TY - JOUR
KW - Adolescent
KW - Adult
KW - Analgesics, Opioid/administration & dosage/adverse effects
KW - Cause of Death
KW - Data Collection
KW - Drug overdose
KW - Humans
KW - Methadone/adverse effects/therapeutic use
KW - Middle Aged
KW - Naltrexone/adverse effects/therapeutic use
KW - Narcotic Antagonists/adverse effects/therapeutic use
KW - Opiate Substitution Treatment/methods
KW - Opioid-Related Disorders/complications/rehabilitation
KW - Registries
KW - Risk
KW - Substance Withdrawal Syndrome
KW - Western Australia
KW - Young Adult
AU - J. Fellows-Smith
A1 - 
AB - OBJECTIVE: To evaluate error processing in contrasting opioid treatment samples by finding the relative risk of fatal dosing errors leading to opioid overdose in a controlled cohort of detoxified patients with opioid dependence. METHODS: Data linkage was performed between the Western Australian deaths register and recorded admissions to the Perth Naltrexone Clinic and community-based methadone program. Death register and corresponding data of coronial findings for all the patients who were treated with rapid opioid detoxification under sedation and oral naltrexone were compared with corresponding data for all the patients who were prescribed methadone over a 2-year period. RESULTS: Data for naltrexone-treated patients (n = 1,097) and community-based methadone-treated patients (n = 2,520) showed mortality rates to be 2.6 percent per year for naltrexone treatment when compared with O.7 percent for methadone treatment (p < 0.001). This was due to 4.3 times the relative risk of death from opioid toxicity for naltrexone-treated patients (p < 0.001). CONCLUSIONS: Naltrexone increases vulnerability to overdose as enhanced opioid effects following neuroanatomical blockade can reverse behavioral tolerance and lead to greater fatal dosing errors on reinstatement of opioid dependence.
BT - Journal of opioid management
C5 - Opioids & Substance Use
CP - 6
CY - United States
IS - 6
JF - Journal of opioid management
N2 - OBJECTIVE: To evaluate error processing in contrasting opioid treatment samples by finding the relative risk of fatal dosing errors leading to opioid overdose in a controlled cohort of detoxified patients with opioid dependence. METHODS: Data linkage was performed between the Western Australian deaths register and recorded admissions to the Perth Naltrexone Clinic and community-based methadone program. Death register and corresponding data of coronial findings for all the patients who were treated with rapid opioid detoxification under sedation and oral naltrexone were compared with corresponding data for all the patients who were prescribed methadone over a 2-year period. RESULTS: Data for naltrexone-treated patients (n = 1,097) and community-based methadone-treated patients (n = 2,520) showed mortality rates to be 2.6 percent per year for naltrexone treatment when compared with O.7 percent for methadone treatment (p < 0.001). This was due to 4.3 times the relative risk of death from opioid toxicity for naltrexone-treated patients (p < 0.001). CONCLUSIONS: Naltrexone increases vulnerability to overdose as enhanced opioid effects following neuroanatomical blockade can reverse behavioral tolerance and lead to greater fatal dosing errors on reinstatement of opioid dependence.
PP - United States
PY - 2011
SN - 1551-7489; 1551-7489
SP - 443
EP - 449
EP - 
T1 - Opioid-dependent error processing
T2 - Journal of opioid management
TI - Opioid-dependent error processing
U1 - Opioids & Substance Use
U2 - 22320026
VL - 7
VO - 1551-7489; 1551-7489
Y1 - 2011
ER -