IntroductionBeginning in November 2008, the Substance Abuse and Mental Health Services Administration (SAMHSA) initiated the Mortality Reporting Project to acquire information on deaths of Opioid Treatment Program (OTP) patients and to assist the field in the risk management of OTP patients, with an overall goal of reducing the number of preventable deaths and improving patient health and safety. A total of 161 OTPs from 29 States voluntarily reported patient deaths during the first year (2009) of the project.

Results 406 deaths reported. All patients were on methadone. 61% had a history of a mental disorder:

• 14% had depression.• 9% had an anxiety disorder.

22% had benzodiazepine prescriptions. 20% tested positive for benzodiazepines at their most

recent drug test. 15% were on prescribed antidepressants. 12% were on Selective Serotonin Reuptake Inhibitors

(SSRIs).

Characteristics of reported overdose cases (N=34): Younger. Shorter time in treatment. Had fewer take-home doses. Did not differ from other decedents in total number of

co-morbid conditions. 27% died within the first 2 weeks of treatment:

• Average dose was 52 mg (range: 25–85 mg). 73% died after more than 2 weeks of treatment:

• Average dose was 95 mg (range: 30–190 mg).

ConclusionsAlthough the reported causes of death were not “official” (i.e., confirmed by medical coroners/examiners), the findings are useful because they show the extent of physical and mental problems of those individuals reported to have died while in an OTP.

Programs should monitor prescription drugs taken by the patients, focusing on potential toxicities of some drugs (e.g., benzodiazepines): Monitor for drug interactions through regular physical

examinations Prescribe medications through a single prescriber—the

OTP physician

The high rate of overdose deaths among newly inducted patients remains a significant concern.

Treatment programs need to: Adhere to induction protocols with low doses Engage in prevention strategies Consistently warn new patients of the dangers of

overdose on methadone alone and the increased dangers if mixed with other drugs

Train friends and families of all patients on patterns of use, early signs of overdose, and resuscitation techniques

For additional information, contact: Alina R. WalizadaDivision of Pharmacologic Therapies, CSAT Phone: 240-276-2755 | E-mail: alina.walizada@samhsa.hhs.gov

SAMHSA’s Mortality Reporting System 2009

Results From the First Mortality Data Collectionby Opioid Treatment Programs

J. C. Maxwell, University of Texas at AustinA. R. Walizada, SAMHSA/CSAT/DPT

S. K. R. Heil, American Institutes for Research