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https://hdl.handle.net/2440/52591
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Type: | Journal article |
Title: | Exposure to opioid maintenance treatment reduces long-term mortality |
Author: | Gibson, A. Degenhardt, L. Mattick, R. Ali, R. White, J. O'Brien, S. |
Citation: | Addiction, 2008; 103(3):462-468 |
Publisher: | Blackwell Publishing Ltd |
Issue Date: | 2008 |
ISSN: | 0965-2140 1360-0443 |
Statement of Responsibility: | Amy Gibson, Louisa Degenhardt, Richard P. Mattick, Robert Ali, Jason White & Susannah O’Brien |
Abstract: | <h4>Aims</h4>To (i) examine the predictors of mortality in a randomized study of methadone versus buprenorphine maintenance treatment; (ii) compare the survival experience of the randomized subject groups; and (iii) describe the causes of death.<h4>Design</h4>Ten-year longitudinal follow-up of mortality among participants in a randomized trial of methadone versus buprenorphine maintenance treatment.<h4>Setting</h4>Recruitment through three clinics for a randomized trial of buprenorphine versus methadone maintenance.<h4>Participants</h4>A total of 405 heroin-dependent (DSM-IV) participants aged 18 years and above who consented to participate in original study.<h4>Measurements</h4>Baseline data from original randomized study; dates and causes of death through data linkage with Births, Deaths and Marriages registries; and longitudinal treatment exposure via State health departments. Predictors of mortality examined through survival analysis.<h4>Findings</h4>There was an overall mortality rate of 8.84 deaths per 1000 person-years of follow-up and causes of death were comparable with the literature. Increased exposure to episodes of opioid treatment longer than 7 days reduced the risk of mortality; there was no differential mortality among methadone versus buprenorphine participants. More dependent, heavier users of heroin at baseline had a lower risk of death, and also higher exposure to opioid treatment. Older participants randomized to buprenorphine treatment had significantly improved survival. Aboriginal or Torres Strait Islander participants had a higher risk of death.<h4>Conclusions</h4>Increased exposure to opioid maintenance treatment reduces the risk of death in opioid-dependent people. There was no differential reduction between buprenorphine and methadone. Previous studies suggesting differential effects may have been affected by biases in patient selection. |
Keywords: | Buprenorphine longitudinal maintenance treatment methadone mortality opioid dependence RCT. |
DOI: | 10.1111/j.1360-0443.2007.02090.x |
Published version: | http://dx.doi.org/10.1111/j.1360-0443.2007.02090.x |
Appears in Collections: | Aurora harvest 5 Pharmacology publications |
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