Citation

Russolillo A, Moniruzzaman A, McCandless LC, Patterson M, Somers JM. Addiction 2018; 113(4): 656-667.

Affiliation

Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.

Copyright

(Copyright © 2018, John Wiley and Sons)

DOI

10.1111/add.14059

PMID

28987068

Abstract

AIMS: To estimate and test the difference in rates of violent and non-violent crime during medicated and non-medicated methadone treatment episodes. DESIGN, SETTING AND PARTICIPANTS: The study involved linkage of population level administrative data (health and justice) for all individuals (n=14,530) in British Columbia, Canada with a history of conviction and who filled a methadone prescription between January 1, 1998 and March 31, 2015. Methadone maintenance treatment was the primary independent variable and was treated as a time-varying exposure. Each participant's follow-up (mean: 8 years) was divided into medicated (methadone was dispensed) and non-medicated (methadone was not dispensed) periods with mean durations of 3.3 and 4.6 years respectively. MEASUREMENTS: Socio-demographics of participants were examined along with the main outcomes of violent and non-violent offences.

FINDINGS: During the first two years of treatment (≤2.0 years), periods in which methadone was dispensed were associated with a 33% lower rate of violent crime [0.67 adjusted hazard ratio (AHR), 95% confidence intervals (CI) (0.59, 0.76)] and a 35% lower rate of non-violent crime [0.65 AHR 95% CI (0.62, 0.69) compared with non-medicated periods. This equates to a risk difference of 3.6 [95% CI (2.6, 4.4)] and 37.2 [95% CI (33.0, 40.4)] fewer violent and non-violent offences per 100 person years, respectively. Significant but smaller protective effects of dispensed methadone were observed across longer treatment intervals (2.0 to ≤ 5.0 years, 5.0 to ≤10.0 years).

CONCLUSIONS: Among a cohort of Canadian offenders, rates of violent and non-violent offending were lower during periods when individuals were dispensed methadone compared with periods in which they were not dispensed methadone.

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Language: en

Keywords

MMT; Methadone; crime; methadone maintenance treatment; offenders; substitution treatment