A multi-state model to estimate incidence of heroin use

Background: Existing incidence estimates of heroin use are usually based on one information source. This study aims to incorporate more sources to estimate heroin use incidence trends in Spain between 1971 and 2005. Methods: A multi-state model was constructed, whereby the initial state "heroin consumer" is followed by transition to either "admitted to first treatment" or to "left heroin use" (i.e. permanent cessation or death). Heroin use incidence and probabilities of entering first treatment ever were estimated following a back-calculation approach. Results: The highest heroin use incidence rates in Spain, around 1.5 per 1,000 inhabitants aged 10-44, occurred between 1985 and 1990; subdividing by route of administration reveals higher incidences of injection between 1980 and 1985 (a mean of 0.62 per 1.000) and a peak for non-injectors in 1990 (0.867 per 1,000). Conclusions: A simple conceptual model for heroin users' trajectories related to treatment admission, provided a broader view of the historical trend of heroin use incidence in Spain

A multi-state model to estimate incidence of heroin use

Background Existing incidence estimates of heroin use are usually based on one information source. This study aims to incorporate more sources to estimate heroin use incidence trends in Spain between 1971 and 2005. Methods A multi-state model was constructed, whereby the initial state “heroin consumer” is followed by transition to either “admitted to first treatment” or to “left heroin use” (i.e. permanent cessation or death). Heroin use incidence and probabilities of entering first treatment ever were estimated following a back-calculation approach. Results The highest heroin use incidence rates in Spain, around 1.5 per 1,000 inhabitants aged 10–44, occurred between 1985 and 1990; subdividing by route of administration reveals higher incidences of injection between 1980 and 1985 (a mean of 0.62 per 1.000) and a peak for non-injectors in 1990 (0.867 per 1,000). Conclusions A simple conceptual model for heroin users’ trajectories related to treatment admission, provided a broader view of the historical trend of heroin use incidence in Spain

A multi-state model to estimate incidence of heroin use

Background: Existing incidence estimates of heroin use are usually based on one information source. This study aims to incorporate more sources to estimate heroin use incidence trends in Spain between 1971 and 2005. Methods: A multi-state model was constructed, whereby the initial state "heroin consumer" is followed by transition to either "admitted to first treatment" or to "left heroin use" (i.e. permanent cessation or death). Heroin use incidence and probabilities of entering first treatment ever were estimated following a back-calculation approach. Results: The highest heroin use incidence rates in Spain, around 1.5 per 1,000 inhabitants aged 10-44, occurred between 1985 and 1990; subdividing by route of administration reveals higher incidences of injection between 1980 and 1985 (a mean of 0.62 per 1.000) and a peak for non-injectors in 1990 (0.867 per 1,000). Conclusions: A simple conceptual model for heroin users' trajectories related to treatment admission, provided a broader view of the historical trend of heroin use incidence in Spain

The role of ageing in the wish to be dead:Disentangling age, period and cohort effects in suicide ideation in European population

Aims To investigate potential age, period and birth cohort effects in the prevalence of suicide ideation in European ageing population. Methods A total of 50 782 community-dwelling adults (aged + 50) from 20 different European countries were collected in the Survey Health Ageing and Retirement study. A multilevel logistic regression model of repeated measures was modelled to assess the effects of age and other variables, including the variability of observations over three levels: birth cohort groups, time period assessment and individual differences. Results The larger effect of variability was attributed to individual-level factors (57.8%). Youngest-old people (65-79 years) showed lower suicide ideation than middle-Aged people (50-64 years). No significative differences were found for suicide ideation between middle-Aged people and oldest-old (80 + years). Only 0.85% and 0.13% of the total variability of suicide ideation accounted for birth cohort and period effects, respectively. Cohorts born between 1941 and 1944 possessed the lowest estimates of suicide ideation. Conversely, suicide ideation started to rise with post-War generations and reached a significant level for people born from 1953-1957 to 1961-1964. Regarding the time period, participants assessed in 2006-2007 showed a lower likelihood of suicide ideation. The rest of the cohorts and period groups did not show any significant effect on the prevalence of suicide ideation. Conclusions Our results suggest that age and suicide ideation relationship is not linear in middle and older age. The European Baby boomers born from 50s to mid-60s might report higher suicide ideation than their ancestors. This scenario would imply a greater need for mental healthcare services for older people in the future.This work was supported by the Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) project which was funded by the European Union’s Horizon 2020 (No. 635316). The present work also received support from the Instituto Carlos III-FIS (project PI16/ 00218) and by The European Union Regional Development Fund (ERDF) ‘A Way to Build Europe’ (project PI16/00218). The first four Waves of the SHARE study have been mainly funded by the European Commission by the 5th framework programme (project QLK6-CT-2001-00360 in the thematic programme Quality of Life)), the 6th framework programme (projects SHARE-I3, RII-CT-2006-062193, COMPARE, CIT5-CT-2005-028857, and SHARE-LIFE (CIT4-CT-2006-028812)) and by the 7th framework programme, projects SHARE-PREP (No 211909), SHARE-LEAP (No 227822) and M4 (No 261982). Additional funding from the German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the US National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_04-064, HHSN271201300071C), and from various national funding sources is gratefully acknowledged (see www.share-project.org)