Changes in somatic disease incidents during opioid maintenance treatment: results from a Norwegian cohort study

Abstract

ObjectivesTo examine the effect of opioid maintenance treatment (OMT) on somatic morbidity in a cohort of OMT patients.DesignRetrospective cohort study.SettingOMT programme in two Norwegian counties.Participants200 OMT patients, participation rate 71.2%.Main outcome measuresIncidence rates (IR) before, during and after OMT for acute/subacute hospital-treated somatic disease incidents (drug-related, non-drug-related, injuries) and rates for inpatient days and outpatient treatment contacts.ResultsIR for drug-related hospital treatment episodes were 76% lower during compared to before OMT (before versus during incidence rate ratio (IRR) 4.2 (95% CI 2.9 to 6.2), p<0.001) and 11 times higher after compared to during OMT (after versus during IRR 11.1 (6.6 to 18.5), p<0.001). For non-drug-related treatment episodes, IR were 35% higher during than before OMT (before versus during IRR 0.7 (0.6 to 1.0), p=0.02) and 32% higher after compared to during OMT (IRR 1.4 (0.9 to 2.2), p=0.15), while injuries showed little change according to OMT status. Although patients with on-going drug-taking during OMT showed less reduction in drug-related hospital-treated incidents during treatment than patients not using illicit drugs, the quartile with most drug-taking showed a significant reduction (before versus during IRR 3.6 (2.4 to 5.3)). Patients who had experienced cessation of OMT showed a significant reduction in drug-related treatment episodes during OMT (before versus during IRR 1.7 (1.0 to 2.9)), although less than patients without OMT interruptions (before versus during IRR 6.1 (3.6 to 10.6)), and a significant increase after OMT cessation compared with during OMT (IRR 5.4 (3.0 to 9.7)).ConclusionAcute/subacute drug-related somatic morbidity is reduced during compared to before OMT. This was also found for patients with on-going drug-taking during OMT. However, acute drug-related health problems show an increase after OMT cessation, and this is a matter of concern. Further studies on somatic morbidity after OMT cessation should be carried out.

Increased Somatic Morbidity in the First Year after Leaving Opioid Maintenance Treatment: Results from a Norwegian Cohort Study

“…A significant reduction in total drug-related acute and sub-acute somatic disease leading to hospital treatment for patients who entered OMT was reported in a previous paper from our group [21]. This reduction was also found among those who later interrupted their OMT, though it was less than among those without interruption of treatment.…”

Factors associated with involuntary admissions among patients with substance use disorders and comorbidity: a cross-sectional study

“…This finding indicates that a pattern of severe substance use increases the risk of somatic disorders. High prevalence of chronic disease, acute disease, and injuries among SUD patients have been demonstrated by others [36,37]. This is an often neglected problem that health service providers should take into consideration.…”

Neonatal outcomes following in utero exposure to methadone or buprenorphine: A National Cohort Study of opioid-agonist treatment of Pregnant Women in Norway from 1996 to 2009

“…4 [15][16][17]. Opioid dependent individuals have increased mortality rates and increased somatic and psychiatric morbidity, as well as social problems [18][19][20][21][22][23][24].…”