{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T17:00:20Z","timestamp":1792602020626,"version":"4.5.0"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,11,25]],"date-time":"2015-11-25T00:00:00Z","timestamp":1448409600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2015,11,25]],"date-time":"2015-11-25T00:00:00Z","timestamp":1448409600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["G1000021"],"award-info":[{"award-number":["G1000021"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["U105260794"],"award-info":[{"award-number":["U105260794"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To compare the change in illicit opioid users\u2019 risk of fatal drug\u2010related poisoning (DRP) associated with opioid agonist pharmacotherapy (OAP) and psychological support, and investigate the modifying effect of patient characteristics, criminal justice system (CJS) referral and treatment completion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>National data linkage cohort study of the English National Drug Treatment Monitoring System and the Office for National Statistics national mortality database. Data were analysed using survival methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>All services in England that provide publicly funded, structured treatment for illicit opioid users.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Adults treated for opioid dependence during April 2005 to March 2009: 151\u2009983 individuals; 69% male; median age 32.6 with 442\u2009950 person\u2010years of observation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>The outcome was fatal DRP occurring during periods in or out of treatment, with adjustment for age, gender, substances used, injecting status and CJS referral.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>There were 1499 DRP deaths [3.4 per 1000 person\u2010years, 95% confidence interval (CI)\u2009=\u20093.2\u20133.6]. DRP risk increased while patients were not enrolled in any treatment [adjusted hazard ratio (aHR)\u2009=\u20091.73, 95% CI\u2009=\u20091.55\u20131.92]. Risk when enrolled only in a psychological intervention was double that during OAP (aHR\u2009=\u20092.07, 95% CI\u2009=\u20091.75\u20132.46). The increased risk when out of treatment was greater for men (aHR\u2009=\u20091.88, 95% CI\u2009=\u20091.67\u20132.12), illicit drug injectors (aHR\u2009=\u20092.27, 95% CI\u2009=\u20091.97\u20132.62) and those reporting problematic alcohol use (aHR\u2009=\u20092.37, 95% CI\u2009=\u20091.90\u20132.98).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients who received only psychological support for opioid dependence in England appear to be at greater risk of fatal opioid poisoning than those who received opioid agonist pharmacotherapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.13193","type":"journal-article","created":{"date-parts":[[2015,10,9]],"date-time":"2015-10-09T09:44:52Z","timestamp":1444383892000},"page":"298-308","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":132,"title":["Impact of treatment for opioid dependence on fatal drug\u2010related poisoning: a national cohort study in England"],"prefix":"10.1111","volume":"111","author":[{"given":"Matthias","family":"Pierce","sequence":"first","affiliation":[{"name":"Institute of Brain Behaviour and Mental Health, Faculty of Medical and Human Sciences University of Manchester  UK"},{"name":"Institute of Population Health, Faculty of Medical and Human Sciences University of Manchester  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila M.","family":"Bird","sequence":"additional","affiliation":[{"name":"MRC Biostatistics Unit  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Hickman","sequence":"additional","affiliation":[{"name":"School of Social and Community Medicine University of Bristol  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Marsden","sequence":"additional","affiliation":[{"name":"Addictions Department, Institute of Psychiatry, Psychology and Neuroscience King's College London  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham","family":"Dunn","sequence":"additional","affiliation":[{"name":"Institute of Population Health, Faculty of Medical and Human Sciences University of Manchester  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3545-4080","authenticated-orcid":false,"given":"Andrew","family":"Jones","sequence":"additional","affiliation":[{"name":"Institute of Population Health, Faculty of Medical and Human Sciences University of Manchester  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Millar","sequence":"additional","affiliation":[{"name":"Institute of Brain Behaviour and Mental Health, Faculty of Medical and Human Sciences University of Manchester  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,11,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61530-5"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2011.05.010"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2014.09.782"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/cki168"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2010.03140.x"},{"key":"e_1_2_7_7_1","article-title":"Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence","volume":"2","author":"Mattick R. 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