New paper out now: Primary care distributes life-saving medication for 17 years

The year was 1996 and Ireland was recovering from a recent heroin epidemic. Methadone, a medical replacement drug for heroin, was jut making its way into specialised clinics in Dublin.

Professor Gerard Bury and colleagues had a revolutionary idea that people who use drugs can receive agonist drugs, like methadone, from their family doctors.

photocredit: tandfonline.com/loi/igen20#.VlO9bHarTrc

The opioid agonist treatment has substantially changed the course of the drug use epidemic. Yet, many continue to die and suffer from chronic diseases. In Ireland, everybody who’s prescribed this medication has to be registered with the Central Treatment List.

In this new study, we wanted to revisit a group of people who were the first to receive their agonist medication, i.e., methadone in the primary care in Ireland.
At follow-up in 2013, 27 (27.6%) of the 98 people had died in Ireland and had relevant entries in the Register of Deaths, 19 (19.4%) were currently in OAT and the status of the remaining 52 (53%) was ‘alive,’ as per the Irish death registry.
The 52 patients ‘alive’ had left the Central Treatment List, but no further information was available on their status.

“Our inability to establish the interval data for the retention in treatment is a significant study limitation, but the overall retention of 19 out of the surviving 71 patients is comparable to previous research.”


The deceased died of multiple causes; only six had a single cause. Drug toxicity, overdose, or both, were the most common causes of death.

Cited study:
Jan Klimas, Anna Keane, Walter Cullen, Fergus O’Kelly, and Gerard Bury (2015) Seventeen year mortality in a cohort of patients attending opioid agonist treatment in Ireland. European Journal of General Practice (http://dx.doi.org/10.3109/13814788.2015.1109076)