High BMI is a specific risk factor for drug-related mortality in patients receiving methadone: A case control study.

IF 5.2 1区医学 Q1 PSYCHIATRY

Addiction Pub Date : 2025-02-13 DOI:10.1111/add.70015

Thikra Algahtani, Tom Le Ruez, John Strang, David Morgan, Martin Smith, Caroline S Copeland

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引用次数: 0

Abstract

Background and aims: Long-term treatment of opioid dependence with the opioid agonist therapy (OAT) methadone can lead to significant weight gain. This study investigated whether OAT patients with a body mass index (BMI) deemed overweight (≥25) are at increased risk of mortality.

Methods: A retrospective case-control study was performed with anonymised data collected from living and deceased persons registered as receiving OAT from Derbyshire or Teesside drug and alcohol services in the United Kingdom. Height, weight, age, gender, OAT type and dose, smoking status and postcode of usual address were collected. Cause of death was collected from deceased individuals. Adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) were calculated using regression models.

Results: Data were collected for 1574 living and 233 deceased individuals. Mean BMI of all individuals (25.75 ± 6.56) was above the threshold considered a healthy weight, and was higher in deceased (26.63 ± 7.87) than living individuals (25.61 ± 6.34; P < 0.05). A BMI of 30 corresponded to an average 7.7% increased risk of mortality, increasing to 37.2% for those with a BMI of 35 and 107.3% for those with a BMI of 40. Risk of death also increased by an average of 43.6% for those deemed underweight (BMI 15). People who were older (mean aOR = 1.019; 95% CI = 1.002-1.036), smoked (mean aOR = 2.917; 95% CI = 1.726-4.934) and lived in more deprived areas (mean aOR = 0.891; 95% CI = 0.831-0.956) were more likely to have died, as were those prescribed methadone (vs buprenorphine) (mean aOR = 1.916; 95% CI = 1.138-3.227). There was no significant effect of gender (mean aOR = 0.844; 95% CI = 0.612-1.162) or methadone dose (aOR = 0.995; 95% CI = 0.988-1.001) on incidence of death. Acute drug toxicity was the predominant underlying cause of death for healthy and overweight people (46% of cases in both groups), with cancer (21% of cases) and infection (18% of cases) greater contributors to cause of death in underweight people.

Conclusions: Opioid agonist therapy (OAT) patients with a body mass index outside of the 'healthy' range appear to have an increased risk of death compared with OAT patients within the 'healthy' range.

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在接受美沙酮治疗的患者中，高BMI是药物相关死亡率的特定危险因素：一项病例对照研究。

背景和目的：长期使用阿片类药物激动剂（OAT）美沙酮治疗阿片类药物依赖可导致体重显著增加。本研究调查了体重指数（BMI）超重（≥25）的OAT患者是否有更高的死亡风险。方法：采用回顾性病例对照研究，收集英国德比郡或提赛德毒品和酒精服务中心登记接受OAT治疗的在世和已故患者的匿名数据。收集身高、体重、年龄、性别、OAT类型及剂量、吸烟状况、常住地址邮编。从死者身上收集死因。采用回归模型计算校正优势比（aOR）和95%置信区间（95% CI）。结果：收集了1574名生者和233名死者的数据。所有个体的平均BMI（25.75±6.56）均高于健康体重阈值，死者（26.63±7.87）高于活着的个体（25.61±6.34）；结论：与处于“健康”范围内的OAT患者相比，体重指数在“健康”范围外的阿片受体激动剂治疗（OAT）患者的死亡风险似乎增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Addiction 医学-精神病学

CiteScore

10.80

自引率

6.70%

发文量

319

审稿时长

3 months

期刊介绍： Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines. Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries. Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.