METHADONE-MAINTENANCE AND ADDICTS RISK OF FATAL HEROIN OVERDOSE

An admission cohort of 296 Australian methadone maintenance patients w as followed over 15 years. The relative risks of death in and out of m aintenance were calculated for two age groups, 20-29 and 30-39 years. Heroin addicts in both age groups were one-quarter as likely to die wh ile receiving methadone maintenance as addicts not in treatment. This is because they were significantly less likely to die by heroin overdo se or suicide while in maintenance. Methadone maintenance had no measu rable effect on the risk of death through nonheroin overdose, violence or trauma, or natural causes. A meta-analysis showed the reduction in overall mortality was consistent with the results of cohort studies c onducted in the United States, Sweden, and Germany. The combined resul ts of the five studies again indicated that methadone maintenance redu ced addicts' risk of death to a quarter, RR 0.25 (95% CI 0.19 to 0.33) .