Deaths of clients in methadone treatment in Texas: 1994-2002.

This study analyzes causes of deaths of 766 patients who died while in methadone treatment in Texas between 1994 and 2002. Compared with deaths in the general population of Texas, deaths of clients in methadone treatment were 4.6 times more likely to be from a drug overdose, 3.4 times more likely to be from liver disease, 1.7 times more likely to be from a respiratory disease, 1.5 times more likely to be from a homicide and 1.4 times more likely to be from AIDS, but less likely to be from suicide, motor vehicle accidents, cardiovascular diseases or cancer. Of the clients, 20% died of liver disease, 18% of cardiovascular disease and 14% of drug overdose. An older cohort had been in treatment longer, had more take-homes, were on higher doses and tended to die of chronic diseases. A younger cohort tended to die from traumas, including drug overdose. Time in treatment was 43.3 months; mean daily dose was 77.3mg; number of days/month dosed in the clinic was 13.9. Given these rates, the scope of services should include on-site treatment for other medical conditions and staff should be educated about and counsel about the risk of death for new patients.