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Heroin Addiction and Related Clinical Problems: 2015, 17, 1 (pages: 17 - 22)

Methadone deaths in Scotland

Nikolaou V., and Luty J.

Summary: Aim: identify factors which may be responsible for variations in methadone-related deaths in Scotland. Method: computer modelling based on data from drug-related deaths in Scotland in 2012 was used to predict the most effective combination of clinical parameters (methadone dose; supervision rates and provision of buprenorphine) that may predict how to reduce methadone-related deaths. Results: doubling the proportion of patients receiving buprenorphine (from 12% to 24%) would reduce the overall death rate by 18% (from 7.58 to 6.20 deaths per thousand problem drug users ~ 82 deaths). This would cost an additional £2.52 million (£31 000 per life saved). Increasing the supervision rate for methadone from 57% to 67% would reduce the overall death rate by 0.68% (3 deaths ~ £423 000 per life saved) while increasing the average daily dose of methadone from 90 mg to 100 mg would reduce the overall death rate by 2.5% (11 deaths ~ £48 000 per life saved). Conclusion: greater use of buprenorphine products could significantly reduce methadone-related deaths.