Predictors of opioid-related death during methadone therapy

Published: April 15, 2015
Category: Bibliography > Papers
Authors: Cavacuiti C, Gomes T, Juurlink DN, Kahan M, Leece P, Luo J, Macdonald EM, Mamdani MM, Srivastava A, Steele L
Countries: Canada
Language: null
Types: Population Health
Settings: Hospital, PCP

J Subst Abuse Treat 57:30-35.

University of Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; St. Michael’s Hospital, Toronto, ON, Canada; St. Joseph’s Health Centre, Toronto, ON, Canada; King Saud University, Riyadh, Saudi Arabia; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Sunnybrook Research Institute, Toronto, ON, Canada

We aimed to examine pharmacologic, demographic and medical comorbidity risk factors for opioid-related mortality among patients currently receiving methadone for an opioid use disorder. We conducted a population-based, nested case-control study linking healthcare and coroner’s records in Ontario, Canada, from January 31, 1994 to December 31, 2010. We included social assistance recipients receiving methadone for an opioid use disorder. Within this group, cases were those who died of opioid-related causes. For each case, we identified up to 5 controls matched on calendar quarter. The primary analysis examined the association between use of psychotropic drugs (benzodiazepines, antidepressants or antipsychotics) and opioid-related mortality. Secondary analyses examined the associations between baseline characteristics, health service utilization, comorbidities and opioid-related mortality. Among 43,545 patients receiving methadone for an opioid use disorder, we identified 175 (0.4%) opioid-related deaths, along with 873 matched controls. Psychotropic drug use was associated with a two fold increased risk of opioid-related death (adjusted odds ratio (OR) 2.0; 95% confidence interval (CI) 1.2 to 3.5). Specifically, benzodiazepines (adjusted OR 1.6; 95% CI 1.1 to 2.5) and antipsychotics (adjusted OR 2.3; 95% CI 1.5 to 3.5) were independently associated with opioid-related death. Other associated factors included chronic lung disease (adjusted OR 1.7; 95% CI 1.2 to 2.6), an alcohol use disorder (adjusted OR 1.9; 95% CI 1.2 to 3.2), mood disorders (adjusted OR 1.8; 95% CI 1.0 to 3.2), and a history of heart disease (adjusted OR 5.3; 95% CI 2.0 to 14.0). Psychotropic drug use is associated with opioid-related death in patients receiving methadone. Mindfulness of these factors may reduce the risk of death among methadone recipients.

PMID: 26014916

Canada,Comorbidity,Targeted Program,High Risk,Population Markers,Adult,Case-Control Studies,Gender,Middle Aged,Ontario/epidemiology,Risk Factors

Please log in/register to access.

Log in/Register

LinkedIn Facebook Twitter

© The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System.
All rights reserved. Terms of Use Privacy Statement

Back to top