(68) Real-World Effectiveness of Methadone Maintenance Treatment on The Reduction of Suicidal Attempts in Patients with Opioid Use Disorder

Saturday, August 27, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 742

Presenting Author(s)

Eric Cheng-Chan Shih
– Tainan City, Taiwan

Co-Author(s)

I-Lin Hsu
– PhD, Public Health Bureau, Tainan City Government, Taiwan, Taiwan (Republic of China)
Edward Lai, PhD
– Associate Professor, National Cheng Kung University, National Cheng Kung University, Tainan City, Tainan, Taiwan (Republic of China)

Background: To receive or maintain the MMT could be consider to curb the increased risk of suicide of the patients with opioid use disorder.

Objectives: To evaluate the association between methadone maintenance treatment (MMT) and the reduced suicide attempts risk.

Methods: We conducted a case-crossover study by analyzing the data from the Suicide Prevention System and Drug Abuse Case Management System. We included patients who were enrolled in MMT program for opioid use disorder (OUD) with a record of suicide attempt between 2013 and 2020 in Tainan metropolitan city. We defined 2-day of event window before the date of suicide attempt and 2-day reference window, and a 60-day washout period between the two windows. The exposure group was defined as those received MMT within the event window; otherwise, patients were considered as non-exposure group. Each case was 1:1 matched with a control patient without an event of suicide attempt by age and gender for the control-cross analysis to adjust the bias from temporal trends. We performed conditional logistic regression to obtain the odds ratios (OR) and the confidence intervals (CI) to examine the risk of exposure of MMT in the event window comparing with reference window. The case-time-control ORs were determined by dividing the case-crossover OR by the control-crossover OR. We redefined the exposure of MMT as at least 3 days within 7 days and repeated the analysis to test the result robustness.

Results: We identified A total of 441 cases with records of suicide attempts between 2013 and 2020. The average age was 46.3 (SD 7.7) and 57.1% were male. In the case-crossover analysis, we found MMT exposure were lower in event window comparing with reference window (OR, 0.46; 95% CI, 0.34-1.49). In the control-crossover analysis, we found MMT exposure were similar between two windows (OR, 0.95; 95% CI,0.59-1.61). The case-time-control OR was 0.49 (95% CI, 0.58-0.93). The results remained consistent in the sensitivity analysis (OR, 0.44; 95% CI, 0.56-0.86).

Conclusions: The findings suggested MMT was associated with a 50% reduced risk of suicide attempt in patients with OUD. Strategy to enhance patients’ motivation to receive or maintain the MMT could be consider to curb the increased risk of suicide of the patients.