Changes in somatic disease incidents during opioid maintenance treatment: results from a Norwegian cohort study. Issue 1 (6th August 2011)

• Record Type: Journal Article
• Authors: Skeie, Ivar; Brekke, Mette; Gossop, Michael; Lindbaek, Morten; Reinertsen, Even; Thoresen, Magne; Waal, Helge
• Is Part Of: BMJ open. Volume 1:Issue 1(2011)
• Publication Date: 2011-08-06
• Subjects: Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2011-000130
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: To examine the effect of opioid maintenance treatment (OMT) on somatic morbidity in a cohort of OMT patients. Design: Retrospective cohort study. Setting: OMT programme in two Norwegian counties. Participants: 200 OMT patients, participation rate 71.2%. Main outcome measures: Incidence 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. Results: IR 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)). Conclusion: Acute/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.