Mortality prior to, during and after opioid maintenance treatment (OMT): A national prospective cross-registry study

Clausen, Thomas; Anchersen, Katinka; Waal, Helge

doi:10.1016/j.drugalcdep.2007.11.003

Cited by 250 publications

(180 citation statements)

References 86 publications

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“…Staying abreast of emerging data will provide better understanding on how to manage patients with substance use disorder. Our knowledge of the genetics underlying predisposition to addiction [6][7][8], alterations in neurotransmitter tone [38,39], and how reward deficiency is contributing to stress and relapse [40] will supply us with a more sophisticated and heuristically useful view of the patient's physiological condition and allow for a more individualized approach.…”

Section: Resultsmentioning

confidence: 99%

Individualizing Opioid Use Disorder (OUD) Treatment: Time to Fully Embrace a Chronic Disease Model

Gustin¹,

Nichols²,

Martin³

2015

J Reward Defic Syndr

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The current opioid epidemic in the United States is changing our perceptions of the face of addiction. Opioid Use Disorder (OUD) has become pervasive and is affecting all ethnicities, races, socioeconomic classes, the young and the old. In 2015, 46 people will lose their life each day to a chronic brain disease that is going unnoticed and undertreated. Over the last five decades, numerous scientific and clinical breakthroughs have allowed for a better understanding of the mechanisms underlying addiction, and the development of medications that can help support a patient's long-term recovery. All of those that have contributed to these advancements have aided in redefining addiction as a primary, chronic disease of the brain reward, motivation, memory and related circuitry; however, our treatment strategies have not necessarily advanced to the same extent as our current understanding of the disease. This commentary will explore how personal philosophies can bias treatments strategies and definitions of treatment success, and prevent adoption of chronic disease treatment models that would significantly improve the quality of life of those suffering with OUD. This is a challenge to consider how our views and stigma can impact a patient's recovery. We are currently losing a battle with a disease that is taking the lives of 46 individuals daily; it is time to fully embrace a chronic disease model which comprises an integrated pharmacopsychosocial approach for treating the biopsychosocial disorder that is addiction to reverse these trends.

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Section: Resultsmentioning

confidence: 99%

Individualizing Opioid Use Disorder (OUD) Treatment: Time to Fully Embrace a Chronic Disease Model

Gustin¹,

Nichols²,

Martin³

2015

J Reward Defic Syndr

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“…It is well documented that there is a high mortality rate among drug users, and that death by overdose is common cause of death in that group (Clausen et al, 2008;Darke and Degenhardt, 2007;Davoli et al, 2007;Bargagli et al, 2006;Johnson et al, 2005;Gossop et al, 2002). Actually, deaths from opiate overdose comprise the vast majority of all drugrelated deaths (Strang et al, 2008;Darke and Zador, 1996).…”

Section: Introductionmentioning

confidence: 99%

Mortality among drug users after discharge from inpatient treatment: An 8-year prospective study

Ravndal

Amundsen²

2010

Drug and Alcohol Dependence

105

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Background:Drug users who are leaving/completing inpatient medication-free treatment may, like drug users released from prison, have an elevated risk of dying from fatal overdoses. This is mainly explained by their low drug tolerance. Methods:Two hundred and seventy-six drug users who had been admitted to eleven inpatient facilities in Norway, were followed prospectively after discharge from treatment during an eight year period (1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006). The following instruments were used: EuropASI, SCL-25 and MCMI-II.Information on deaths and causes of death were obtained from the National Death Register. Results:A total of 36 deaths were registered after discharge from treatment during the observation period, of which 24 were classified as overdose deaths. During the first 4 weeks after discharge six persons died, yielding an unadjusted excess mortality of 15.7 (rate ratio) in this period (CI 5.3-38.3). All were dropouts and all deaths were classified as opiate overdoses.There was no significant association between time in index treatment and mortality after discharge, nor did any background characteristics correlate significantly with elevated mortality shortly after discharge. Conclusions:The elevated risk of dying from overdose within the first four weeks of leaving medicationfree inpatient treatment is so dramatic that preventive measures should be taken. More studies from similar inpatient programmes are needed in order to obtain systematic knowledge about determinants of overdose deaths shortly after leaving treatment, and possible preventive measures..

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“…Studies have shown that patients who leave methadone programmes have increased mortality risks relative to those remaining in treatment. ( Caplehorn, Dalton, Haldar, Petrenas, & et al, 1996;Clausen, Anchersen, & Waal, 2008;Davoli, et al, 2007;Fugelstad, Stenbacka, Leifman, Nylander, & Thiblin, 2007;Langendam, van Brussel, Coutinho, & van Ameijden, 2001;Zanis & Woody, 1998) A recent prospective cohort study of Italian opiate users found that the risk of overdose following treatment cessation was more than three times higher in the first 30 days after treatment drop-out or discharge compared to the subsequent 31 days or more after treatment. (Davoli, et al, 2007) However, these effects are not specific to MMT but rather a range of treatments for heroin dependence, including MMT, methadone detoxification, other pharmacological detoxification and psychological interventions.…”

Section: Introductionmentioning

confidence: 99%

Risk of drug-related mortality during periods of transition in methadone maintenance treatment: A cohort study

Cousins

Teljeur

Mondaini

et al. 2011

Journal of Substance Abuse Treatment

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Mortality prior to, during and after opioid maintenance treatment (OMT): A national prospective cross-registry study

Cited by 250 publications

References 86 publications

Individualizing Opioid Use Disorder (OUD) Treatment: Time to Fully Embrace a Chronic Disease Model

Individualizing Opioid Use Disorder (OUD) Treatment: Time to Fully Embrace a Chronic Disease Model

Mortality among drug users after discharge from inpatient treatment: An 8-year prospective study

Risk of drug-related mortality during periods of transition in methadone maintenance treatment: A cohort study

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