Associations between methadone maintenance treatment and crime: a 17-year longitudinal cohort study of Canadian provincial offenders
Corresponding Author
Angela Russolillo
Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
Correspondence to: Angela Russolillo, Somers Research Group, Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada. E-mail: [email protected]Search for more papers by this authorAkm Moniruzzaman
Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
Search for more papers by this authorLawrence C. McCandless
Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
Search for more papers by this authorMichelle Patterson
Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
Search for more papers by this authorJulian M. Somers
Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
Search for more papers by this authorCorresponding Author
Angela Russolillo
Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
Correspondence to: Angela Russolillo, Somers Research Group, Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada. E-mail: [email protected]Search for more papers by this authorAkm Moniruzzaman
Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
Search for more papers by this authorLawrence C. McCandless
Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
Search for more papers by this authorMichelle Patterson
Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
Search for more papers by this authorJulian M. Somers
Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
Search for more papers by this authorAbstract
Aims
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.
Measurements
Socio-demographics of participants were examined along with the main outcomes of violent and non-violent offences.
Findings
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).
Conclusions
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.
Supporting Information
| Filename | Description |
|---|---|
| add14059-sup-0001-supplementary_appendix.docxWord 2007 document , 22.1 KB |
Appendix S1 Supplementary information and description of analytic methods. Table S1A Data structure of primary exposure variable (methadone) for the cox regression for three hypothetical participants. Table S1B Summary statistics for three hypothetical participants. |
| add14059-sup-0002-supplementary_tables.docxWord 2007 document , 14.1 KB |
Table S2 Distribution of violent offences (n = 6541). Table S3 Distribution of non-violent offences (n = 61283). |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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