{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T08:11:30Z","timestamp":1790237490399,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2012,5,8]],"date-time":"2012-05-08T00:00:00Z","timestamp":1336435200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2012,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p><jats:bold>Aims\u2003<\/jats:bold> To identify dose\u2010tapering strategies associated with sustained success following methadone maintenance treatment (MMT).<\/jats:p><jats:p><jats:bold>Design\u2003<\/jats:bold> Population\u2010based retrospective cohort study.<\/jats:p><jats:p><jats:bold>Setting\u2003<\/jats:bold> Linked administrative medication dispensation data from British Columbia, Canada.<\/jats:p><jats:p><jats:bold>Participants\u2003<\/jats:bold> From 25\u2003545 completed MMT episodes, 14\u2003602 of which initiated a taper, 4183 individuals (accounting for 4917 MMT episodes) from 1996 to 2006 met study inclusion criteria.<\/jats:p><jats:p><jats:bold>Measurements\u2003<\/jats:bold> The primary outcome was sustained successful taper, defined as a daily dose \u22645\u2003mg per day in the final week of the treatment episode and no treatment re\u2010entry, opioid\u2010related hospitalization or mortality within 18 months following episode completion.<\/jats:p><jats:p><jats:bold>Findings\u2003<\/jats:bold> The overall rate of sustained success was 13% among episodes meeting inclusion criteria (646 of 4917), 4.4% (646 of 14\u2003602) among all episodes initiating a taper and 2.5% (646 of 25\u2003545) among all completed episodes in the data set. The results of our multivariate logistic regression analyses suggested that longer tapers had substantially higher odds of success [12\u201352 weeks versus &lt;12 weeks: odds ratio (OR): 3.58; 95% confidence interval (CI): 2.76\u20134.65; &gt;52 weeks versus &lt;12 weeks: OR: 6.68; 95% CI: 5.13\u20138.70], regardless of how early in the treatment episode the taper was initiated, and a more gradual, stepped tapering schedule, with dose decreases scheduled in only 25\u201350% of the weeks of the taper, provided the highest odds of sustained success (versus &lt;25%: OR: 1.61; 95% CI: 1.22\u20132.14).<\/jats:p><jats:p><jats:bold>Conclusions\u2003<\/jats:bold> The majority of patients attempting to taper from methadone maintenance treatment will not succeed. Success is enhanced by gradual dose reductions interspersed with periods of stabilization. These results can inform the development of a more refined guideline for future clinical practice.<\/jats:p>","DOI":"10.1111\/j.1360-0443.2012.03870.x","type":"journal-article","created":{"date-parts":[[2012,3,5]],"date-time":"2012-03-05T15:35:42Z","timestamp":1330961742000},"page":"1621-1629","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":68,"title":["Defining dosing pattern characteristics of successful tapers following methadone maintenance treatment: results from a population\u2010based retrospective cohort study"],"prefix":"10.1111","volume":"107","author":[{"given":"Bohdan","family":"Nosyk","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiying","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Evans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C.","family":"Marsh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Douglas","family":"Anglin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yih\u2010Ing","family":"Hser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aslam H.","family":"Anis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,5,8]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.284.13.1689"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.280.22.1936"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2005.02.007"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002207.pub3"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2009.02633.x"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2011.04.003"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2010.03140.x"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.10.1303"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003409.pub3"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD005031.pub4"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0376-8716(99)00084-8"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2005.11.007"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.3109\/00952997709007010"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1151\/ascp074145"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.64.12_Suppl.44"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2005.01.013"},{"key":"e_1_2_7_18_2","unstructured":"Substance Abuse and Mental Health Services Administration (SAMHSA) Office of Applied Studies.Treatment Episode Data Set (TEDS). Highlights\u20142006. National Admissions to Substance Abuse Treatment Services DASIS Series: S\u201040 DHHS Publication no. (SMA) 08\u20104313. Rockville MD: SAMHSA;2008."},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2010.03.008"},{"key":"e_1_2_7_20_2","doi-asserted-by":"publisher","DOI":"10.3109\/10826089409047404"},{"key":"e_1_2_7_21_2","unstructured":"Health Canada.Best Practices\u2014Methadone Maintenance Treatment.2002. Available at:http:\/\/www.hc\u2010sc.gc.ca\/hc\u2010ps\/pubs\/adp\u2010apd\/methadone\u2010bp\u2010mp\/index\u2010eng.php(accessed 2 April 2012; archived by WebCite\u00aeathttp:\/\/www.webcitation.org\/66dS63tYg)."},{"key":"e_1_2_7_22_2","unstructured":"College of Physicians and Surgeons of British Columbia.Methadone Maintenance Handbook.2012. Available at:https:\/\/www.cpsbc.ca\/files\/u6\/Methadone\u2010Maintenance\u2010Handbook\u2010PUBLIC.pdf(accessed 23 February 2012) (archived by WebCite\u00ae athttp:\/\/www.webcitation.org\/65g1S47Yd)."},{"key":"e_1_2_7_23_2","unstructured":"Centre for Addiction and Mental Health.Methadone Maintenance Treatment: Client Handbook.2008. Available at:http:\/\/www.camh.net\/Care_Treatment\/Resources_clients_families_friends\/Methadone_Maintenance_Treatment\/mmt_clienthndbk_ch8.html#tapering(accessed 23 February 2012) (archived by WebCite\u00ae athttp:\/\/www.webcitation.org\/65g1YzP17)."},{"key":"e_1_2_7_24_2","unstructured":"College of Physicians and Surgeons of Ontario.Methadone Maintenance Treatment Program Standards and Clinical Guidelines. February 2011. Available at:http:\/\/www.cpso.on.ca\/uploadedFiles\/policies\/guidelines\/methadone\/Meth%20Guidelines%20_Oct07.pdf(accessed 23 February 2012) (archived by WebCite\u00ae athttp:\/\/www.webcitation.org\/65g1e49hS)."},{"key":"e_1_2_7_25_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1977.01770150119014"},{"key":"e_1_2_7_26_2","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.1996.10472486"},{"key":"e_1_2_7_27_2","first-page":"62","article-title":"Leaving methadone treatment: lessons learned, lessons forgotten, lessons ignored","volume":"68","author":"Magura S.","year":"2001","journal-title":"Mt Sinai J Med"},{"key":"e_1_2_7_28_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-198807000-00003"},{"key":"e_1_2_7_29_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwp186"},{"key":"e_1_2_7_30_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.1994.tb00879.x"},{"key":"e_1_2_7_31_2","first-page":"47","volume-title":"State Methadone Treatment Guidelines: Treatment Improvement Series #1","author":"Payte J. T.","year":"1991"},{"key":"e_1_2_7_32_2","unstructured":"Population Data BC: BC PharmaNet database BC Ministry of Health Discharge Abstract Database Vital Statistics database.2012. Available at:http:\/\/www.popdata.bc.ca\/(accessed 23 February 2012) (archived by WebCite\u00ae athttp:\/\/www.webcitation.org\/65g1vFGrB)."},{"key":"e_1_2_7_33_2","doi-asserted-by":"publisher","DOI":"10.1080\/10826080701681473"},{"key":"e_1_2_7_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2007.04.014"},{"key":"e_1_2_7_35_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/154.9.854"},{"key":"e_1_2_7_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0740-5472(03)00130-2"},{"key":"e_1_2_7_37_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.2003.00354.x"},{"key":"e_1_2_7_38_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2005.01050.x"},{"key":"e_1_2_7_39_2","first-page":"75","volume-title":"Methadone Maintenance Treatment and Other Opioid Replacement Therapies","author":"Darke S.","year":"1998"},{"key":"e_1_2_7_40_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002208"},{"key":"e_1_2_7_41_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.6191.627"},{"key":"e_1_2_7_42_2","doi-asserted-by":"publisher","DOI":"10.3109\/10826089409047387"},{"key":"e_1_2_7_43_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwm165"}],"container-title":["Addiction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1360-0443.2012.03870.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1360-0443.2012.03870.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T18:09:57Z","timestamp":1695492597000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1360-0443.2012.03870.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,5,8]]},"references-count":42,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2012,9]]}},"alternative-id":["10.1111\/j.1360-0443.2012.03870.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1360-0443.2012.03870.x","archive":["Portico"],"relation":{},"ISSN":["0965-2140","1360-0443"],"issn-type":[{"value":"0965-2140","type":"print"},{"value":"1360-0443","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,5,8]]},"assertion":[{"value":"2012-05-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}