Kelly et al., 2004; Turk & Tsokos, 2004). Finally, there are the specific psychotropic effects of particular drugs to consider.