Ageing opioid users’ increased risk of methadone-specific death in the UK

International Journal of Drug Policy

Publications

Ageing opioid users’ increased risk of methadone-specific death in the UK

12 June 2018

By Matthias Pierce, Tim Millar, J. Roy Robertson, Sheila M. Bird

What is known already

•The first evidence that the hazard ratio (HR) for methadone-specific death rises more steeply with age-group than for all drug-related deaths (DRDs) came from Scotland’s cohort of 33,000 methadone-prescription clients. We aim to examine, for England, whether illicit opioid users’ risk of methadone-specific death increases with age; and to pool age-related HRs for methadone-specific deaths with those for Scotland’s methadone-prescription clients.

• Despite harm reduction measures, such as opioid substitution therapy, UK’s DRDs have increased markedly in the past decade, in a strongly age-related manner.

• One powerful record-linkage study on Scotland’s methadone-prescription clients in 2009–2013 has shown that their adjusted hazard ratios for methadone-specific DRD increased sharply by age-group, irrespective of gender.

What this study adds

• By analysing the opioid-specificity of deaths for England’s National Drug Treatment Monitoring System (NDTMS) cohort of nearly 130,000 opioid users who started a prescribing treatment modality, predominantly methadone, during 1 April 2005 to 31 March 2009, we confirmed that their hazard ratios for methadone-specific DRDs also increased sharply by age-group.

• Importantly, nearly half of the cohort’s person-years were aged 35+ years; and age-effects persisted after adjustment for risk-behaviours.

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