Implication of this English study is that to save the lives of people dependent on heroin or similar drugs, they should be engaged and retained in substitute prescribing programmes like methadone maintenance until there is little risk of their relapsing after leaving. Shortly after leaving residential/inpatient settings was the highest risk period.

Key points From summary and commentary
• In England the study investigated the relationship between ‘overdose’ deaths and being in or out of different kinds of treatments for opioid dependence.
• The least risky period was while in methadone maintenance and allied treatments, the most risky, the four weeks after leaving residential/inpatient care.
• The death rate jumped after leaving residential/inpatient or maintenance treatments, but not after leaving non-residential psychological support programmes.
• Whether a patient had been recorded as having successfully completed their treatment made little difference to their risk of overdose death shortly after leaving