Abstract: Objective To systematically review cohort studies of mortality among people who inject drugs, examine mortality rates and causes of death in this group, and identify participant- and study-level variables associated with a higher risk of death. Methods Tailored search strings were used to search EMBASE, Medline and PsycINFO. The grey literature was identified through online grey literature databases. Experts were consulted to obtain additional studies and data. Random effects meta-analyses were performed to estimate pooled crude mortality rates (CMRs) and standardized mortality ratios (SMRs). Findings Sixty-seven cohorts of people who inject drugs were identified, 14 of them from low- and middle-income countries. The pooled CMR was 2.35 deaths per 100 person–years (95% confidence interval, CI: 2.12–2.58). SMRs were reported for 32 cohorts; the pooled SMR was 14.68 (95% CI: 13.01–16.35). Comparison of CMRs and the calculation of CMR ratios revealed mortality to be higher in low- and middle-income country cohorts, males and people who injected drugs that were positive for human immunodeficiency virus (HIV). It was also higher during off-treatment periods. Drug overdose and acquired immunodeficiency syndrome (AIDS) were the primary causes of death across cohorts. Conclusion Compared with the general population, people who inject drugs have an elevated risk of death, although mortality rates vary across different settings. Any comprehensive approach to improving health outcomes in this group must include efforts to reduce HIV infection as well as other causes of death, particularly drug overdose.

Abstract: Selected issues: 1: European drug policies: extended beyond illicit drugs? Nearly all European countries now frame their drug policy initiatives within an overall national drugs strategy or action plan. An in-depth analysis of drug policy in Europe in this selected issue reveals a broadening of the scope of these drug strategies to encompass licit addictive substances, such as alcohol, tobacco and medicines, as well as illicit drugs. 2: A gender perspective on drug use and responding to drug problems The influence of gender not only on patterns and levels of drug consumption in Europe but also on how responses to drug problems are planned and implemented is explored in this selected issue. Based on a scientific analysis of the available data, it concludes that policy-makers, professionals and scientists must always take gender into consideration in the planning of research, analysis, interventions and policy in the drugs field. 3: Developments in drug use within recreational settings This selected issue covers all aspects of drug use by young people in music and dance settings, providing data on prevalence and patterns of use, drug availability and the role of the Internet in drug supply and promotion. The risk factors for this type of drug use are outlined as are the health consequences of drug use in these settings. Responses to drug use in recreational settings are covered in depth, both in terms of legislation at national and European levels and in terms of drug prevention programmes.

Abstract: Olaf Möller: Clubcommission Berlin – political work plus situation of Berlin club and party scene Sylvia Thyssen: Experience counts : research chemical self-reports on Erowid.org Remo Michel: Street parade Zurich : development, risks & chances of a unique event Chris Luke: A little nightclub medicine : caring for clubber’s health in the 21st century Emmanuel Kuntsche: Going out to have fun and get drunk? : motivational aspects of young adults’ drinking on weekends Gregor Burkhard: Polydrug use : similarities and differences in Europe : implications for prevention policies Bill Sanders: The illicit use of legal substances Matthew Nice: The state of the global synthetic drug situation Ninette van Hasselt: Introducing the Healthy Nightlife Toolbox Ross Homel: Violence in and around bars, clubs and pubs : why it happens, what we know about stopping it, and what we need to do to know more? Divera Twisk: They (almost) made it home : overcoming the deadly mix of immaturity, fatigue, alcohol/drugs, and lack od driving experience Syan Schaap: Safety and security issues at large crowd events Boris Quednow: Brain serotonin function in MDMA (ecstasy) users Samantha Wells: Male barroom aggression : the explanatory roles of alcohol, drinking contexts, and young men’s perceptions, attitudes and beliefs Antonia Abbey: alcohol’s role in sexual assault : explanations and applications for nightlife environments Sven Andreasson: Cost-effectiveness of prevention of alcohol-related violence Alexander Bücheli: Fourteen years of recreational drug prevention in the city of Zurich : what results have been achieved and what we can learn from these experiences? Mark Bellis: Safer nightlife – it’s not what you do, it’s the way that you do it? Muriel Allart: Party+ : an European network for safer party labels Brian Hayes: The “booze bus” : an alternative response to the alcohol problem Alexander Bücheli: Nightlife, was steckt dahinter? Maurice Illi: Vom Kino zum pulsierenden Club! : sind die Emissionen quartierverträglich? Lars Stark: Problematischer Substanzkonsum von Kokain und Designerdrogen : praktische Aspekte der Behandlung, Intervention und Schadensminderung Corine Kibora: Prévention en milieu festif : renforcer la collaboration : faire face aux nouveaux défis Alwin Bachmann: Risikominderung im Nightlife-Milieu : Herausforderungen der Beziehungsarbeit mit Veranstaltern und Partygängern – eine Bilanz bisheriger Erfahrungen Guido De Angeli: Les enjeux du partenariat avec les promoteurs et les fétards Jean-Pierre Gervasoni: Consommations de drogues : analyse de la situation et pistes de réflexions Roger Flury: Substanzkonsum im Nachtleben – Lageeinschätzung und Massnahmen aus polizeilicher Sicht Hans-Jörg Helmlin, Daniel Allemann: Party-Drogen – Drugchecking : die Chemie im Wandel der Zeit Sam Frey: Safer Clubbing Schweiz, erfolgreiche Prävention im Nachtleben dank Partizipation