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STUDY 2013 HTM file
Increased somatic morbidity in the first year after leaving opioid maintenance treatment: results from a Norwegian cohort study
From Norway, strong evidence that being in a methadone or buprenorphine maintenance programme protects heroin-dependent patients from drug-related ill-health including life-threatening overdoses and infections, even if the treatment has not completely subdued illegal drug use.
DOCUMENT 2014 HTM file
Time limiting opioid substitution therapy
Rather than being ‘parked’ on methadone, generally Britain’s heroin-addicted patients leave too soon to fully benefit, argue official government advisers on drug policy. Their report unambiguously countered concerns within the current UK government over methadone maintenance.
STUDY 2010 HTM file
Were the changes to Sweden’s maintenance treatment policy 2000–06 related to changes in opiate-related mortality and morbidity?
Ironically, the fact that opiate substitute prescribing has been opposed and limited in Sweden has meant that country has been able provide solid evidence of its lifesaving potential. This study concluded that easing the restrictions was associated with and may have led to fewer opiate-related deaths.
REVIEW 2012 HTM file
Opiate substitution treatment and HIV transmission in people who inject drugs: systematic review and meta-analysis
The first study to synthesise the relevant evidence adds weight to the conclusion that methadone programmes protect dependent opiate injectors against HIV infection, and that the evidence in their favour is more convincing than for alternative types of treatments.
STUDY 2015 HTM file
Estimation of life expectancy and the expected years of life lost among heroin users in the era of opioid substitution treatment (OST) in Taiwan
After adjusting for other influences, heroin users diagnosed as dependent at a psychiatric centre in Taiwan who started opioid substitution treatment lived nearly eight years longer than those who did not enter treatment. However, the treated group were more likely to commit suicide, usually associated with a history of depression.
STUDY 2015 HTM file
Risk of mortality on and off methadone substitution treatment in primary care: a national cohort study
Primary care methadone patients in Ireland were nearly four times more likely to die during periods out of treatment; the first few weeks after leaving were the peak risk period. The study’s support for unbroken, long-term treatment runs counter to recent UK government policy.
REVIEW 2017 HTM file
Supervised dosing with a long-acting opioid medication in the management of opioid dependence
Trials challenge the need for the widely accepted policy of making opioid-dependent patients take their methadone or other opioid substitutes at the clinic or pharmacy, but ‘no difference’ findings may be due to the limitations of the research.
A randomised trial conducted in England found that the (at the time) recommended three months of supervised consumption of prescribed opioid substitutes like methadone conferred no significant advantages over supervising only for up to the first four weeks of treatment, but the findings applied only to the minority of patients for whom random allocation was thought feasible and safe.
In everyday practice at methadone maintenance clinics and with the full range of patients, does implementing clinical guidelines lead to better outcomes for patients? Two sets of US clinics selected for high versus low adherence to guidelines provided evidence that the recommended high doses and intensive psychosocial services really do make the intended difference.
STUDY 2019 HTM file
Criminal justice outcomes over 5 years after randomization to buprenorphine-naloxone or methadone treatment for opioid use disorder
Can a limited period of being prescribed opiate-type medications generate longer term reductions in the criminal behaviour of patients dependent on illegal opiates like heroin? And of the two main medications – buprenorphine and methadone – which performs best? It seems a key factor is how well they retain patients in treatment.
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