From restrictive to more liberal: variations in moratlity among patients in opioid maintenance treament over a 12-year period

BMC Health Services Research
Anne BuktenThomas Clasuen

Abstract

As the effect of opioid maintenance treatment (OMT) on overdose mortality varies both between and within countries, treatment programs need to be evaluated in different treatment settings and over time within settings. We evaluated variations in mortality in a national programme: from the initial rollout as restrictive and low-capacity to its gradual change into more liberal and higher-volume. A 12-year prospective longitudinal cohort study including all persons (n = 6871) applying for and entering OMT in Norway (1997-2009). We followed all patients until 2009 or until death. We used crude mortality rates (CMR) to calculate overdose and all-cause mortality among patients in OMT before, during and after treatment, during a 12-year time-period. We also calculated variations in overdose and all-cause mortality over the course of treatment and after treatment termination. We fitted proportional hazards models with covariates to the data. OMT significantly reduces risk of mortality compared to being outside of treatment. The reduction in overdose death was most substantial during the initial phase of the Norwegian OMT-programme, still; we consistently find that overdose deaths were more than halved in all calendar-periods throughout...Continue Reading

References

Jul 5, 2005·Drug and Alcohol Dependence·James BellStuart Gilmour
Jun 24, 2011·Journal of Substance Abuse Treatment·Gráinne CousinsTom Fahey
Feb 17, 2015·The International Journal on Drug Policy·P RouxM P Carrieri
Jan 1, 2009·International Journal of Prisoner Health·M T ArendsG I C M Van 't Hoff
May 8, 2015·Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række·Anne Gro Pedersen, Christian Lycke Ellingsen
Jun 2, 2016·European Addiction Research·Christian TjagvadThomas Clausen
Jan 31, 2017·Journal of Substance Abuse Treatment·Anders Ledberg
Apr 28, 2017·BMJ : British Medical Journal·Luis SordoRoberto Pastor-Barriuso

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Citations

May 4, 2020·Journal of Substance Abuse Treatment·Gabrielle K Welle-StrandMonica Sarfi
Jun 13, 2021·Drug and Alcohol Dependence·Morten HesseThomas Clausen

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