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The impact of harm-reduction-based methadone treatment on mortality among heroin users

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  • Langendam, M.W.
  • Van Brussel, G.H.A.
  • Coutinho, R.A.
  • Van Ameijden, E.J.C.

Abstract

Objectives: The purpose of this study was to investigate the impact of harm-reduction-based methadone programs on mortality among heroin users. Methods: A prospective cohort investigation was conducted among 827 participants in the Amsterdam Cohort Study. Poisson regression was used to identify methadone maintenance treatment characteristics (dosage, frequency of program attendance, and type of program) that are significantly and independently associated with mortality due to natural causes and overdose. Results: From 1985 to 1996, 89 participants died of natural causes, and 31 died as a result of an overdose. After adjustment for HIV and underweight status, there was an increase in natural-cause mortality among subjects who left methadone treatment (relative risk [RR] = 2.38, 95% confidence interval [CI] = 1.28, 4.55). Leaving treatment was also related to higher overdose mortality, but only among injection drug users (RR = 4.55, 95% CI = 1.89, 10.00). Conclusions: Harm-reduction-based methadone treatment, in which the use of illicit drugs is tolerated, is strongly related to decreased mortality from natural causes and from overdoses. Provision of methadone in itself, together with social-medical care, appears more important than the actual methadone dosage.

Suggested Citation

  • Langendam, M.W. & Van Brussel, G.H.A. & Coutinho, R.A. & Van Ameijden, E.J.C., 2001. "The impact of harm-reduction-based methadone treatment on mortality among heroin users," American Journal of Public Health, American Public Health Association, vol. 91(5), pages 774-780.
    • Handle: RePEc:aph:ajpbhl:2001:91:5:774-780_3
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    Cited by:

    1. Nickolas D. Zaller & Alexander R. Bazazi & Lavinia Velazquez & Josiah D. Rich, 2009. "Attitudes toward Methadone among Out-of-Treatment Minority Injection Drug Users: Implications for Health Disparities," IJERPH, MDPI, vol. 6(2), pages 1-11, February.
    2. Alain Origer & Etienne Le Bihan & Michèle Baumann, 2015. "A Social Gradient in Fatal Opioids and Cocaine Related Overdoses?," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-10, May.
    3. Suzan M. Walters & Weiwei Liu & Phoebe Lamuda & Jimi Huh & Russell Brewer & O’Dell Johnson & Ricky N. Bluthenthal & Bruce Taylor & John A. Schneider, 2023. "A National Portrait of Public Attitudes toward Opioid Use in the US: A Latent Class Analysis," IJERPH, MDPI, vol. 20(5), pages 1-16, March.

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