Misfortune magnified

Overdoses of drugs, particularly prescription painkillers and heroin, have overtaken AIDS to become the leading cause of death of homeless adults, according to a study of homeless people in Boston released last month.

The finding came from a five-year study of homeless adults who received treatment from the Boston Health Care for the Homeless Program. But its broad conclusions apply to homeless populations in many urban parts of the United States, the studys author and homeless advocates said.

The tripling in the rate of death by drug overdose reflects an overall rise in painkiller abuse, said Dr. Travis Baggett of Massachusetts General Hospital, the lead author of the study published Feb. 11 in the journal JAMA Internal Medicine.

This trend is happening across the country, in non-homeless populations, too, Baggett said. Homeless people tend to experience in a magnified way the health issues that are going on in the general population.

The study, which tracked 28,033 homeless adults from 2003 through 2008, found that of those who died,

17 percent died of drug overdoses, while 6 percent died of causes related to HIV, the virus that causes AIDS.

That is a rough reversal of the trend found in a similar study 15 years earlier, when 6 percent of deaths were due to drug overdose and 18 percent due to AIDS.

After the drug overdoses, the second and third leading causes of death in the most recent study were cancer and heart disease, which each accounted for about 16 percent of the deaths.

Homeless people are significantly more likely to die in a given year than their peers in the rest of the population, with those aged 25 to 44 nine times more likely, and those aged 45 to 64 four-and-a-half times more likely to die, the study said.

The decline in AIDS-related deaths reflected an overall decline in infection rates as well as improvement in care and services for patients since the prior study, which was conducted during the peak years of the U.S. AIDS epidemic.

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Misfortune magnified