Loss of tolerance and overdose mortality after inpatient opiate detoxification: follow up study

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Abstract
In many countries opiate overdose remains the main source of the 10-fold excess mortality among opiate addicts, notwithstanding the effects of HIV/AIDS.1 Treatment reduces mortality but can sometimes increase mortality transiently—for example, during the first few weeks of methadone maintenance treatment and among former opiate addicts after their release from prison. 2 3 The increase in mortality among released prisoners who were formerly opiate addicts has been attributed to loss of tolerance and erroneous judgment of dose when they returned to opiate use. 1 3 We wished to investigate whether opiate addicts who have undergone inpatient detoxification might have a similarly increased mortality after treatment. We followed up patients who received inpatient opiate detoxification, looked for evidence of increased mortality, and investigated the distinctive characteristics of patients who died. View this table: Predictors of mortality among patients who underwent inpatient opiate detoxification. Values are numbers (percentage) of patients …