Nav: Home

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

July 31, 2018

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 premature mortality. 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 opioid dependence. "If the US government wants to reduce the unconscionable toll that opioid overdose deaths 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 methadone and buprenorphine-assisted treatment and maximizing their uptake by funding educational programs to reduce the stigma of addiction that discourages treatment seeking."
-end-
Research Article

Funding:

This research was supported by funds provided by the Canadian Institutes of Health Research (AR: GSD-14620; JMS: 2009 s0231), the British Columbia Ministry of Justice (JMS: 2014 s0040), and Health Canada (JMS:2009s0231). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests:

The authors declare that no competing interests exist.

Citation:

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. https://doi.org/10.1371/journal.pmed.1002625

Image Credit: K-State Research and Extension, Flickr

Author Affiliations:

Somers Research Group, Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada

In your coverage please use this URL to provide access to the freely available paper:

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002625

Perspective

Funding:

The authors received no specific funding for this work.

Competing Interests:

I have read the journal's policy, and the authors of this manuscript have the following competing interests: as Director of NDARC, MF has received research grants from Indivior, Mundipharma, and from the Australian Government Drug Strategy Branch of the Department of Health. No other competing interests exist.

Citation:

Hall WD, Farrell M (2018) Reducing the opioid overdose death toll in North America. PLoS Med 15(7): e1002626. https://doi.org/10.1371/journal.pmed.1002626

Author Affiliations:

Centre for Youth Substance Abuse Research, the University of Queensland, St Lucia, Australia

National Addiction Centre, Kings College London, London, United Kingdom

National Drug and Alcohol Research Centre, the University of New South Wales, Sydney, Australia

In your coverage please use this URL to provide access to the freely available paper:

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002626

PLOS

Related Mortality Articles:

Highest mortality risks for poor and unemployed
Large dataset shows that income, work status and education have a clear influence on mortality in Germany.
Addressing causes of mortality in Zambia
Despite the fact that people in sub-Saharan Africa are now living longer than they did two decades ago, their average life expectancy remains below that of the rest of the world population.
Examining the link between caste and under-five mortality in India
In India, children that belong to disadvantaged castes face a much higher likelihood of not living past their fifth birthday than their counterparts in non-deprived castes.
Mortality rates rising for Gens X and Y too
Declining life expectancies in the US include Gen X and Y Americans, in addition to the older Baby Boomers.
Trust in others predicts mortality in the United States
Do you trust other people? It may prolong your life.
Breast cancer screening does not reduce mortality
Fewer and fewer women die from breast cancer in recent years but, surprisingly, the decline is just as large in the age groups that are not screened.
Cold fronts may increase stroke mortality
Study conducted in Southern Hemisphere's subtropical zone detects correlation between drop in temperature and rise in deaths from stroke, especially among women and older people.
Far 'over-the-hill' lies the plateau of human mortality
Above age 105, the rise in risk of death by age slows -- and even plateaus -- according to a new study, one that provides valuable insight into one of the most fundamental questions of human aging; Is there a fixed maximum lifespan for humans?
Associating frailty to cardiovascular disease and mortality
Frailty is common in elderly people with cardiovascular disease and goes along with elevated mortality.
Increasing tree mortality in a warming world
A mix of factors is contributing to an increasing mortality rate of trees in the moist tropics, where trees in some areas are dying at about twice the rate that they were 35 years ago.
More Mortality News and Mortality Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: Reinvention
Change is hard, but it's also an opportunity to discover and reimagine what you thought you knew. From our economy, to music, to even ourselves–this hour TED speakers explore the power of reinvention. Guests include OK Go lead singer Damian Kulash Jr., former college gymnastics coach Valorie Kondos Field, Stockton Mayor Michael Tubbs, and entrepreneur Nick Hanauer.
Now Playing: Science for the People

#562 Superbug to Bedside
By now we're all good and scared about antibiotic resistance, one of the many things coming to get us all. But there's good news, sort of. News antibiotics are coming out! How do they get tested? What does that kind of a trial look like and how does it happen? Host Bethany Brookeshire talks with Matt McCarthy, author of "Superbugs: The Race to Stop an Epidemic", about the ins and outs of testing a new antibiotic in the hospital.
Now Playing: Radiolab

Dispatch 6: Strange Times
Covid has disrupted the most basic routines of our days and nights. But in the middle of a conversation about how to fight the virus, we find a place impervious to the stalled plans and frenetic demands of the outside world. It's a very different kind of front line, where urgent work means moving slow, and time is marked out in tiny pre-planned steps. Then, on a walk through the woods, we consider how the tempo of our lives affects our minds and discover how the beats of biology shape our bodies. This episode was produced with help from Molly Webster and Tracie Hunte. Support Radiolab today at Radiolab.org/donate.