Vitamin D status and associations with substance use patterns among people with severe substance use disorders in Western Norway

Abstract

Chronic and harmful substance use is associated with a cluster of harms to health, including micronutrient deficiencies. Maintaining adequate levels of vitamin D is important for musculoskeletal and other aspects of health. In this prospective longitudinal cohort study, 666 participants drawn from outpatient opioid agonist therapy (OAT) clinics and community care clinics for substance use disorder in Western Norway were assessed annually for determination of serum 25-hydroxyvitamin D [s-25(OH)D] levels. Fifty-seven percent were deficient at baseline (s-25(OH)D < 50 nmol/l), and 19% were severely deficient (s-25(OH)D < 25 nmol/l). Among those deficient/severely deficient at baseline, 70% remained deficient/severely deficient at the last measurement (mean duration 714 days). Substance use patterns and dosage of opioids for OAT were not associated with vitamin D levels. One exception was found for cannabis, where consumption on a minimum weekly basis was associated with lower levels at baseline (mean difference: −5.2 nmol/l, 95% confidence interval [CI]: −9.1, − 1.3), but without clear time trends (mean change per year: 1.4 nmol/l, CI: − 0.86, 3.7). The high prevalence of sustained vitamin D deficiency in this cohort highlights the need for targeted monitoring and supplementation for this and similar at-risk populations.

The Skin–Brain Axis: From UV and Pigmentation to Behaviour Modulation

“…Therefore, vitamin D-deficient individuals may be at higher risk for developing maladaptive opioid-dependent behaviour. This observation has also been supported by a few independent population-based studies [ 129 , 136 , 137 ]. Thus, UV radiation-induced endorphin elevation may trigger opioid-related central effects, e.g., reward and dependency, to prevent vitamin D deficiency by promoting maximal vitamin D synthesis through sun-seeking behaviour.…”

Healthy eating among people on opioid agonist therapy: a qualitative study of patients’ experiences and perspectives

“…Furthermore, substance use can severely impact an individuals’ nutritional habits and diet, as substances are often favored over food [ 11 ]. According to recent Norwegian research [ 12 , 13 ], approximately half of the patients receiving opioid agonist therapy (OAT) are deficient in vitamin D and folic acid.…”