Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
Addiction. 2018 Apr;113(4):656-667. doi: 10.1111/add.14059. Epub 2017 Nov 19.
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 1 January 1998 and 31 March 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.
Socio-demographics of participants were examined along with the main outcomes of violent and non-violent offences.
During the first 2 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).
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.
估计和检验在美沙酮治疗期间和非美沙酮治疗期间暴力和非暴力犯罪率的差异。
设计、地点和参与者：本研究涉及对加拿大不列颠哥伦比亚省所有（n=14530）有定罪记录并在 1998 年 1 月 1 日至 2015 年 3 月 31 日期间开有美沙酮处方的个体的人群水平行政数据（健康和司法）进行链接。美沙酮维持治疗是主要的独立变量，被视为随时间变化的暴露因素。每位参与者的随访（平均：8 年）分为用药期（美沙酮发放）和非用药期（美沙酮未发放），平均持续时间分别为 3.3 年和 4.6 年。
检查参与者的社会人口统计学特征以及暴力和非暴力犯罪的主要结果。
在治疗的前 2 年（≤2.0 年），发放美沙酮的时期与暴力犯罪率降低 33%相关[0.67 调整后的风险比（AHR），95%置信区间（CI）=0.59，0.76]，与非用药期相比，非暴力犯罪率降低 35%（0.65 AHR，95% CI=0.62，0.69）。这相当于每 100 人年分别减少 3.6（95% CI=2.6，4.4）和 37.2（95% CI=33.0，40.4）的暴力和非暴力犯罪。在更长的治疗间隔（2.0 至≤5.0 年，5.0 至≤10.0 年）期间，美沙酮发放的保护作用虽小，但仍具有显著意义。
在加拿大罪犯队列中，与未发放美沙酮相比，发放美沙酮期间个体的暴力和非暴力犯罪率较低。
