title: A 25-year follow-up of patients admitted to methadone treatment for the first time: mortality and gender differences.
abstract: BACKGROUND
  We conducted a follow-up study to evaluate the outcome of a heroin-dependent population 25 years after their first enrollment in methadone maintenance treatment (MMT). We assessed mortality in the sample plus actual drug use, treatment, and medical factors associated with drug dependence, focusing on possible gender differences.
  
  
  METHODS
  Prospective follow-up study of 214 heroin-dependent patients consecutively admitted for MMT between 1980 and 1984 in the Asturias Public Health Service. The standardized mortality ratio (SMR) and 95% confidence interval (CI) were calculated. An ad-hoc protocol on drug misuse and treatment, drug-related morbidity and Clinical Global Impression (CGI) scores were assessed in the survivors' sample.
  
  
  RESULTS
  Information was received on 159 subjects, 106 of whom were deceased. Men accounted for 76.2% of the study cohort. Over the 25-year follow-up period, the SMR was 22.51 (95% CI=22.37-22.64). In the survivors sample, 39.6% were still enrolled in MMT; human immunodeficiency virus (HIV) was diagnosed in 47.2% and hepatitis B/C in 81.1%; current heroin use was reported by 22.6%. There were no gender differences in mortality or HIV and hepatitis B/C status. None of the female survivors were using heroin at the 25-year follow-up compared with 31.1% of males.
  
  
  CONCLUSIONS
  This study confirms the high mortality of heroin addicts even after enrollment in MMT. Severity of the addiction in terms of mortality was similar in both genders. Women who survived the 25-year follow-up were more likely to have stopped using heroin than men.
authors.affiliation: Department of Psychiatry, University of Oviedo, c/Julian Claveria 6, 33006 Oviedo, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Jimenez-Treviño
authors.forename: Pilar A
authors.initials: PA
authors.lastname: Saiz
authors.forename: M Paz
authors.initials: MP
authors.lastname: García-Portilla
authors.forename: Eva M
authors.initials: EM
authors.lastname: Díaz-Mesa
authors.forename: Fernando
authors.initials: F
authors.lastname: Sánchez-Lasheras
authors.forename: Patricia
authors.initials: P
authors.lastname: Burón
authors.forename: M José
authors.initials: MJ
authors.lastname: Casares
authors.forename: Pedro
authors.initials: P
authors.lastname: Marina
authors.forename: Eduardo
authors.initials: E
authors.lastname: Gutiérrez
authors.forename: Julio
authors.initials: J
authors.lastname: Bobes
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications; D006509:Hepatitis B / Q000150:complications; D006526:Hepatitis C / Q000150:complications; D006556:Heroin Dependence / Q000150:complications / Q000453:epidemiology / Q000401:mortality* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D011446:Prospective Studies; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D008691:Methadone