Nine-year follow-up of 86 consecutive patients treated with methadone in general practice, Sydney, Australia

FRANÇAIS :
De moyenne d'âge 29 ans, les patients suivis étaient héroïnomanes depuis 8,5 (+ ou - 5,1) années en 1987/1988. En 1996, 41% des patients suivis continuaient leur traitement par la méthadone. 36% avaient effectué un sevrage d'opiacés (y compris la méthadone) depuis un intervalle de 3 à 36 mois, le tiers ayant repris la méthadone après une longue abstinence. 9% des patients étaient morts, dont la moitié par overdose. 6% de ceux qui avaient arrêté leur traitement avaient rechuté et consommaient de l'héroïne, 8% ont été perdus de vue. Le résultat intéressant réside dans le fait que 56% de l'échantillon d'origine allait bien après 9 ans.
ENGLISH :
The status of 86 consecutive heroin addicted patients who presented for methadone treatment to an inner-city Sydney general practice in 1987 and 1988 was sought in 1996, using patients' files and official records; follow-up information was obtained for 79 patients (92%) after a mean period of 8.6 + 0.5 years. The mean age at intake was 29 years, patients having used heroin for a mean of 8.5+ 5.1 years (range 1-25). By 1996, 35 (41%) of the S6 patients had remained in continuous treatment. Successful withdrawal from opioids including methadone for it period of 3 months or more was reported by 31 patients (36%) for a mean of 36 months (range 3-84) with 10 of these returning to methadone treatment after prolonged periods of abstinence. Eight patients (9%) died, four from drug overdose. Five patients (6%) who had left treatment were reportedly using street heroin. Seven patients (8%) could not be traced. The most conservative interpretation of these patients' reports is that 56% of the original 86 were well and functional at follow-up. The most optimistic interpretation was that 81% of patients were doing well 9 years later. This study confirms the benefits of methadone maintenance while also demonstrating the serious nature of heroin (Author's abstract.)