We demonstrate that health inequalities between opioid users and the general population persist and, for some diseases, widen with age. These findings underline the importance for public health policy and treatment providers of delivering effective addiction treatment for older age groups, who

are characterised by multiple and complex health problems. Importantly, as the opioid using population ages, so their risk of death due to drug-related poisoning is likely to increase: national targets need to adjust for age in order effectively to monitor the impact of policies with the aim of reducing drug-related Apoptosis Compound Library supplier poisoning deaths. Crucially, the new health information on drug-related poisoning mortality risk in older age as presented here should be promoted to opioid users themselves, to emphasise that their risk of overdose does not decline, but rather increases, with NVP-AUY922 age. The increased SMRs with age for homicide and cancer (in addition to infectious diseases and liver fibrosis/cirrhosis) also merit attention. The research was

funded by a grant from the Medical Research Council (MRC grant number G1000021), provided within the RCUK Addiction Research Strategy. The MRC had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for

publication. Public Health England, The Home Office, and The Office for National Statistics have been provided with a pre-submission version of this manuscript but have not exerted any editorial control over, or commented on, its MYO10 content. Millar and Bird conceived of the study. Pierce with input from Bird wrote the analysis plan. Pierce analysed the data and wrote a first draft of the manuscript. Millar, Bird and Hickman supervised data analysis. All interpreted the data and edited the manuscript. Millar has received research funding from the UK National Treatment Agency for Substance Misuse and the Home Office. He is a member of the organising committee for, and chairs, conferences supported by unrestricted educational grants from Reckitt Benckiser, Lundbeck, Martindale Pharma, and Britannia Phamaceuticals Ltd, for which he receives no personal remuneration. Bird holds GSK shares, is an MRC programme leader. She chaired Home Office’s Surveys, Design and Statistics Subcommittee (SDSSC) when SDSSC published its report on 21st Century Drugs and Statistical Science. She has previously served as UK representative on the Scientific Committee for European Monitoring Centre for Drugs and Drug Addiction. She is co-principal investigator for MRC-funded, prison-based N-ALIVE pilot Trial.