Survival study of opioid addicts in relation to its adherence to methadone maintenance treatment

Esteban, Javier; Gimeno, Carmen; Barril, J.; Aragonés, Amparo; Climent, José M.; Pellín, María de la Cruz

doi:10.1016/s0376-8716(03)00002-4

Cited by 48 publications

(35 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Interestingly, recent studies have found methadone-induced overdosing is decreasing despite an increase in the number of methadone prescriptions. They also found that survival is improved by entry and re-enrolment (when previous treatment had failed) into MMT [64,65] .…”

Section: Discussionmentioning

confidence: 99%

Mortality in Opioid-Maintained Patients after Release from an Addiction Clinic

Bauer¹,

Loipl²,

Jagsch³

et al. 2008

Eur Addict Res

View full text Add to dashboard Cite

Aim: To investigate the mortality rate in a cohort of 269 opioid-dependent patients and the outcome of survivors meeting DSM-IV criteria for opioid dependence. Design: Retrospective cohort study. Participants: Patients enrolled in synthetic opioid maintenance therapy during a time frame from 1998 to 1999 originally at the Addiction Clinic and then discharged to general practitioners. Methods: Structured interviews (Europ-ASI), urinalysis at time of interview as well as autopsy findings from deceased patients. Results: After six mailings, information from 147 (54.6%) patients was gained. 85 patients (31.6%) were interviewed. From these 76.5% (n = 65) were still enrolled in maintenance therapy, 18.8% (n = 16) were drug-free and 4.7% (n = 4) relapsed. From 29 fatalities, 37.9% died of intoxication with illicit substances, 34.5% related to AIDS and 27.6% of somatic complications. The Standardized Mortality Ratio (SMR) was 29.13 (95% CI = 19.27–44.04). A higher lifetime frequency of hospitalization, less working days and a lack of social relationships were factors associated with high mortality. Conclusions: The study confirms the high mortality rate in this patient group and supports the importance of maintenance therapy. Although great efforts were undertaken in locating patients, about 45% of the target group could not be located.

show abstract

Section: Discussionmentioning

confidence: 99%

Mortality in Opioid-Maintained Patients after Release from an Addiction Clinic

Bauer¹,

Loipl²,

Jagsch³

et al. 2008

Eur Addict Res

View full text Add to dashboard Cite

show abstract

“…In patients undergoing treatment for opioid use disorders, methadone therapy is associated with several improved outcomes, including retention in drug treatment as well as reduced opioid use, and some observational studies have observed reductions in allcause mortality and risk of death from overdose (Esteban et al, 2003;Gibson et al, 2008;Huang & Lee, 2013;Langendam, van Brussel, Coutinho, & van Ameijden, 2001;Mattick, Breen, Kimber, & Davoli, 2009;Perry et al, 2013;Schwartz et al, 2013). On the basis of its effectiveness, the World Health Organization added methadone to its list of essential medicines in 2005.…”

Section: Introductionmentioning

confidence: 97%

Predictors of Opioid-Related Death During Methadone Therapy

Leece

Cavacuiti

Macdonald

et al. 2015

Journal of Substance Abuse Treatment

View full text Add to dashboard Cite

We aimed to examine pharmacologic, demographic and medical comorbidity risk factors for opioid-related mortality among patients currently receiving methadone for an opioid use disorder. We conducted a population-based, nested case-control study linking healthcare and coroner's records in Ontario, Canada, from January 31, 1994 to December 31, 2010. We included social assistance recipients receiving methadone for an opioid use disorder. Within this group, cases were those who died of opioid-related causes. For each case, we identified up to 5 controls matched on calendar quarter. The primary analysis examined the association between use of psychotropic drugs (benzodiazepines, antidepressants or antipsychotics) and opioid-related mortality. Secondary analyses examined the associations between baseline characteristics, health service utilization, comorbidities and opioid-related mortality. Among 43,545 patients receiving methadone for an opioid use disorder, we identified 175 (0.4%) opioid-related deaths, along with 873 matched controls. Psychotropic drug use was associated with a two fold increased risk of opioid-related death (adjusted odds ratio (OR) 2.0; 95% confidence interval (CI) 1.2 to 3.5). Specifically, benzodiazepines (adjusted OR 1.6; 95% CI 1.1 to 2.5) and antipsychotics (adjusted OR 2.3; 95% CI 1.5 to 3.5) were independently associated with opioid-related death. Other associated factors included chronic lung disease (adjusted OR 1.7; 95% CI 1.2 to 2.6), an alcohol use disorder (adjusted OR 1.9; 95% CI 1.2 to 3.2), mood disorders (adjusted OR 1.8; 95% CI 1.0 to 3.2), and a history of heart disease (adjusted OR 5.3; 95% CI 2.0 to 14.0). Psychotropic drug use is associated with opioid-related death in patients receiving methadone. Mindfulness of these factors may reduce the risk of death among methadone recipients.

show abstract

“…Highly concordant sites used more of their resources to treat new patients. Expediting treatment and reenrollment in methadone has been found to improve the survival of the opiate-dependent patient (Esteban et al, 2003). This emphasis on new patients may maximize the health benefits to the opiate-dependent population.…”

Section: Discussionmentioning

confidence: 97%