A 25-year follow-up of patients admitted to methadone treatment for the first time: Mortality and gender differences

• Published in: Addictive behaviors 2011-12, Vol.36 (12), p.1184-1190
• Main Authors: Jimenez-Treviño, Luis, Saiz, Pilar A, García-Portilla, M. Paz, Díaz-Mesa, Eva M, Sánchez-Lasheras, Fernando, Burón, Patricia, Casares, M. José, Marina, Pedro, Gutiérrez(†), Eduardo, Bobes, Julio
• Format: Article
• Language: English
• Subjects: Adult; Aged, 80 and over; Drug addiction; Female; Follow-Up Studies; Gender; Gender differences; Hepatitis B - complications; Hepatitis C - complications; Heroin addiction; Heroin Dependence - complications; Heroin Dependence - epidemiology; Heroin Dependence - mortality; Heroin Dependence - rehabilitation; HIV Infections - complications; Humans; Male; Methadone; Methadone - therapeutic use; Methadone Maintenance Therapy; Middle Aged; Mortality; Patients; Prospective Studies; Psychiatry; Sex Factors; Spain - epidemiology; Substance abuse treatment; Treatment Outcome
• ISSN: 0306-4603; 1873-6327
• DOI: 10.1016/j.addbeh.2011.07.019

Abstract Introduction We conducted a follow-up study to evaluate the outcome of a heroin-dependent population 25 years after their first enrollment in methadone maintenance treatment (MMT). We assessed mortality in the sample plus actual drug use, treatment, and medical factors associated with drug dependence, focusing on possible gender differences. Methods Prospective follow-up study of 214 heroin-dependent patients consecutively admitted for MMT between 1980 and 1984 in the Asturias Public Health Service. The standardized mortality ratio (SMR) and 95% confidence interval (CI) were calculated. An ad-hoc protocol on drug misuse and treatment, drug-related morbidity and Clinical Global Impression (CGI) scores were assessed in the survivors' sample. Results Information was received on 159 subjects, 106 of whom were deceased. Men accounted for 76.2% of the study cohort. Over the 25-year follow-up period, the SMR was 22.51 (95% CI = 22.37–22.64). In the survivors sample, 39.6% were still enrolled in MMT; human immunodeficiency virus (HIV) was diagnosed in 47.2% and hepatitis B/C in 81.1%; current heroin use was reported by 22.6%. There were no gender differences in mortality or HIV and hepatitis B/C status. None of the female survivors were using heroin at the 25-year follow-up compared with 31.1% of males. Conclusions This study confirms the high mortality of heroin addicts even after enrollment in MMT. Severity of the addiction in terms of mortality was similar in both genders. Women who survived the 25-year follow-up were more likely to have stopped using heroin than men.