Historique
Périodique
Mortality associated with New South Wales methadone programs in 1994: lives lost and saved
(Mortalité associée aux programmes méthadone du nouveau pays de Galles en 1994 : combien de vie sauvées ?)
Auteur(s) :
J. R. M. CAPLEHORN ;
O. H. DRUMMER
Article en page(s) :
104-109
Refs biblio. :
31
Domaine :
Drogues illicites / Illicit drugs
Langue(s) :
Français
Discipline :
EPI (Epidémiologie / Epidemiology)
Thésaurus mots-clés
METHADONE
;
ADDICTION
;
MORTALITE
;
TRAITEMENT DE MAINTENANCE
;
TOXICITE
;
EPIDEMIOLOGIE
;
ETUDE TRANSVERSALE
Thésaurus géographique
AUSTRALIE
Note générale :
Medical Journal of Australia, 1999, 170, (3), 104-109
Note de contenu :
tabl.
Résumé :
ENGLISH :
OBJECTIVES: To estimate the effects of methadone programs in New South Wales on mortality. DESIGN AND CASES: Retrospective, cross-sectional study of all 1994 New South Wales coronial cases in which methadone was detected in postmortem specimens taken from the deceased. Cases were people we identified as patients in NSW methadone maintenance programs or those whose deaths involved methadone syrup diverted from maintenance programs. OUTCOME MEASURES: Relative risks of fatal, accidental drug toxicity in the first two weeks of treatment and later; the number of lives lost as a result of maintenance treatment; preadmission risks and the number of lives saved by maintenance programs, calculated from data from a previous study. RESULTS: There was very close agreement between this study's classifications and official pathology reports of accidental drug toxicity. The relative risk (RR) of fatal accidental drug toxicity for patients in the first two weeks of methadone maintenance was 6.7 times that of heroin addicts not in treatment (95% CI RR, 3.3-13.9) and 97.8 times that of patients who had been in maintenance more than two weeks (95% CI RR, 36.7-260.5). Despite 10 people dying from iatrogenic methadone toxicity and diverted methadone syrup being involved in 26 fatalities. In 1994, NSW maintenance programs are estimated to have saved 68 lives (adjusted 95% CI, 29-128). CONCLUSIONS: In 1994, untoward events associated with NSW methadone programs cost 36 lives in NSW. To reduce this mortality, doctors should carefully assess and closely monitor patients being admitted to methadone maintenance and limit the use of takeaway doses of methadone.
ENGLISH :
OBJECTIVES: To estimate the effects of methadone programs in New South Wales on mortality. DESIGN AND CASES: Retrospective, cross-sectional study of all 1994 New South Wales coronial cases in which methadone was detected in postmortem specimens taken from the deceased. Cases were people we identified as patients in NSW methadone maintenance programs or those whose deaths involved methadone syrup diverted from maintenance programs. OUTCOME MEASURES: Relative risks of fatal, accidental drug toxicity in the first two weeks of treatment and later; the number of lives lost as a result of maintenance treatment; preadmission risks and the number of lives saved by maintenance programs, calculated from data from a previous study. RESULTS: There was very close agreement between this study's classifications and official pathology reports of accidental drug toxicity. The relative risk (RR) of fatal accidental drug toxicity for patients in the first two weeks of methadone maintenance was 6.7 times that of heroin addicts not in treatment (95% CI RR, 3.3-13.9) and 97.8 times that of patients who had been in maintenance more than two weeks (95% CI RR, 36.7-260.5). Despite 10 people dying from iatrogenic methadone toxicity and diverted methadone syrup being involved in 26 fatalities. In 1994, NSW maintenance programs are estimated to have saved 68 lives (adjusted 95% CI, 29-128). CONCLUSIONS: In 1994, untoward events associated with NSW methadone programs cost 36 lives in NSW. To reduce this mortality, doctors should carefully assess and closely monitor patients being admitted to methadone maintenance and limit the use of takeaway doses of methadone.
Affiliation :
Australie. Australia.
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