{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:20:36Z","timestamp":1792099236658,"version":"4.4.0"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2020,3,27]],"date-time":"2020-03-27T00:00:00Z","timestamp":1585267200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2020,3,27]],"date-time":"2020-03-27T00:00:00Z","timestamp":1585267200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001590","name":"Health Research Board","doi-asserted-by":"publisher","award":["HRA\u2010PHR\u20102015\u20101088"],"award-info":[{"award-number":["HRA\u2010PHR\u20102015\u20101088"]}],"id":[{"id":"10.13039\/501100001590","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To examine the risk of mortality associated with interruptions to the continuity of methadone maintenance treatment (MMT), including transfers between services, in opioid\u2010dependent individuals attending specialist addiction services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study using addiction services and primary care dispensing records, the National Methadone Register and National Drug\u2010Related Death Index (NDRDI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Geographically defined population in Dublin, Ireland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 2899 people prescribed and dispensed methadone in specialist addiction services between January 2010 and December 2015. There were five exposure groups: weeks 1\u20134 following transfer between treatment providers; weeks 1\u20134 out of treatment; weeks 5\u201352 out of treatment; weeks 1\u20134 of treatment initiation; and weeks 5+ of continuous treatment (reference category).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Primary outcome: drug\u2010related poisoning (DRP) deaths. Secondary outcome: all\u2010cause mortality (ACM). Mortality rates calculated by dividing number of deaths (DRP; ACM) in exposure groups by person\u2010years exposure. Unadjusted and adjusted Poisson regression (covariates age, sex, incarceration, methadone dose and comorbidities) estimated differences in mortality rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      There were 154 ACM deaths, 55 (35.7%) identified as DRP deaths. No deaths were observed in the first month following transfer between treatment providers. The risk of DRP mortality was highest in weeks 1\u20134 out of treatment [adjusted relative risk (aRR\u00a0=\u00a04.04, 95% confidence interval (CI)\u00a0=\u00a01.43\u201311.43,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.009] and weeks 1\u20134 of treatment initiation (ARR\u00a0=\u00a03.4, 95% CI\u00a0=\u00a01.2\u20139.64,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.02). Similarly, risk of ACM was highest in weeks 1\u20134 out of treatment (ARR\u00a0=\u00a011.78, 95% CI\u00a0=\u00a07.73\u201317.94,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), weeks 1\u20134 of treatment initiation (aRR\u00a0=\u00a05.11, 95% CI\u00a0=\u00a02.95\u20138.83, P\u00a0&lt;\u00a00.001) and weeks 5\u201352 off treatment (aRR\u00a0=\u00a02.04, 95% CI =\u00a01.2\u20133.47,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.009).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Interruptions to the continuity of methadone maintenance treatment by treatment provider do not appear to be periods of risk for drug\u2010related poisoning or all\u2010cause mortality deaths. Risk of drug related poisoning and all\u2010cause mortality deaths appears to be greatest during the first 4\u00a0weeks of treatment initiation\/re\u2010initiation and after treatment cessation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.15004","type":"journal-article","created":{"date-parts":[[2020,2,8]],"date-time":"2020-02-08T01:09:58Z","timestamp":1581124198000},"page":"1867-1877","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Do interruptions to the continuity of methadone maintenance treatment in specialist addiction settings increase the risk of drug\u2010related poisoning deaths? A retrospective cohort study"],"prefix":"10.1111","volume":"115","author":[{"given":"Louise","family":"Durand","sequence":"first","affiliation":[{"name":"School of Pharmacy and Biomolecular Sciences Royal College of Surgeons in Ireland  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"O'Driscoll","sequence":"additional","affiliation":[{"name":"HSE Addiction Services  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Boland","sequence":"additional","affiliation":[{"name":"HRB Centre for Primary Care Research Royal College of Surgeons in Ireland  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eamon","family":"Keenan","sequence":"additional","affiliation":[{"name":"HSE National Social Inclusion Office, Stewarts Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedict K.","family":"Ryan","sequence":"additional","affiliation":[{"name":"School of Pharmacy and Biomolecular Sciences Royal College of Surgeons in Ireland  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Barry","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care Trinity College Dublin  Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Bennett","sequence":"additional","affiliation":[{"name":"Division of Population Health Sciences Royal College of Surgeons in Ireland  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Fahey","sequence":"additional","affiliation":[{"name":"Department of General Practice and HRB Centre for Primary Care Research Royal College of Surgeons in Ireland  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2985-7668","authenticated-orcid":false,"given":"Gr\u00e1inne","family":"Cousins","sequence":"additional","affiliation":[{"name":"School of Pharmacy and Biomolecular Sciences Royal College of Surgeons in Ireland  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,3,27]]},"reference":[{"key":"e_1_2_8_2_1","article-title":"Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence","volume":"3","author":"Mattick R. 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