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Regarding the article by Ngo and colleagues on “drug-related hospital morbidity” associated with methadone treatment and with naltrexone implants,1 insufficient information makes interpretation of the findings impossible.
For methadone treatment, there is reference to “statewide annual report estimates” of retention for inpatient methadone maintenance treatment (could there really be such programs in Australia?) and for outpatient services. However, based on those statewide figures, without even a time frame as to duration of retention, one cannot venture a guess as to how many of the 522 individuals starting methadone treatment and included in this analysis remained in treatment for a few days or conceivably for the entire 3½-year observation period after enrollment. In any event, the reader also has no way of ascertaining the intervals between “hospital morbidity” and the last administration of methadone; here, too, it might have been a day or more than 3 years.
For the naltrexone group, it is unclear if there was only a single treatment episode during the period of observation or perhaps many. In treating a chronic, notoriously recurrent problem such as opiate addiction, one would expect clinicians to urge implant patients to return for consideration of additional implants and/or other treatment approaches. Since we know nothing of the course after the first implant, there is no way to draw even tentative conclusions of a relationship—positive or negative—between naltrexone and hospitalization or death.
Correspondence: Dr Newman, Baron Edmond de Rothschild Chemical Dependency Institute of Beth Israel Medical Center, 555 W 57th St, NY, NY 10019 (rnewman@icaat.org).
Financial Disclosure: None reported.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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