| Researchers found that almost nine in 10 recovering addicts who eventually died were mixing heroin substitute methadone with benzodiazepines.
The study was led by experts from Ninewells Hospital and Medical School and involved 2378 patients — 8% of whom died during the research period.
Dr Brian Kidd, a member of the Dundee team, said the retrospective study backed the approach to prescribing adopted in Tayside, and identified further areas of study vital to cutting the number of drug-related deaths.
He said, “The findings support local policy such as avoiding benzodiazepine prescribing and add to the understanding of factors affecting premature death in this population.
“They identify key areas of concern, such as mental health, which must be addressed as part of a joined-up approach to combating drug-related death.”
The paper, published by the British Medical Journal, showed that 181 Tayside patients on a methadone prescription died during the 1993-2004 period.
The research was carried out using data from the Health Information Centre — a database which records all medication prescribed by GPs in Tayside.
Clinical data is rendered anonymous and linked to other databases that record hospital admission or deaths so it can be used for research purposes.
As a result, Tayside is the only area where such research of this depth can be cross-referenced and used to study such large numbers of patients.
Strong predictors of death were identified as taking the methadone over a shorter period than the prescribed period, a history of being prescribed benzodiazepines, and a history of psychiatric admission.
Of those people who commit suicide, 40% have substance abuse problems and the study identifies a need to address issues of access to appropriate mental health care and treatment.
Patients who took their methadone in a shorter period than that stated within the prescription had increased risk while those addicts who were assessed and monitored by doctors through urine testing were less likely to die prematurely.
Subjects prescribed benzodiazepines were found to be at increased risk if prescribed, which is an important issue for GPs who may prescribe such drugs for a range of complaints.
Many of the factors identified in the study have already been addressed in a review of prescribing policy in Tayside, researchers said. |
