Mortality in an Opioid Treatment Program

Area of Science:

• Addiction Medicine
• Public Health
• Pharmacology

Background:

• Opioid Treatment Programs (OTPs) using methadone are proven to reduce mortality and morbidity.
• Historically, patient retention in OTPs has been challenged by barriers like continued substance use.
• This study addresses mortality within an OTP prioritizing minimal admission and retention barriers.

Purpose of the Study:

• To examine mortality patterns in an Opioid Treatment Program (OTP) with low-barrier admission and retention policies.
• To compare causes of death, specifically drug poisoning versus non-drug poisoning, among OTP patients.
• To identify factors associated with drug poisoning deaths within the study population.

Main Methods:

• Retrospective analysis of patient deaths over three years in an OTP serving ~2400 patients daily.
• Data collection from electronic health records and medical examiner reports for demographics and causes of death.
• Pairwise comparisons to analyze differences between drug poisoning and non-drug poisoning fatalities.

Main Results:

• 155 deaths occurred during the study period; the average age of deceased patients was 54.
• 26% (41 patients) died from drug poisoning.
• Drug poisoning deaths were more prevalent in younger patients, females, those with recent positive drug tests, documented alprazolam use, and shorter treatment durations.

Conclusions:

• The majority of deaths were among long-term patients over 50 and were not drug-poisoning related.
• Findings support the retention of patients in treatment programs even with ongoing drug use.
• Integrating primary care services for OTP patients is recommended to address non-drug poisoning mortality.