There is no age limit for methadone: a retrospective cohort study

Kenneth M Dürsteler-Macfarland,Marc Vogel,Sylvie A Petitjean,Gerhard A Wiesbeck

doi:10.1186/1747-597x-6-9

Kenneth M Dürsteler-Macfarland, Marc Vogel + Show 2 more

Open Access

https://doi.org/10.1186/1747-597x-6-9

Copy DOI

Abstract

BackgroundData from the US indicates that methadone-maintained populations are aging, with an increase of patients aged 50 or older. Data from European methadone populations is sparse. This retrospective cohort study sought to evaluate the age trends and related developments in the methadone population of Basel-City, Switzerland.MethodsThe study included methadone patients between April 1, 1995 and March 31, 2003. Anonymized data was taken from the methadone register of Basel-City. For analysis of age distributions, patient samples were split into four age categories from '20-29 years' to '50 years and over'. Cross-sectional comparisons were performed using patient samples of 1996 and 2003.ResultsAnalysis showed a significant increase in older patients between 1996 and 2003 (p < 0.001). During that period, the percentage of patients aged 50 and over rose almost tenfold, while the proportion of patients aged under 30 dropped significantly from 52.8% to 12.3%. The average methadone dose (p < 0.001) and the 1-year retention rate (p < 0.001) also increased significantly.ConclusionsFindings point to clear trends in aging of methadone patients in Basel-City which are comparable, although less pronounced, to developments among US methadone populations. Many unanswered questions on medical, psychosocial and health economic consequences remain as the needs of older patients have not yet been evaluated extensively. However, older methadone patients, just as any other patients, should be accorded treatment appropriate to their medical condition and needs. Particular attention should be paid to adequate solutions for persons in need of care.

Highlights

Data from the US indicates that methadone-maintained populations are aging, with an increase of patients aged 50 or older
The form collects a limited amount of information about methadone patients and their treatment but provides a population-based data source recording the duration of treatment episodes as well as the characteristics of the prescribing provider
Of the 958 patients registered on March, 31, 2003, 458 persons had been on maintenance treatment (MMT)

Summary

Introduction

Data from the US indicates that methadone-maintained populations are aging, with an increase of patients aged 50 or older. While a new generation of opioid-dependent persons is entering treatment for the first time, at the other end of the age spectrum the population of older long-term patients continues to grow rapidly [18,19,20,21]. This is largely due to the success of methadone programs in retaining patients in treatment and helping to prolong their lives–all that in spite of often complex and comorbid cases [20,22,23,24,25]. Arndt et al recently found increasing proportions of patients aged older than 55 mentioning problematic heroin use when presenting for first-time treatment of substance use in the US [26]

Methods

Results

Discussion

Conclusion