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

海洛因依赖是一种与高死亡率、疾病和受伤率相关的长期状况。死亡率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、丙型肝炎和艾滋病毒等血液传播病毒并发症以及混乱的吸毒生活方式造成的其他医疗并发症。维持类阿片药物疗法是对海洛因依赖采取危害最小化方法的一部分，旨在通过在医疗监督下提供定期剂量的合法高质量类阿片，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循环。与未经治疗的海洛因依赖者相比，接受定期维持治疗的患者死亡率更低，在药物使用方面的结果也更好。然而，在美沙酮和丁丙诺啡治疗中仍然发生死亡，尽量减少死亡率是治疗方案的一个重要目标。这是一项大型的纵向研究，调查了1985年至2006年间新南威尔士州所有美沙酮和丁丙诺啡的客户，估计有44,000人。该研究特别关注了它们的死亡率。这是一个数据链接项目，因为它使用了两个现有的数据库（治疗数据库和死亡率数据库），并将每个受试者的信息结合起来，以更好地了解美沙酮和丁丙诺啡患者的生存时间，他们接受了多少维持治疗，以及客户死于什么。这是第一次对NSW所有美沙酮和丁丙诺啡接受者的死亡率进行系统的检查。这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。这将是一个重要的政策资源。

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.