Dose-effect relationship between overdose mortality and prescribed methadone dosage in low-threshold maintenance programs.
The present study evaluates the effectiveness of low-threshold methadone maintenance in reducing overdose mortality.
In a prospective cohort study conducted in Amsterdam, 498 Dutch injecting drug users (IDU) provided 1,969 person years of follow-up (1989-1995).
Forty-four IDU died in this period, 15 due to illicit drug overdose.
Compared to IDU not in maintenance, the adjusted relative risk for overdose mortality among those receiving 5-50 mg, 55-70 mg, and 75+mg were 0.35,0.13, and 0.11, respectively (p<. 05).
Also current injection use and HIV-seropositivity were independent predictors for overdose mortality.
Whereas previous studies indicated effectiveness of methadone-assisted detoxification and high-dose maintenance programs in reducing mortality, the present study findings suggest that low-threshold maintenance programs also reduce overdose mortality, with higher dosages being most protective.
Mots-clés Pascal : Toxicomanie, Opiacés, Chimiothérapie, Méthadone, Analgésique narcotique, Traitement substitutif, Posologie, Prescription médicale, Prévention, Mortalité, Overdose, Etude longitudinale, Epidémiologie, Facteur risque, Santé mentale, Pays Bas, Europe, Homme
Mots-clés Pascal anglais : Drug addiction, Opiates, Chemotherapy, Methadone, Narcotic analgesic, Replacement therapy, Posology, Medical prescription, Prevention, Mortality, Overdose, Follow up study, Epidemiology, Risk factor, Mental health, Netherlands, Europe, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0429489
Code Inist : 002B03D. Création : 22/03/2000.