Self-injuring behavior and mental illness in opioid-dependent patients treated with implant naltrexone, methadone, and buprenorphine in Western Australia

Document Type

Journal Article

Publication Title

International Journal of Mental Health and Addiction


Springer New York LLC


School of Medical and Health Sciences




Kelty, E., & Hulse, G. (2018). Self-Injuring Behavior and Mental Illness in Opioid-Dependent Patients Treated with Implant Naltrexone, Methadone, and Buprenorphine in Western Australia. International Journal of Mental Health and Addiction, 16(1), 187-198. doi:/10.1007/s11469-017-9856-6

Available here.


This study aims to compare rates of intentional self-harm (ISH) and other mental illness events in opioid-dependent patients treated implant naltrexone, with those treated with methadone or buprenorphine. Patients treated between 2001 and 2010 were linked with hospital, emergency (ED), outpatient mental health, and mortality records. Rates of health events were compared between the three groups using survival analysis and generalized estimating equations. Rates of suicide and ISH in patients treated with naltrexone were comparable to patients treated with methadone or buprenorphine. Rates of mental health and psychiatric hospital admissions, ED attendances, and outpatient mental health events were significantly lower in patients treated with methadone compared with naltrexone. Buprenorphine patients had higher rates of psychiatric admission, but lower rates of ED and outpatient mental health events compared with naltrexone patients. Naltrexone was associated with high rates of mental health events, however further controlled research is required.



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