The elevated risk of death in the first month of treatment and especially in the month after treatment may negate any protective effect of OST, unless duration of treatment is prolonged. Further research is required to test this hypothesis and investigate the impact of average OST duration on drug related deaths.
Heroin users prescribed methadone to help them control their addiction are more at risk of death at the beginning and end of treatment than at any other time during treatment, according to new research from the University of Bristol published today in the BMJ. However, the overall risk of death for prescribed-methadone users is still lower than the risk of death out of treatment. The annual mortality rate was 0.7 per cent during treatment and 1.3 per cent off treatment; 5.3 and 10.9 times higher respectively than the mortality rate in the general population. Opiate using men had approximately twice the risk of mortality of women. Opiate substitution therapy (OST), where patients with a substance abuse diagnosis are prescribed methadone or buprenorphone, is central to the prevention of drug-related deaths. OST is effective also in improving physical and mental health and decreasing illicit drug use, criminal activity and the risk of HIV infection. In the UK, in the last decade, opiate prescription has more than doubled while the number of deaths involving methadone have declined.
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