Survival study of opioid addicts in relation to its adherence to methadone maintenance treatment

Objectives: To study the putative role of methadone maintenance treatment in the improvement of life expectancy of opioid addicts. Design: Retrospective longitudinal study. Participants: All 1487 patients receiving methadone maintenance treatment in Alicante between June 1990 and December 1997. Statistical analysis: Mortality rates were studied using Kaplan-Meier survival curves. Protection or risk factors were analyzed using Cox's proportional hazards model. Results: Mortality rates decreased from 87/1000 in 1991 to 17/1000 in 1997. The following factors influenced mortality: HIV infection [Hazard Ratio (HR) = 7, 95% confidence interval (CI) = 4-12]; current methadone status (HR = 3.2, 95%CI 1.5-7.1) and MMT retention (retained vs. dropout, HR = 0.5, 95%CI = 0.2-1.1; re-enrolled vs. drop-out, HR = 0.3, 95%CI = 0.2-0.5). Conclusion: Expediting entry and re-enrolling in methadone maintenance treatment improves survival. (C) 2003 Elsevier Science Ireland Ltd. All rights reserved.