Four-year follow-up of imprisoned male heroin users and methadone treatment: mortality, re-incarceration and hepatitis C infection

ABSTRACT Aims To examine the long‐term impact of methadone maintenance treatment (MMT) on mortality, re‐incarceration and hepatitis C seroconversion in imprisoned male heroin users. Design, setting and participants The study cohort comprised 382 imprisoned male heroin users who had participated in a randomized controlled trial of prison‐based MMT in 1997/98. Subjects were followed‐up between 1998 and 2002 either in the general community or in prison. Measurements All‐cause mortality, re‐incarceration, hepatitis C and HIV serostatus and MMT retention. Findings There were no deaths recorded while subjects were enrolled in MMT. Seventeen subjects died while out of MMT, representing an untreated mortality rate of 2.0 per 100 person‐years (95% CI, 1.2–3.2). Re‐incarceration risk was lowest during MMT episodes of 8 months or longer (adjusted hazard ratio 0.3 (95% CI, 0.2–0.5; P