[Mortality among drug addicts in Norway]. / Dødelighet blant stoffmisbrukere i Norge.

Current drug abusers in Norway seem to differ from those of 25-30 years ago in several respects, namely with regard to selection to drug abuse, living conditions, and the social responses to drug abuse. These factors may all be relevant for morbidity and mortality. Mortality and excess mortality under the age of 50 was assessed on the basis of data on 1,491 drug abusers admitted to the National Clinic for Drug Abusers (Statens klinikk for narkomane) during the years 1961-91. A significant excess mortality among the drug abusers was found for both genders, in all age groups and for all three decades. Males displayed a higher mortality than females, and the mortality among drug abusers increased with increasing age. Excess mortality was higher for women than for men and decreased with increasing age. The most prevalent causes of death were overdoses, suicides and accidents. Mortality from overdoses and diseases was higher among persons admitted during the 1970s and 1980s compared with persons admitted during the 1960s. The results are discussed in light of the qualitative differences between the former and present populations of drug abusers in Norway.

[Night calls for general practitioners]. / Henvendelser til lege om natten.

We examined night calls in each of four rural Norwegian municipalities with 6,000-7,000 inhabitants during three months in winter 1992/1993. Most out-of-hours calls were covered by general practitioners on rota. The overall rate of night calls (2300-0700) was 55 per 1,000 inhabitants per year, varying from 39 to 77 in the municipalities (p < 0.01). In 42% of the night calls the patient was advised over the telephone, 23% were seen in the surgery and 34% were visited at home. We found a higher rate of night calls in our material than found in previous studies on the subject. We assume that this difference in the number of night calls can be explained to some extent by the different attitudes signalled by the doctors to their patient populations.

[Urinary excretion of cannabis metabolites]. / Urinutskillelse av cannabismetabolitter.

Urine testing is increasingly used to detect drug abuse, most commonly by easily performed immunological tests. There is large interpersonal variation in the excretion time of cannabinoids. Excretion times of up to 11 weeks have been demonstrated. In cases with a long excretion time a negative test result may be followed by a positive result without concomitant abuse. We describe a case where cannabinoid metabolites in urine were detected by a routine immunological method (Abbotts ADx) after 95 days of supervised abstinence. It is important that personnel evaluating test results have a thorough knowledge of possible pitfalls.

[Hepatitis A-, B- and C-markers among Norwegian drug addicts in the period 1975-89]. / Hepatitt A-, B- og C-markører hos norske stoffmisbrukere i perioden 1975-89.

The prevalence of hepatitis A-, B- and C-markers has been studied in patients at a Norwegian rehabilitation centre for drug addicts. The prevalence of hepatitis C-antibodies was fairly constant in the years 1976 (56%), 1985 (78%) and 1988-89 (73%), but may be decreasing in younger addicts. The data suggest a highly variable incidence of HAV with few infections in recent years. The prevalence of hepatitis B-markers, which has been calculated from 1975 to 1988-89, reached a maximum of 93% in 1986. Since then a significant decrease in prevalence has been observed among younger patients, suggesting that the HIV campaign has led to improved hygiene precautions among intravenous drug addicts. A strong correlation was observed between positive markers for HBV and presence of anti-HCV, and, similarly, between the presence of anti-HAV and markers for HBV and HCV. Anti-HCV was significantly associated with pathological ALT-values.