15-Year survival and retention of patients in a general hospital-affiliated methadone maintenance treatment (MMT) center in Israel
Abstract We have extended our previous 10-year follow-up study of MMT retention for another 5 years and added data on survival of all patients ever admitted to our MMT clinic (6/1993 to 6/2007). Data were calculated from admission to MMT until leaving, death, or study closure (6/2008). Ninety-four o...
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| Veröffentlicht in: | Drug and alcohol dependence 2010-03, Vol.107 (2), p.141-148 |
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| creator | Peles, Einat Schreiber, Shaul Adelson, Miriam |
| description | Abstract We have extended our previous 10-year follow-up study of MMT retention for another 5 years and added data on survival of all patients ever admitted to our MMT clinic (6/1993 to 6/2007). Data were calculated from admission to MMT until leaving, death, or study closure (6/2008). Ninety-four of a total of 613 patients (4711.6 person-years [py]) died. Cancer was the primary cause of death for those who remained in treatment, and overdose for those who left MMT. Longer survival ( p = 0.051) with a trend for a lower mortality rate ( p = 0.08) was noted among the 464 patients who stayed in treatment ≥1 year (1.8/100 py), compared with the 149 patients who left MMT |
| doi_str_mv | 10.1016/j.drugalcdep.2009.09.013 |
| format | Article |
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Data were calculated from admission to MMT until leaving, death, or study closure (6/2008). Ninety-four of a total of 613 patients (4711.6 person-years [py]) died. Cancer was the primary cause of death for those who remained in treatment, and overdose for those who left MMT. Longer survival ( p = 0.051) with a trend for a lower mortality rate ( p = 0.08) was noted among the 464 patients who stayed in treatment ≥1 year (1.8/100 py), compared with the 149 patients who left MMT <1 year (2.6/100 py). Predictors of survival in multivariate analyses were younger age (<40 years) at admission, living with a spouse/partner, being hepatitis B sera-negative, not abusing benzodiazepines on admission (interaction effect), not being referred directly from hospitalization to MMT, and not leaving the MMT program for hospitalization. The two latter variables also predicted longer retention, as did a high methadone dose (≥100 mg/d), no opiate and, no benzodiazepine abuse after 1 year and either having any DSM-IV-TR Axis I, or no Axis I&II psychiatric diagnoses. Unlike retention, mortality was associated with pre-treatment severity and comorbidities thus only partially reflects MMT outcome (opiate abstinence and treatment success). Benzodiazepine abuse reduced both retention and survival, emphasizing the high priority that should be given to stopping it.</description><identifier>ISSN: 0376-8716</identifier><identifier>EISSN: 1879-0046</identifier><identifier>DOI: 10.1016/j.drugalcdep.2009.09.013</identifier><identifier>PMID: 19914783</identifier><identifier>CODEN: DADEDV</identifier><language>eng</language><publisher>Shannon: Elsevier Ireland Ltd</publisher><subject>Addictive behaviors ; Adolescent ; Adult ; Adult and adolescent clinical studies ; Age Factors ; Aged ; Anti-Anxiety Agents - administration & dosage ; Anti-Anxiety Agents - adverse effects ; Benzodiazepine ; Benzodiazepines ; Benzodiazepines - administration & dosage ; Benzodiazepines - adverse effects ; Biological and medical sciences ; Cause of death ; Death ; Drug addiction ; Female ; Follow-Up Studies ; Hospitalization ; Humans ; Israel ; Male ; Medical sciences ; Methadone ; Methadone - administration & dosage ; Methadone - therapeutic use ; Methadone maintenance treatment ; Middle Aged ; Miscellaneous ; Multivariate Analysis ; Narcotics - administration & dosage ; Narcotics - therapeutic use ; Opiate abuse ; Opiates ; Opioid-Related Disorders - mortality ; Opioid-Related Disorders - rehabilitation ; Opioid-Related Disorders - therapy ; Patient Compliance ; Psychiatry ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Retention ; Retention (Psychology) ; Severity of Illness Index ; Substance Abuse Treatment Centers ; Substance-Related Disorders - mortality ; Substance-Related Disorders - rehabilitation ; Substance-Related Disorders - therapy ; Survival ; Treatment Outcome ; Young Adult</subject><ispartof>Drug and alcohol dependence, 2010-03, Vol.107 (2), p.141-148</ispartof><rights>Elsevier Ireland Ltd</rights><rights>2009 Elsevier Ireland Ltd</rights><rights>2015 INIST-CNRS</rights><rights>Copyright 2009 Elsevier Ireland Ltd. 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Data were calculated from admission to MMT until leaving, death, or study closure (6/2008). Ninety-four of a total of 613 patients (4711.6 person-years [py]) died. Cancer was the primary cause of death for those who remained in treatment, and overdose for those who left MMT. Longer survival ( p = 0.051) with a trend for a lower mortality rate ( p = 0.08) was noted among the 464 patients who stayed in treatment ≥1 year (1.8/100 py), compared with the 149 patients who left MMT <1 year (2.6/100 py). Predictors of survival in multivariate analyses were younger age (<40 years) at admission, living with a spouse/partner, being hepatitis B sera-negative, not abusing benzodiazepines on admission (interaction effect), not being referred directly from hospitalization to MMT, and not leaving the MMT program for hospitalization. The two latter variables also predicted longer retention, as did a high methadone dose (≥100 mg/d), no opiate and, no benzodiazepine abuse after 1 year and either having any DSM-IV-TR Axis I, or no Axis I&II psychiatric diagnoses. Unlike retention, mortality was associated with pre-treatment severity and comorbidities thus only partially reflects MMT outcome (opiate abstinence and treatment success). Benzodiazepine abuse reduced both retention and survival, emphasizing the high priority that should be given to stopping it.</description><subject>Addictive behaviors</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Adult and adolescent clinical studies</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Anti-Anxiety Agents - administration & dosage</subject><subject>Anti-Anxiety Agents - adverse effects</subject><subject>Benzodiazepine</subject><subject>Benzodiazepines</subject><subject>Benzodiazepines - administration & dosage</subject><subject>Benzodiazepines - adverse effects</subject><subject>Biological and medical sciences</subject><subject>Cause of death</subject><subject>Death</subject><subject>Drug addiction</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Israel</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Methadone</subject><subject>Methadone - administration & dosage</subject><subject>Methadone - therapeutic use</subject><subject>Methadone maintenance treatment</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Multivariate Analysis</subject><subject>Narcotics - administration & dosage</subject><subject>Narcotics - therapeutic use</subject><subject>Opiate abuse</subject><subject>Opiates</subject><subject>Opioid-Related Disorders - mortality</subject><subject>Opioid-Related Disorders - rehabilitation</subject><subject>Opioid-Related Disorders - therapy</subject><subject>Patient Compliance</subject><subject>Psychiatry</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Retention</subject><subject>Retention (Psychology)</subject><subject>Severity of Illness Index</subject><subject>Substance Abuse Treatment Centers</subject><subject>Substance-Related Disorders - mortality</subject><subject>Substance-Related Disorders - rehabilitation</subject><subject>Substance-Related Disorders - therapy</subject><subject>Survival</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0376-8716</issn><issn>1879-0046</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqNkk2LFDEQhoMo7uzoX5Bc1PXQYz76KxdBFz8WdvHgevAUatKV3Yzd6d4kPbBXf7lpZnDBgxgKksBTbxX1FiGUsw1nvH6723RhvoHedDhtBGNqswSXj8iKt40qGCvrx2TFZFMXbcPrE3Ia447lUyv2lJxwpXjZtHJFfvGq-IEQaJzD3u2hp-A7GjChT270dLR0guTyL1LnKdAb9BgydjvGySXoC7DW9Q4SdnTAdAvd6JEO4HyWAG-QpoCQhqxAz66urt9Qk58YFrWLGAD7Z-SJhT7i8-O9Jt8_fbw-_1Jcfv18cf7-sjBlq1JRdRWreCulRdm0FVjZVFDKkpdMtI3dbs0WpRGlRa6EqBtumehay0CJKgNGrsnrg-4UxrsZY9KDiwb7HjyOc9SNlFm_bcpMvvonWWW0lKrOYHsATRhjDGj1FNwA4V5zphen9E4_OKUXp_QSXObUF8ca83bA7iHxaE0GXh4BiAZ6G_IwXfzDCVHxUuRO1uTDgcM8u73DoKPJfhnsXECTdDe6_-nm3V8ipnfe5bo_8R7jbpyDz95orqPQTH9bNmtZLKYYkyor_AY2dMvc</recordid><startdate>20100301</startdate><enddate>20100301</enddate><creator>Peles, Einat</creator><creator>Schreiber, Shaul</creator><creator>Adelson, Miriam</creator><general>Elsevier Ireland Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7X8</scope></search><sort><creationdate>20100301</creationdate><title>15-Year survival and retention of patients in a general hospital-affiliated methadone maintenance treatment (MMT) center in Israel</title><author>Peles, Einat ; Schreiber, Shaul ; Adelson, Miriam</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c489t-5d5051833fe3785af375a434140287fbbcbe3c24fe1922671f02d8f0a925287c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Addictive behaviors</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Adult and adolescent clinical studies</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Anti-Anxiety Agents - administration & dosage</topic><topic>Anti-Anxiety Agents - adverse effects</topic><topic>Benzodiazepine</topic><topic>Benzodiazepines</topic><topic>Benzodiazepines - administration & dosage</topic><topic>Benzodiazepines - adverse effects</topic><topic>Biological and medical sciences</topic><topic>Cause of death</topic><topic>Death</topic><topic>Drug addiction</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Israel</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Methadone</topic><topic>Methadone - administration & dosage</topic><topic>Methadone - therapeutic use</topic><topic>Methadone maintenance treatment</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Multivariate Analysis</topic><topic>Narcotics - administration & dosage</topic><topic>Narcotics - therapeutic use</topic><topic>Opiate abuse</topic><topic>Opiates</topic><topic>Opioid-Related Disorders - mortality</topic><topic>Opioid-Related Disorders - rehabilitation</topic><topic>Opioid-Related Disorders - therapy</topic><topic>Patient Compliance</topic><topic>Psychiatry</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Retention</topic><topic>Retention (Psychology)</topic><topic>Severity of Illness Index</topic><topic>Substance Abuse Treatment Centers</topic><topic>Substance-Related Disorders - mortality</topic><topic>Substance-Related Disorders - rehabilitation</topic><topic>Substance-Related Disorders - therapy</topic><topic>Survival</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Peles, Einat</creatorcontrib><creatorcontrib>Schreiber, Shaul</creatorcontrib><creatorcontrib>Adelson, Miriam</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>MEDLINE - Academic</collection><jtitle>Drug and alcohol dependence</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Peles, Einat</au><au>Schreiber, Shaul</au><au>Adelson, Miriam</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>15-Year survival and retention of patients in a general hospital-affiliated methadone maintenance treatment (MMT) center in Israel</atitle><jtitle>Drug and alcohol dependence</jtitle><addtitle>Drug Alcohol Depend</addtitle><date>2010-03-01</date><risdate>2010</risdate><volume>107</volume><issue>2</issue><spage>141</spage><epage>148</epage><pages>141-148</pages><issn>0376-8716</issn><eissn>1879-0046</eissn><coden>DADEDV</coden><abstract>Abstract We have extended our previous 10-year follow-up study of MMT retention for another 5 years and added data on survival of all patients ever admitted to our MMT clinic (6/1993 to 6/2007). Data were calculated from admission to MMT until leaving, death, or study closure (6/2008). Ninety-four of a total of 613 patients (4711.6 person-years [py]) died. Cancer was the primary cause of death for those who remained in treatment, and overdose for those who left MMT. Longer survival ( p = 0.051) with a trend for a lower mortality rate ( p = 0.08) was noted among the 464 patients who stayed in treatment ≥1 year (1.8/100 py), compared with the 149 patients who left MMT <1 year (2.6/100 py). Predictors of survival in multivariate analyses were younger age (<40 years) at admission, living with a spouse/partner, being hepatitis B sera-negative, not abusing benzodiazepines on admission (interaction effect), not being referred directly from hospitalization to MMT, and not leaving the MMT program for hospitalization. The two latter variables also predicted longer retention, as did a high methadone dose (≥100 mg/d), no opiate and, no benzodiazepine abuse after 1 year and either having any DSM-IV-TR Axis I, or no Axis I&II psychiatric diagnoses. Unlike retention, mortality was associated with pre-treatment severity and comorbidities thus only partially reflects MMT outcome (opiate abstinence and treatment success). Benzodiazepine abuse reduced both retention and survival, emphasizing the high priority that should be given to stopping it.</abstract><cop>Shannon</cop><pub>Elsevier Ireland Ltd</pub><pmid>19914783</pmid><doi>10.1016/j.drugalcdep.2009.09.013</doi><tpages>8</tpages></addata></record> |
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| ispartof | Drug and alcohol dependence, 2010-03, Vol.107 (2), p.141-148 |
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| subjects | Addictive behaviors Adolescent Adult Adult and adolescent clinical studies Age Factors Aged Anti-Anxiety Agents - administration & dosage Anti-Anxiety Agents - adverse effects Benzodiazepine Benzodiazepines Benzodiazepines - administration & dosage Benzodiazepines - adverse effects Biological and medical sciences Cause of death Death Drug addiction Female Follow-Up Studies Hospitalization Humans Israel Male Medical sciences Methadone Methadone - administration & dosage Methadone - therapeutic use Methadone maintenance treatment Middle Aged Miscellaneous Multivariate Analysis Narcotics - administration & dosage Narcotics - therapeutic use Opiate abuse Opiates Opioid-Related Disorders - mortality Opioid-Related Disorders - rehabilitation Opioid-Related Disorders - therapy Patient Compliance Psychiatry Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Public health. Hygiene Public health. Hygiene-occupational medicine Retention Retention (Psychology) Severity of Illness Index Substance Abuse Treatment Centers Substance-Related Disorders - mortality Substance-Related Disorders - rehabilitation Substance-Related Disorders - therapy Survival Treatment Outcome Young Adult |
| title | 15-Year survival and retention of patients in a general hospital-affiliated methadone maintenance treatment (MMT) center in Israel |
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