To identify dose-tapering strategies associated with sustained success following methadone maintenance treatment (MMT).
Population-based retrospective cohort study.
Linked administrative medication dispensation data from British Columbia, Canada.
From 25 545 completed MMT episodes, 14 602 of which initiated a taper, 4183 individuals (accounting for 4917 MMT episodes) from 1996 to 2006 met study inclusion criteria.
The primary outcome was sustained successful taper, defined as a daily dose =5 mg per day in the final week of the treatment episode and no treatment re-entry, opioid-related hospitalization or mortality within 18 months following episode completion.
The overall rate of sustained success was 13% among episodes meeting inclusion criteria (646 of 4917), 4.4% (646 of 14 602) among all episodes initiating a taper and 2.5% (646 of 25 545) among all completed episodes in the data set. The results of our multivariate logistic regression analyses suggested that longer tapers had substantially higher odds of success [12-52 weeks versus 52 weeks versus