Methadone treatment can reduce mortality

Poser, W.; Koc, John; Ehrenreich, Hannelore

doi:10.1136/bmj.310.6977.463a

Cited by 13 publications

(10 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…7 Heroin addicts have nearly 60-fold greater mortality compared with the general population; MMT was found to significantly reduce the mortality related to illicit drug use. 18 In addition, MMT was associated with increased employment rates, decreased dependence on public assistance, reduced criminal activity, and marked improvement in overall health status of rehabilitated patients. 6 Finally, heroin use can successfully be eliminated in more than 90% of patients on MMT.…”

Section: Discussionmentioning

confidence: 99%

Liver transplantation for patients on methadone maintenance

Kanchana

Kaul

Manzarbeitia

et al. 2002

Liver Transplantation

View full text Add to dashboard Cite

Most transplant programs require abstinence of at least 6 months from alcohol and illicit drugs before orthotopic liver transplantation (OLT). However, there are no published data regarding OLT outcomes in patients who are currently on methadone maintenance treatment (MMT) as part of the treatment of their heroin addiction at the time of OLT. The objective of this study is to evaluate our experience regarding the outcome of OLT in patients with end-stage liver disease (ESLD) who were on MMT at the time of OLT. Between March 1993 and May 1999, a total of 185 patients with ESLD underwent OLT at our center. Five transplant recipients (2.7%) had a history of heroin abuse and had undergone drug and alcohol rehabilitation, but could not be weaned off methadone. Pre-OLT status, drug history, perioperative course, compliance with medical therapy, post-OLT follow-up, and patient and allograft survival were analyzed in detail in these patients. All patients on MMT underwent uneventful OLTs. Their compliance with medications and follow-up was excellent. One patient was weaned completely off methadone after OLT. Post-OLT mean hospital stay in this group was 43 ؎ 25 days. Although the number of patients was small, long-term outcome of liver transplant recipients on MMT appears similar to that of patients not on MMT who underwent OLT during this period. Our results suggest cirrhotic patients on MMT should be considered for OLT if they meet the same psychosocial requirements as patients with alcohol abuse. Furthermore, it is not necessary for patients to be weaned off methadone before OLT. O rthotopic liver transplantation (OLT) is well established as an effective treatment for patients with end-stage liver disease (ESLD). One of the major challenges currently facing OLT is that the number of candidates far exceeds available organs. As of May 2000, a total of 15,258 patients were on waiting lists. Hepatitis C is the leading cause for OLT, followed by alcoholic liver disease; both are primarily substance abuse-related diagnoses. 1,2 Recipient selection is a critical aspect of OLT and involves a multidisciplinary approach. 3,4 Patients undergo an extensive psychosocial evaluation in addition to medical evaluation. Currently, patients actively using illicit drugs are excluded from consideration for OLT. 3-5 Methadone maintenance treatment (MMT) is routinely prescribed for patients during and after rehabilitation from heroin use. Patients on MMT appear to fare better with respect to social functioning, job rates, lower imprisonment, and human immunodeficiency virus infection compared with patients denied methadone after rehabilitation from heroin use. 6,7 Although patients fully rehabilitated from previous drug use are considered OLT candidates, there is a paucity of data regarding OLT in patients administered methadone at the time of OLT as part of MMT.Only 56% of transplant programs accept patients on MMT for OLT, and 32% of programs require discontinuation of MMT before OLT. 8 This apparent discrimination against patients on MM...

show abstract

Section: Discussionmentioning

confidence: 99%

Liver transplantation for patients on methadone maintenance

Kanchana

Kaul

Manzarbeitia

et al. 2002

Liver Transplantation

View full text Add to dashboard Cite

show abstract

“…Improved health and reduced mortality are important goals of substance abuse treatment but relatively little attention is paid to these benefits in outcome studies (Poser, Koc, & Ehrenreich, 1995). Although death rates among opioid users continue to be elevated even during periods of treatment, the available research indicates that methadone maintenance reduces addicts' risk of death significantly.…”

Section: Discussionmentioning

confidence: 97%

Deaths Among Heroin Users in and out of Methadone Treatment

Desmond

Maddux

2000

Journal of Maintenance in the Addictions

View full text Add to dashboard Cite

In this report we review both published and unpublished studies of mortality among opioid drug users in order to summarize current knowledge about the impact of methadone maintenance on death rates. Only a handful of studies spanning three decades of research employed designs judged adequate to answer this question reliably. These seven studies, which directly compared death rates of opioid users during measured periods on and off methadone, produced clear results. The risk of death while on methadone maintenance relative to that while off methadone varied form 0.24 to 0.43; the median value was 0.30. Reductions in death were attributable in large part to protection from opioid drug overdose.

show abstract

“…19 The greatly elevated mortality rate associated with the disorders of substance dependence is also well known and well documented. [20][21][22][23][24][25] In the process of examining the agedependent prevalence of psychopathology including psychoses in our own drug-dependent patients, we noted that the age-dependent profi le of such disorders was very different in a group of addicted patients compared to medical controls, with the drug-dependent group developing more psychopathologies more rapidly and with greater severity than the medical controls. 26 Drug-dependent patients develop a wide variety of disorders in addition to the infective and neuropsychiatric diseases for which they are well known, and these appear similar to the disorders of old age.…”

Section: Introductionmentioning

confidence: 99%

An intriguing association between dental and mental pathology in addicted and control subjects: a cross-sectional survey

Reece

2008

Br Dent J

View full text Add to dashboard Cite

Methadone treatment can reduce mortality

Cited by 13 publications

References 2 publications

Liver transplantation for patients on methadone maintenance

Liver transplantation for patients on methadone maintenance

Deaths Among Heroin Users in and out of Methadone Treatment

An intriguing association between dental and mental pathology in addicted and control subjects: a cross-sectional survey

Contact Info

Product

Resources

About