Comparing drug-related hospital morbidity following heroin dependence treatment with methadone maintenance or naltrexone implantation.

Comparing drug-related hospital morbidity following heroin dependence treatment with methadone maintenance or naltrexone implantation. Research Abstract Details 

Research Abstract Table of Contents

Jump to the:

Comparing drug-related hospital morbidity following heroin dependence treatment with methadone maintenance or naltrexone implantation. Abstract Text:

CONTEXT: Most research on heroin dependence treatments assesses short-term changes in patients' self-reported drug use. To our knowledge, long-term sustainability of changes in patients' drug use and associated hospital morbidity posttreatment have not been studied. OBJECTIVES: To evaluate drug-related hospital morbidity in heroin users at 6 months and 3(1/2) years after receiving naltrexone implant treatment and to compare these results with outcomes from a similar cohort treated with methadone maintenance treatment. DESIGN: Retrospective longitudinal follow-up, using data prospectively collected via a state hospital (public and private) reporting system. SETTING: Perth, Western Australia. Methadone maintenance dosage was generally dispensed daily by registered community pharmacies. Naltrexone implant treatment was performed as a day procedure at a community clinic. PARTICIPANTS: A total of 522 and 314 heroin-dependent persons (according to DSM-IV), first time treated with methadone maintenance or a naltrexone implant, respectively, between January 1, 2001, and December 30, 2002, were identified, using health record linkage. MAIN OUTCOME MEASURES: Planned outcomes included crude hospital admission rates, adjusted changes in risks (odds ratio [OR]), and rates (rate ratio) of "overdose-related" and "non-overdose-related" hospital morbidity associated with opioid vs nonopioid drugs 6 months and 3(1/2) years posttreatment. RESULTS: Following naltrexone implant treatment, opioid-related risk decreased for overdose (OR, 0.23; 95% confidence interval [CI], 0.11-0.48) and nonoverdose (OR, 0.64; 95% CI, 0.46-0.89) conditions at 3(1/2) years. Such reductions were not observed after methadone treatment. Overdose on nonopioid drugs increased in older patients to 6 months: OR of 16.31 (95% CI, 3.07-86.53) for naltrexone and OR of 5.03 (95% CI, 1.18-21.54) for methadone. Nonoverdose (eg, dependence and withdrawal) associated with nonopioid drugs also increased for patients receiving the naltrexone implant: OR of 1.52 (95% CI, 1.04-2.23) at 3(1/2) years. In addition, there were 6 drug-related deaths: 5 after methadone maintenance and 1 after naltrexone implantation. CONCLUSIONS: Naltrexone implants, but not methadone maintenance, has long-term benefits in reducing opioid-related hospital morbidity. However, long-lasting and increased nonopioid drug-related morbidity following naltrexone implantation is particularly concerning. Similar studies are required to confirm these findings.

Comparing drug-related hospital morbidity following heroin dependence treatment with methadone maintenance or naltrexone implantation. Publishing Authors By Initials

For similar abstracts research abstracts see: abstracts research

PUBMED ID PMID:

MEDLINE DATE:

Comparing drug-related hospital morbidity following heroin dependence treatment with methadone maintenance or naltrexone implantation. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Archives of general psychiatry

VOLUME: 65

Page Numbers: 457-65

Journal Abbreviation: Arch. Gen. Psychiatry

ISSN: 1538-3636

DAY: 8

MONTH: Apr

YEAR: 2008

Comparing drug-related hospital morbidity following heroin dependence treatment with methadone maintenance or naltrexone implantation. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 372435

Comparing drug-related hospital morbidity following heroin dependence treatment with methadone maintenance or naltrexone implantation. Keywords Mesh Terms:

KEYWORDS:

MESH TERMS:

Chemical & Substance for Abstract: Comparing drug-related hospital morbidity following heroin dependence treatment with methadone maintenance or naltrexone implantation. Information

Substance Name:

Registry Number:

Grant and Affiliation Information for Comparing drug-related hospital morbidity following heroin dependence treatment with methadone maintenance or naltrexone implantation.

AFFILIATION: BSc(Hons), School of Psychiatry and Clinical Neurosciences, University of Western Australia. hanh.ngo@uwa.edu.au.

Country: United States

AGENCY:

GRANT:

ACRONYM:

MEDLINETA: Arch Gen Psychiatry

REFSOURCE:

DATABASENAME:

ACCESSION NUMBER:

Number Hits: 0

Comparing drug-related hospital morbidity following heroin dependence treatment with methadone maintenance or naltrexone implantation Related Publications

• A comparison of mental health hospital admissions in a cohort of heroin users prior to and after rapid opiate detoxification and oral naltrexone maintenance.
• Blood naltrexone levels over time following naltrexone implant.
• Comparing drug-related hospital morbidity following heroin dependence treatment with methadone maintenance or naltrexone implantation.
• Emergency psychotherapy in general practice; the doctor and the patient; general psychotherapeutic considerations.
• Gasteric erosions: a terminal phenomenon in starved an in aged mice.
• Group psychotherapy with soldiers and veterans.
• Health Officers' Exchange: Sketch Mapping for Public Health Problems.
• Mortality in heroin users 3 years after naltrexone implant or methadone maintenance treatment.
• Mucocutaneous lymph node syndrome.
• Primary renal neoplasms.
• Role of the hospital in primary paediatric care.
• Sustained-release naltrexone: novel treatment for opioid dependence.
• The effect of streptomycin on eighth nerve function.
• [Not Available.]