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Cohort study
Mortality is reduced while on opiate maintenance treatment, but there is a temporary increase in mortality immediately after starting and stopping treatment, a finding that may vary by setting
  1. Thomas Clausen
  1. Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
  1. Correspondence to Thomas Clausen
    SERAF, Norwegian Centre for Addiction Research, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway; thomas.clausen{at}medisin.uio.no

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Context

The absolute risk of overdose varies considerably across different regions, and characteristics of the drug users and the structure of the treatment provided may explain these observed variations. Provision of opioid maintenance treatment (OMT) has been found to be an effective strategy in reducing the risk of overdose deaths among heroin-using adults.1 However, much remains to be learned of optimal treatment delivery. Harm reduction and easy access to OMT by general practitioner (GP) prescription is one treatment model, whereas prescription from specialist OMT centres is another. The current study is novel in describing outcomes from a GP-based prescription model.

Methods

In this study, adult patients prescribed with methadone or buprenorphine between 1990 and 2005 in the UK General Practice settings made up a cohort of 5577 persons followed for mortality assessments up to 1 year after their final prescription. Persons included …

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