TY - JOUR
KW - Adult
KW - drop-outs
KW - Female
KW - Humans
KW - Male
KW - Opiate Substitution Treatment
KW - opioid maintenance treatment
KW - Opioid-Related Disorders/rehabilitation
KW - Patient Discharge
KW - Patient Readmission/statistics & numerical data
KW - Sweden
KW - Treatment Outcome
KW - treatment process
AU - B. Monwell
AU - A. Gerdner
A1 - 
AB - PROBLEM: Although efficacy studies of opioid maintenance treatment (OMT) have shown evidence of treatment benefits, there is still need for studies on its effectiveness in natural clinical processes. This study investigates the development in health, substance use and social conditions of those who applied for OMT, including those denied access or discharged. METHOD: First, persons assessed for admittance in 2005-2011 (n = 127) were categorized into four trajectory groups based on whether they were admitted or denied (n = 19), discharged (n = 31), readmitted (n = 21) or had been undergoing OMT without interruption (n = 56). Second, 99 of these, the analytical sample, were interviewed at follow-up using (a) the Addiction Severity Index (ASI) for seven problem-areas and housing, and (b) self-rated change in 11 problem areas. The ASI was compared to baseline interviews after 55 months (mean). Third, outcomes within groups was studied in relation to alternative interventions. RESULTS: Within the analytical sample, those denied OMT showed no improvements at group level, those discharged had some improvements, more if readmitted than if not and those with uninterrupted OMT showed the most comprehensive improvements. Those outside OMT, denied and discharged, had considerable mortality risks related to ongoing drug use, especially in lack of well-planned alternative interventions. CONCLUSION: Improvements strongly relate to access to OMT. This study underscores that access to OMT improves the situation in all areas investigated and decreases the risk for drug-related death. It underscores the importance of two major risk situations, i.e. being denied OMT and being discharged.
BT - Nordic journal of psychiatry
C5 - Measures; Opioids & Substance Use
CP - 1
CY - England
DO - 10.1080/08039488.2018.1539120
IS - 1
JF - Nordic journal of psychiatry
N2 - PROBLEM: Although efficacy studies of opioid maintenance treatment (OMT) have shown evidence of treatment benefits, there is still need for studies on its effectiveness in natural clinical processes. This study investigates the development in health, substance use and social conditions of those who applied for OMT, including those denied access or discharged. METHOD: First, persons assessed for admittance in 2005-2011 (n = 127) were categorized into four trajectory groups based on whether they were admitted or denied (n = 19), discharged (n = 31), readmitted (n = 21) or had been undergoing OMT without interruption (n = 56). Second, 99 of these, the analytical sample, were interviewed at follow-up using (a) the Addiction Severity Index (ASI) for seven problem-areas and housing, and (b) self-rated change in 11 problem areas. The ASI was compared to baseline interviews after 55 months (mean). Third, outcomes within groups was studied in relation to alternative interventions. RESULTS: Within the analytical sample, those denied OMT showed no improvements at group level, those discharged had some improvements, more if readmitted than if not and those with uninterrupted OMT showed the most comprehensive improvements. Those outside OMT, denied and discharged, had considerable mortality risks related to ongoing drug use, especially in lack of well-planned alternative interventions. CONCLUSION: Improvements strongly relate to access to OMT. This study underscores that access to OMT improves the situation in all areas investigated and decreases the risk for drug-related death. It underscores the importance of two major risk situations, i.e. being denied OMT and being discharged.
PP - England
PY - 2019
SN - 1502-4725; 0803-9488
SP - 24
EP - 30
EP - 
T1 - Opioid maintenance treatment: trajectories in and out of treatment
T2 - Nordic journal of psychiatry
TI - Opioid maintenance treatment: trajectories in and out of treatment
U1 - Measures; Opioids & Substance Use
U2 - 30636473
U3 - 10.1080/08039488.2018.1539120
VL - 73
VO - 1502-4725; 0803-9488
Y1 - 2019
ER -