Historique
Périodique
Four-year follow-up of imprisoned male heroin users and methadone treatment: mortality, re-incarceration and hepatitis C infection
(Suivi sur 4 ans d'usagers d'héroïne incarcérés et impact d'un traitement de maintenance à la méthadone sur la mortalité, la réincarcération et l'hépatite C)
Auteur(s) :
DOLAN, K. A. ;
SHEARER J. ;
WHITE, B. ;
ZHOU, J. ;
KALDOR, J. ;
WODAK, A. D.
Année
2005
Page(s) :
820-828
Langue(s) :
Anglais
Refs biblio. :
30
Domaine :
Drogues illicites / Illicit drugs
Thésaurus mots-clés
PRISON
;
FACTEUR DE RISQUE
;
MORTALITE
;
HEPATITE
;
RECIDIVE
;
TRAITEMENT DE MAINTENANCE
;
METHADONE
Thésaurus géographique
AUSTRALIE
Note générale :
Addiction, 2005, 100, (6), 820-828
Note de contenu :
fig. ; tabl.
Résumé :
FRANÇAIS :
Suivi de 1998 à 2002 de 382 usagers d'héroïne incarcérés en 1997/1998 en Australie (New South Wales). La rétention en traitement est associée à des taux plus faibles de mortalité, de réincarcération et d'hépatite C, d'où l'intérêt de la continuité du traitement de maintenance à la méthadone.
ENGLISH :
AIMS: To examine the long-term impact of methadone maintenance treatment (MMT) on mortality, re-incarceration and hepatitis C seroconversion in imprisoned male heroin users. DESIGN, SETTING AND PARTICIPANTS: The study cohort comprised 382 imprisoned male heroin users who had participated in a randomized controlled trial of prison-based MMT in 1997/98. Subjects were followed-up between 1998 and 2002 either in the general community or in prison. MEASUREMENTS: All-cause mortality, re-incarceration, hepatitis C and HIV serostatus and MMT retention. FINDINGS: There were no deaths recorded while subjects were enrolled in MMT. Seventeen subjects died while out of MMT, representing an untreated mortality rate of 2.0 per 100 person-years (95% CI, 1.2-3.2). Re-incarceration risk was lowest during MMT episodes of 8 months or longer (adjusted hazard ratio 0.3 (95% CI, 0.2-0.5; P < 0.001), although MMT periods 2 months or less were associated with greatest risk of re-incarceration (P < 0.001). Increased risk of hepatitis C seroconversion was significantly associated with prison sentences of less than 2 months [adjusted hazard ratio 20 (95% CI, 5-76; < P = 0.001)] and MMT episodes less than 5 months [adjusted hazard ratio 4.2 (95% CI, 1.4-12.6; P = 0.01)]. Subjects were at greatest risk of MMT dropout during short prison sentences of 1 month or less (adjusted hazard ratio 10.4 (95% CI, 7.0-15.7; P < 0.001). HIV incidence was 0.3 per 100 person-years (95% CI, 0.03-0.99). CONCLUSIONS: Retention in MMT was associated with reduced mortality, re-incarceration rates and hepatitis C infection. Prison-based MMT programmes are integral to the continuity of treatment needed to ensure optimal outcomes for individual and public health. (Author's abstract)
Suivi de 1998 à 2002 de 382 usagers d'héroïne incarcérés en 1997/1998 en Australie (New South Wales). La rétention en traitement est associée à des taux plus faibles de mortalité, de réincarcération et d'hépatite C, d'où l'intérêt de la continuité du traitement de maintenance à la méthadone.
ENGLISH :
AIMS: To examine the long-term impact of methadone maintenance treatment (MMT) on mortality, re-incarceration and hepatitis C seroconversion in imprisoned male heroin users. DESIGN, SETTING AND PARTICIPANTS: The study cohort comprised 382 imprisoned male heroin users who had participated in a randomized controlled trial of prison-based MMT in 1997/98. Subjects were followed-up between 1998 and 2002 either in the general community or in prison. MEASUREMENTS: All-cause mortality, re-incarceration, hepatitis C and HIV serostatus and MMT retention. FINDINGS: There were no deaths recorded while subjects were enrolled in MMT. Seventeen subjects died while out of MMT, representing an untreated mortality rate of 2.0 per 100 person-years (95% CI, 1.2-3.2). Re-incarceration risk was lowest during MMT episodes of 8 months or longer (adjusted hazard ratio 0.3 (95% CI, 0.2-0.5; P < 0.001), although MMT periods 2 months or less were associated with greatest risk of re-incarceration (P < 0.001). Increased risk of hepatitis C seroconversion was significantly associated with prison sentences of less than 2 months [adjusted hazard ratio 20 (95% CI, 5-76; < P = 0.001)] and MMT episodes less than 5 months [adjusted hazard ratio 4.2 (95% CI, 1.4-12.6; P = 0.01)]. Subjects were at greatest risk of MMT dropout during short prison sentences of 1 month or less (adjusted hazard ratio 10.4 (95% CI, 7.0-15.7; P < 0.001). HIV incidence was 0.3 per 100 person-years (95% CI, 0.03-0.99). CONCLUSIONS: Retention in MMT was associated with reduced mortality, re-incarceration rates and hepatitis C infection. Prison-based MMT programmes are integral to the continuity of treatment needed to ensure optimal outcomes for individual and public health. (Author's abstract)
Affiliation :
National Drug and Alcohol Research Centre, University of New South Wales, Sydney 2052 ; k.dolan@unsw.edu.au
Australie. Australia.
Australie. Australia.