Do Mortality Rates Differ by Type of Pharmacotherapy for Opioid Dependence?
The risk of death from overdose associated with induction, maintenance, or discontinuation of an opioid pharmacotherapy may depend on the opioid’s mechanism of action. For example, methadone (full agonist) treatment may pose the greatest risk during treatment induction, whereas oral naltrexone (an antagonist) may be riskiest immediately after treatment is discontinued because of diminished opioid tolerance. In this study, Australian researchers analyzed coroner’s reports and various prescription data sources to estimate mortality rates possibly associated with these pharmacotherapies. • From 2000 to 2003, 1 buprenorphine-*, 32 oral naltrexone-, and 282 methadone-related deaths occurred. • The overall mortality rate associated with methadone was significantly lower than the rate associated with oral naltrexone (2.7 vs. 10.1 per 1000 treatment episodes). • The mortality rate associated with methadone treatment was 3.0 per 100 person years during the first week of treatment versus 0.34 pe
