Methadone linked to lower death rates among convicted offenders with opioid dependence

July 31, 2018, Public Library of Science
Credit: CC0 Public Domain

Among convicted offenders, receiving methadone is associated with lower rates of death from external and non-external causes, according to new research published this week in PLOS Medicine by Angela Russolillo of Simon Fraser University, Canada, and colleagues.

Deaths caused by opioids are rising acutely throughout North America and individuals with criminal histories experience high rates of opioid dependence and . In this new study, researchers analyzed population-level data spanning 1998 to 2015 on 14,530 people with criminal convictions who had been prescribed methadone in British Columbia, Canada. The data included prescriptions, convictions, and deaths; researchers were able to compare overall and cause-specific mortality rates between periods when methadone was and was not dispensed.

The overall all-cause mortality rate was 11.2 per 1000 person-years. Participants were significantly less likely to die from both non-external (adjusted hazard ratio [AHR] 0.27; 95% CI 0.23-0.33) and external (AHR 0.41; 95% CI 0.33- 0.51) causes during periods when they were dispensed methadone, even after controlling for socio-demographic, criminological, and health-related factors. Death due to infectious diseases was 5 times lower (AHR 0.20, 95% CI 0.13-0.30) and deaths due to overdoses were nearly 3 times lower (AHR 0.39, 95% CI 0.30-0.50) during medicated periods. It is unclear whether the results of this study are generalizable to jurisdictions without universal healthcare or to non-offender populations.

"Achieving higher rates of [methadone] adherence may reduce overdose deaths and other causes of mortality among offenders and similarly marginalized populations," the authors say. "Our findings warrant examination in other study centers in response to the crisis of opioid-involved deaths."

In an accompanying Perspective, Wayne Hall of the University of Queensland, Australia and Michael Farrell of the University of New South Wales, Australia, write that there are a number of good public health reasons for expanding methadone-assisted treatment for . "If the US government wants to reduce the unconscionable toll that opioid is taking among its citizens, then it needs to adopt the effective public health approaches advocated by expert committees and Commissions," they say. This should include increasing access to and buprenorphine-assisted treatment and maximizing their uptake by funding educational programs to reduce the stigma of addiction that discourages treatment seeking."

Explore further: Buprenorphine may be safer than methadone if treatment duration is longer, study suggests

More information: Russolillo A, Moniruzzaman A, Somers JM (2018) Methadone maintenance treatment and mortality in people with criminal convictions: A population-based retrospective cohort study from Canada. PLoS Med 15(7): e1002625. doi.org/10.1371/journal.pmed.1002625

Related Stories

Buprenorphine may be safer than methadone if treatment duration is longer, study suggests

April 20, 2018
The less commonly prescribed opioid substitute buprenorphine may be safer than methadone for problem opioid users, especially if used during the first month of treatment, according to a study which includes University of ...

Methadone and buprenorphine decrease mortality after nonfatal overdose

June 19, 2018
A new study out of Boston Medical Center's Grayken Center for Addiction on opioid overdose survivors indicates that two FDA approved medications to treat opioid use disorder save lives, but only three out of 10 overdose survivors ...

Methadone linked to 30 percent of painkiller overdoses

July 4, 2012
The prescription drug methadone is linked to over 30 percent of painkiller overdose deaths, according to a report released by the Centers for Disease Control (CDC) and Prevention Tuesday.

Study reveals opioid patients face multiple barriers to treatment

July 12, 2018
In areas of the country disproportionately affected by the opioid crisis, treatment programs are less likely to accept patients paying through insurance of any type or accept pregnant women, a new Vanderbilt study found.

Disparities in opioid abuse treatment increased among Medicaid recipients, study finds

June 25, 2018
The number of Medicaid recipients receiving medication to treat opioid abuse increased sharply in the years after approval of a new drug, but the increase was smaller in poorer counties and areas with larger populations of ...

Slow-release oral morphine could expand options for treating opioid abuse

December 25, 2017
Slow-release oral Morphine (SROM) has emerged as a promising candidate for oral opioid agonist therapy. However, more research is needed before it can be incorporated into U.S. treatment guidelines. A commentary from the ...

Recommended for you

Medical management of opioid-induced constipation differs from other forms of condition

October 17, 2018
Traditional laxatives are recommended as first-line agents to treat patients with a confirmed diagnosis of opioid-induced constipation (OIC), according to a new guideline from the American Gastroenterological Association ...

Research assesses geographic distribution of new antibiotics following market introduction

October 16, 2018
There is a growing need for new antibiotics to help combat the looming threat of antimicrobial resistance. According to a new study conducted by researchers at the Center for Disease Dynamics, Economics & Policy (CDDEP) with ...

Health insurer policies may discourage use of non-opioid alternatives for lower back pain

October 5, 2018
Public and private health insurance policies in the U.S. are missing important opportunities to encourage the use of physical therapy, psychological counseling and other non-drug alternatives to opioid medication for treating ...

Opioid overdoses, depression linked

October 3, 2018
The link between mental health disorders and substance abuse is well-documented. Nearly one in 12 adults in the U.S is depressed, and opioid-related deaths are skyrocketing. As these numbers continue to climb, some mental ...

Do price spikes on some generic drugs indicate problems in the market?

October 1, 2018
A new USC study reports that sudden price spikes for some generic drugs—such as the recently reported increases of a decades-old generic heart medication and an antibiotic—are becoming more common.

Reclassification recommendations for drug in 'magic mushrooms'

September 26, 2018
In an evaluation of the safety and abuse research on the drug in hallucinogenic mushrooms, Johns Hopkins researchers suggest that if it clears phase III clinical trials, psilocybin should be re-categorized from a schedule ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.