Systematic Review on Mortality in the Elderly on Methadone Maintenance Treatment

Farhana Nazmin; Tuheen Sankar Nath; Therese Anne Limbaña; Vignesh Murugan; Jian Garcia; Sanjana Singareddy

doi:10.7759/cureus.68910

Systematic Review on Mortality in the Elderly on Methadone Maintenance Treatment

Cureus. 2024 Sep 7;16(9):e68910. doi: 10.7759/cureus.68910. eCollection 2024 Sep.

Authors

Farhana Nazmin¹, Tuheen Sankar Nath², Therese Anne Limbaña^{3

4}, Vignesh Murugan⁵, Jian Garcia⁵, Sanjana Singareddy⁶

Affiliations

¹ Psychiatry, BronxCare Health System, Bronx, USA.
² Surgical Oncology, Tata Medical Center, Kolkata, IND.
³ Research, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
⁴ Dermatology, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, USA.
⁵ Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
⁶ Internal Medicine, Bhaskar Medical College, Hyderabad, IND.

Abstract

Opioid dependence is a serious public health concern, particularly for older individuals who have a high prevalence of comorbid conditions. To effectively manage opioid use disorder (OUD), methadone maintenance treatment (MMT) is crucial; however, the MMT poses certain challenges for the aging population. The purpose of this review is to evaluate the impact of MMT on health outcomes, identify predictive factors for mortality, and assess mortality rates among older individuals receiving MMT. A systematic search was performed across databases, including PubMed, Scopus, Web of Science, and Google Scholar, adhering to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Studies included were published between January 2000 and December 2023, focused on elderly patients (60 years of age and older) receiving MMT and provided information on death rates. A total of 15 studies were examined. The main causes of death for older MMT patients were overdose, respiratory issues, and cardiovascular diseases. The annual mortality rates for these patients ranged from 2% to 10%. Treatment outcomes and mortality were significantly impacted by comorbid conditions. Greater treatment adherence and longer care periods were observed in older individuals, which correlated with better health outcomes and lower mortality. This review makes clear how elderly MMT patients with addiction and chronic health issues require integrated care models. Treatment effectiveness may be further increased by gender-specific interventions. For this aging population, policy reforms and enhanced healthcare support are essential. To enhance clinical results and lower mortality rates among older individuals enrolled in MMT programs, comprehensive age-appropriate care models are crucial. Long-term health outcomes should be investigated further and evidence-based treatments for older individuals with OUD should be developed.

Keywords: elderly; mathadone maintenance; methadone; methadone maintenance treatment; mortality; opioid.

Publication types

Review