Premature deaths after discharge from methadone maintenance: A replication
Premature deaths after discharge from methadone maintenance: A replication
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DOI：
10.1097/adm.0b013e318155980e
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发表时间：
2007-12-01
影响因子：
5.5
通讯作者：
Thompson, Richard
中科院分区：
文献类型：
--
作者：
Woody, George E.;Kane, Vince;Thompson, Richard
目的：检查美沙酮维持治疗出院患者的死亡率和原因，将其与出院原因联系起来，并讨论治疗意义。方法：对 2000 年 1 月 1 日至 2002 年 8 月 31 日期间接受美沙酮维持治疗的 636 名阿片类药物依赖退伍军人的死亡和死因进行自然主义研究。结果：在 456 名继续使用美沙酮的患者中，31 名（6.8%）死亡（服药过量、1 名事故、 13 肝脏 问题，16 其他医疗）。 180名出院患者中，死亡34人（18.8%）。出院原因和死亡原因为：继续吸毒（52 例），11 例死亡（4 例服药过量，4 例肝脏问题，3 例其他医疗）；其他纪律问题（N = 31），8 例死亡（2 例自杀，2 例服药过量，3 例其他医疗问题，1 例未知）；其他原因 (N = 97)，15 例死亡（2 例自杀，1 例服药过量，1 例事故，7 例肝脏问题，3 例其他医疗原因，1 例未知）。继续使用美沙酮的患者的死亡人数明显低于各类别出院患者的死亡人数 (P < 0.05)。对 146 名出院患者中的 99 名进行的后续访谈显示，他们在吸毒、医疗、就业和精神方面存在问题，并且只有 21% 的人正在接受治疗。 结论：这些发现与同一项目之前的研究以及其他研究一致，表明参与美沙酮维持治疗可降低死亡率。考虑到因继续吸毒或行为问题而出院的患者死亡率增加，这些数据表明，通过让患者继续接受治疗和/或采取措施确保出院患者立即参加另一个计划，可以降低过早死亡率。
Objective: Examine rate and causes of death among patients discharged from methadone maintenance, relate them to reasons for discharge, and discuss treatment implications.Method: Naturalistic study of deaths and causes of death among 636 opioid-dependent veterans treated with methadone maintenance between January 1, 2000 and August 31, 2002.Results: Among 456 patients who remained on methadone, 31 (6.8%) died (overdose, 1 accident, 13 liver problems, 16 other medical). Among 180 discharged patients, 34 (18.8%) died. Reasons for discharge and causes of death were: continuing drug use IN 52), 11 deaths (4 overdoses, 4 liver problems, 3 other medical); other disciplinary problems (N = 31), 8 deaths (2 suicides, 2 overdoses, 3 other medical, 1 unknown); other reasons (N = 97), 15 deaths (2 suicides, 1 overdose, 1 accident, 7 liver problems, 3 other medical, 1 unknown). Deaths were significantly less (P < 0.05) among patients who remained on methadone than in each category of those discharged. Follow-up interviews of 99 of 146 discharged patients showed problems in drug use, medical, employment, and psychiatric areas, and that only 21% were in treatment.Conclusions: These findings are consistent with a previous study from the same program, and also from other studies, showing that participating in methadone maintenance reduces mortality. Considered in light of the increased mortality among patients discharged for continuing drug use or behavioral problems, these data suggest that premature mortality can be reduced by keeping patients in treatment and/or taking steps to ensure that discharged patients are promptly enrolled in another program.