Cited by 288Opioid Use Disorder TreatmentSubstance Abuse Treatment and OutcomesHIV, Drug Use, Sexual Risk

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Mortality prior to, during and after opioid maintenance treatment (OMT): A national prospective cross-registry study

Clausen, Thomas, Anchersen, Katinka, Waal, Helge·2008·Drug and Alcohol Dependence

DOI 10.1016/j.drugalcdep.2007.11.003

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Abstract

Background Opioid maintenance treatment (OMT) is generally considered to reduce mortality in opiate dependents. However, the level of mortality reduction is still uncertain. This study investigates mortality reductions in an "intention-to-treat" perspective including all dropouts. The mortality reducing effects of OMT are examined both within treatment and post-treatment. The study separates overdose and total mortality reductions.Methods The study is a prospective cross-registry study with up to 7 years follow-up. All opiate dependents in Norway who applied for OMT (a total of 3789 subjects) were cross-linked with data from the death registry from Statistics Norway. Date and cause of death were crossed with dates for initiation and termination of OMT, and subjects' age and gender. A baseline was established from the waiting list mortality rate. Intention-to-treat was investigated by analysing mortality among the entire population that started OMT.Results Mortality in treatment was reduced to RR 0.5 (relative risk) compared with pre-treatment. In the "intention-to-treat" perspective, the mortality risk was reduced to RR 0.6 compared with pre-treatment. The patients who left the treatment programme showed a high-mortality rate, particularly males.Conclusions OMT significantly reduces risk of mortality also when examined in an intention-to-treat perspective. Studies that evaluate effects of OMT only in patients retained in treatment tend to overestimate benefits. Levels of overdose mortality will influence the risk reduction. Cross-registry studies as the current one are an important supplement to other observational designs in this field.

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Authors: Clausen, T., Anchersen, K., & Waal, H.
Affiliations: University of Oslo (NO)
Corresponding author: Clausen, Thomas
ORCID: Clausen, Thomas
Venue: Drug and Alcohol Dependence
Publisher: Elsevier BV
Published: 2008-04
Volume: 94
Issue: 1-3
Pages: 151-157
ISSN: 0376-8716 (ISSN-L)
DOI: 10.1016/j.drugalcdep.2007.11.003
OpenAlex: W2032728846
Cited by: 287
References: 34
Citations by year: 2026: 7 · 2025: 1 · 2024: 12 · 2023: 10 · 2022: 9 · 2021: 24 · 2020: 15 · 2019: 18 · 2018: 16 · 2017: 13 · 2016: 15 · 2015: 21 · 2014: 17 · 2013: 30 · 2012: 14
FWCI: 14.81
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Drug and Alcohol Dependence (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Keywords: opioid maintenance treatment, opioid use disorder, mortality reduction, drug overdose deaths, intention-to-treat analysis, treatment discontinuation
MeSH terms: Adult, Buprenorphine, Cross-Sectional Studies, Female, Follow-Up Studies, Humans, Male, Methadone, Opioid-Related Disorders, Narcotics, Prospective Studies, Registries, Time Factors, Drug Overdose

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Mortality prior to, during and after opioid maintenance treatment (OMT): A national prospective cross-registry study

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