Serious adverse events in the Australian National Evaluation of Pharmacotherapies for Opioid Dependence (NEPOD)
AIMS: The study estimated serious adverse event (SAE) rates among entrants to pharmacotherapies for opioid dependence, during treatment and after leaving treatment. DESIGN: A longitudinal study based on data from 12 trials included in the Australian National Evaluation of Pharmacotherapies for Opioi...
| Publicado en: | Addiction Vol. 99; no. 4; pp. 450 - 461 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Apr2004
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106749112&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106749112 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09652140 AIO jtl: Addiction issn: 09652140 maglogo: Y pubinfo: dt: Apr2004 vid: 99 iid: 4 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106749112 106749112 2004099423 10.1111/j.1360-0443.2004.00654.x NLM15049745 106749112 ppf: 450 ppct: 11 formats: fmt: @attributes: type: P tig: atl: Serious adverse events in the Australian National Evaluation of Pharmacotherapies for Opioid Dependence (NEPOD) aug: au: Digiusto E Shakeshaft A Ritter A O'Brien S Mattick RP affil: National Centre in HIV Social Research UNSW, Sydney, Australia; Erol@accsoft.com.au sug: subj: Drug Therapy Adverse Effects Narcotics Substance Dependence Drug Therapy Adult Australia Buprenorphine Confidence Intervals Death Detoxification, Alternative Therapy Female Funding Source Heroin Male Methadone Naltrexone Adverse Effects Overdose Prospective Studies Human Adult: 19-44 years Female Male ab: AIMS: The study estimated serious adverse event (SAE) rates among entrants to pharmacotherapies for opioid dependence, during treatment and after leaving treatment. DESIGN: A longitudinal study based on data from 12 trials included in the Australian National Evaluation of Pharmacotherapies for Opioid Dependence (NEPOD). PARTICIPANTS AND SETTINGS: A total of 1244 heroin users and methadone patients treated in hospital, community and GP settings. Intervention Six trials included detoxification; all included treatment with methadone, buprenorphine, levo-alpha-acetyl-methadol (LAAM) or naltrexone. FINDINGS: During 394 person-years of observation, 79 SAEs of 28 types were recorded. Naltrexone participants experienced 39 overdoses per 100 person-years after leaving treatment (44% occurred within 2 weeks after stopping naltrexone). This was eight times the rate recorded among participants who left agonist treatment. Rates of all other SAEs were similar during treatment versus out of treatment, for both naltrexone-treated and agonist-treated participants. Five deaths occurred, all among participants who had left treatment, at a rate of six per 100 person-years. Total SAE rates during naltrexone and agonist treatments were similar (20, 14 per 100 person-years, respectively). Total SAE and death rates observed among participants who had left treatment were three and 19 times the corresponding rates during treatment. CONCLUSIONS: Individuals who leave pharmacotherapies for opioid dependence experience higher overdose and death rates compared with those in treatment. This may be due partly to a participant self-selection effect rather than entirely to pharmacotherapy being protective. Clinicians should alert naltrexone treatment patients in particular about heroin overdose risks. Duty of care may extend beyond cessation of dosing. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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