Abstract
Aims: Methadone is effective for the treatment of heroin
dependence and it also improves survival. However, it has been
reported an increased risk of death during the first weeks of treatment. We aimed to analyze early mortality and causes of death
in the only community-based methadone treatment program in
Badalona, Spain.
Methods: Longitudinal study in heroin users enrolled in theMTP
since its introduction in January 1992 through December 2010.
Socio-demographic, drug use characteristics, serology for HIV, Hepatitis B, Hepatitis C and psychiatric co-morbidity were assessed
at entry. In all cases information on date and cause of death was
obtained from clinical charts and the Catalonian mortality register.
Causes of death were established according to the International
Classification of Diseases (ICD-9 and ICD-10).
Results: Between 1992 and 2010, 798 patients (83% men)
started treatment with methadone; median age at admission was
29 years (IQR: 25–34 years), age at first heroin use was 19 years
(IQR: 16–23 years) and 75% were injection drug users. Regarding
other characteristics, 56% had at least 8 years of education. Prevalence of HIV, HCV and HBV (HBcAb) infections was 50%, 67% and
58%, respectively. At the end of study in Dec. 2010, 220 (27.6%)
patients had died; 10/220 (4.5%) died during the first month of
methadone treatment; all of them were men and 50% of deaths
occurred in the first period of admission (1992–96). Among the
deceased patients, 6 were HIV-positive and 4 had history of psychiatric disorders. Causes of death included: drug-related in 3 cases,
cardio-respiratory in 3 cases, liver-related (2), non-natural (1) and
unknown (1).
Conclusions: We observe an increased risk of death at the
beginning of treatment with methadone in a low threshold program. Mortality is not only drug-related but also attributable to the
impact of HIV/Aids before the introduction of HAART.
dependence and it also improves survival. However, it has been
reported an increased risk of death during the first weeks of treatment. We aimed to analyze early mortality and causes of death
in the only community-based methadone treatment program in
Badalona, Spain.
Methods: Longitudinal study in heroin users enrolled in theMTP
since its introduction in January 1992 through December 2010.
Socio-demographic, drug use characteristics, serology for HIV, Hepatitis B, Hepatitis C and psychiatric co-morbidity were assessed
at entry. In all cases information on date and cause of death was
obtained from clinical charts and the Catalonian mortality register.
Causes of death were established according to the International
Classification of Diseases (ICD-9 and ICD-10).
Results: Between 1992 and 2010, 798 patients (83% men)
started treatment with methadone; median age at admission was
29 years (IQR: 25–34 years), age at first heroin use was 19 years
(IQR: 16–23 years) and 75% were injection drug users. Regarding
other characteristics, 56% had at least 8 years of education. Prevalence of HIV, HCV and HBV (HBcAb) infections was 50%, 67% and
58%, respectively. At the end of study in Dec. 2010, 220 (27.6%)
patients had died; 10/220 (4.5%) died during the first month of
methadone treatment; all of them were men and 50% of deaths
occurred in the first period of admission (1992–96). Among the
deceased patients, 6 were HIV-positive and 4 had history of psychiatric disorders. Causes of death included: drug-related in 3 cases,
cardio-respiratory in 3 cases, liver-related (2), non-natural (1) and
unknown (1).
Conclusions: We observe an increased risk of death at the
beginning of treatment with methadone in a low threshold program. Mortality is not only drug-related but also attributable to the
impact of HIV/Aids before the introduction of HAART.
| Original language | English |
|---|---|
| Pages (from-to) | e191-e191 |
| Number of pages | 1 |
| Journal | Drug Alcohol Depend |
| Volume | 156 |
| DOIs | |
| Publication status | Published - Nov 2015 |
