The methadone maintenance treatments pharmacologically treat the
addiction to opiate, but they are also based on the harm reduction,
partly due to the high prevalence of the infection of the human immunodeficiency
virus. The opiate addiction together with the parenteral
route of administration constitute a risk to acquire this illness. In fact in
the province of Alicante between June 1990 and December 1997, the
addicts that used the parenteral route of administration presented a
relative risk of acquiring the infection for the HIV equal to 4.0 when
compared with those that used the non-parenteral route of administration.
In fact, the AIDS-related death is one of the most frequent cause of
death in opiate addicts (27/1,000 person – years, Barcelona 1987 - 1990).
However, the mortality of the opioids addicts is determined by three
factors: infectious diseases; overdose-related death or acute reactions
after the consumption, including methadone and heroine; and violent
deaths, being one of the most frequent the suicide by means of overdose.
However, it has been demonstrated that the methadone maintenance
treatments increase the survival of the patients. The relative risk of
dying in patients not receiving methadone was 3.2 (Province of Alicante,
1990 - 1997) when compared with those that received treatment. It
was found in Amsterdam in the period encompassed between 1985 and
1996 a relative risk equal to 2.38 in natural-cause deaths and 4.55 and
IC95% = 1.89 – 10.0 in drug injectors. Nevertheless, the protective effect
of the methadone maintenance treatments is associated to the fact that
they are based on harm reduction, rather than in the pharmacological
effect of the methadone.