10779/rcsi.10778090.v1 Grainne Cousins Grainne Cousins Conor Teljeur Conor Teljeur Nicola Motterlini Nicola Motterlini Colin McCown Colin McCown Borislav D. Dimitrov Borislav D. Dimitrov Tom Fahey Tom Fahey Risk of drug related mortality during periods of transition in methadone maintenance treatment: a cohort study Royal College of Surgeons in Ireland 2019 Adolescent Adult Cohort Studies Databases Factual Female Humans Lung Diseases Male Medical Records Methadone Middle Aged Opiate Substitution Treatment Opioid-Related Disorders Patient Dropouts Prescriptions Risk Time Factors Young Adult Family Care 2019-11-22 16:00:25 Journal contribution https://repository.rcsi.com/articles/journal_contribution/Risk_of_drug_related_mortality_during_periods_of_transition_in_methadone_maintenance_treatment_a_cohort_study/10778090 <p>This study aims to identify periods of elevated risk of drug related mortality during methadone maintenance treatment (MMT) in primary care using a cohort of 3,162 Scottish drug users between January 1993 and February 2004. Deaths occuring during treatment or within 3 days after last methadone prescription expired were considered as cases “on treatment”. Fatalities occuring 4 days or more after leaving treatment were cases “off treatment”. 64 drug related deaths were identified. The greatest risk of drug related death was in the first 2 weeks of treatment (Adjusted hazard ratio 2.60, 95% CI 1.03 to 6.56). Risk of drug related death was lower after the first 30 days following treatment cessation, relative to the first 30 days off treatment. History of psychiatric admission was associated with increased risk of drug related death in treatment. Increasing numbers of treatment episodes and urine testing were protective. History of psychiatric admission, increasing numbers of urine tests and co-prescriptions of benzodiazepines increased the risk of mortality out of treatment. The risk of drug related mortality in MMT is elevated during periods of treatment transition, specifically treatment intitiation and the first 30 days following treatment drop-out or discharge.</p>