Mortality among opioid dependent persons in pharmacotherapy, NSW 1985-2006

海洛因依赖是一种与高死亡率、患病率和受伤率相关的长期状况。死亡率远远高于澳大利亚一般人口，死亡原因包括药物中毒或过量、创伤、自杀、血生病毒并发症，如丙型肝炎和艾滋病毒-艾滋病以及混乱的吸毒生活方式造成的其他医疗并发症。作为海洛因依赖的危害最小化方法的一部分，维持阿片类药物治疗寻求通过在医疗监督下提供常规剂量的法律的高质量阿片类药物来稳定混乱的海洛因使用生活方式。维持治疗使用长效阿片类药物，如美沙酮和丁丙诺啡，以提供一致的血液阿片类药物水平，使客户避免阿片类药物中毒和戒断的持续和破坏性周期。接受定期维持治疗的患者死亡率低于未经治疗的海洛因依赖者，并且在药物使用方面取得了更好的结果。然而，死亡仍然发生在美沙酮和丁丙诺啡治疗中，最大限度地降低死亡率是治疗计划的重要目标。这是一项大型纵向研究，研究对象是1985年至2006年期间所有新南威尔士州美沙酮和丁丙诺啡的客户，估计有44，000人。特别是，这项研究着眼于他们的死亡率。这是一个数据连接项目，因为它使用两个现有的数据库（治疗数据库和死亡率数据库），并结合每个主题的信息，以更好地了解美沙酮和丁丙诺啡客户的生存时间，他们接受了多少维持治疗，以及客户的死亡原因。这是第一次以系统的方式检查所有新南威尔士州美沙酮和丁丙诺啡接受者的死亡率。它将使我们能够比较接受美沙酮和丁丙诺啡治疗的受试者的死亡率，并观察死亡率和死亡原因随时间的变化。这将是一项重要的政策资源。

Heroin dependence is a long term condition associated with high rates of death, illness and injury. Death rates are much higher than the general Australian population and the causes of death include drug intoxication or overdose, trauma, suicide, complications from blood born viruses such as Hepatitis C and HIV-AIDS and other medical complications of a chaotic drug-using lifestyle. As a part of a harm minimisation approach to heroin dependence, maintenance opioid pharmacotherapies seek to stabilise a chaotic heroin-using lifestyle by providing a regular dose of a legal, high quality opioid under medical supervision. Maintenance treatment uses long-acting opioids such as methadone and buprenorphine to provide consistent blood opioid levels so the client avoids the constant and disruptive cycles of opioid intoxication and withdrawal. Clients in regular maintenance treatments have lower death rates than untreated heroin dependent people and better outcomes with regards to drug use. However, death still occurs in methadone and buprenorphine treatment and minimising death rates is an important goal of treatment programs. This is a large longitudinal study looking at all NSW methadone and buprenorphine clients between 1985 and 2006, an estimated 44,000 people. In particular, the study looks at their mortality. It is a data linkage project, in that it uses two existing databases (a treatment database and a mortality database) and combines the information for each subject to get a better picture of how long methadone and buprenorphine clients survive, how much maintenance treatment they have received, and what the clients die of. This is the first time the mortality of all NSW methadone and buprenorphine recipients will be examined in a systematic way. It will allow us to compare the mortality of subjects receiving methadone and buprenorphine treatments and look at changes in mortality rates and causes of death over time. This will be an important policy resource.