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Premature deaths after discharge from methadone maintenance: a replication
George E Woody1, Vince Kane, Kimberly Lewis
1From the VISN 4 Mental Illness, Research Education and Clinical Center (MIRECC) (GEW, VK, KL, RT),, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA; Department of Psychiatry (GEW), Medical School of the University of Pennsylvania, Philadelphia, PA; and Department of Psychiatry (GEW) and Psychology (RT), University of Illinois at Chicago, Chicago, IL.
Patients in methadone maintenance treatment have lower mortality rates. Discharging patients from methadone treatment, especially for drug use or behavioral issues, significantly increases their risk of premature death.
Area of Science:
- Addiction Medicine
- Public Health
- Opioid Use Disorder Treatment
Background:
- Methadone maintenance treatment (MMT) is a cornerstone for managing opioid use disorder.
- Understanding mortality risks associated with MMT discharge is crucial for patient outcomes.
Purpose of the Study:
- To investigate the mortality rates and causes of death among patients discharged from MMT.
- To correlate mortality with reasons for discharge and discuss treatment implications.
Main Methods:
- A naturalistic study tracked deaths and causes of death in 636 opioid-dependent veterans receiving MMT.
- Data collected between January 1, 2000, and August 31, 2002.
Main Results:
- Patients remaining on methadone had a 6.8% mortality rate, while discharged patients had an 18.8% mortality rate.
- Discharge for continuing drug use or disciplinary problems was associated with significantly higher mortality.
- Follow-up revealed ongoing issues and low treatment engagement among discharged patients.
Conclusions:
- Continued participation in MMT is associated with reduced mortality.
- Premature mortality can be mitigated by retaining patients in treatment and facilitating prompt re-enrollment upon discharge.
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