TY - JOUR
KW - Adult
KW - Comorbidity
KW - Diagnosis, Dual (Psychiatry)/statistics & numerical data
KW - Female
KW - Finland/epidemiology
KW - Forensic Psychiatry/statistics & numerical data
KW - Humans
KW - Male
KW - Opiate Substitution Treatment/statistics & numerical data
KW - Opioid-Related Disorders/drug therapy/epidemiology
KW - Registries
KW - Retrospective Studies
KW - Schizophrenia/epidemiology
KW - Young Adult
KW - Forensic psychiatry
KW - Opioid replacement treatment
KW - Schizophrenia
AU - K. Kivimies
AU - E. Repo-Tiihonen
AU - H. Kautiainen
AU - J. Tiihonen
A1 - 
AB - BACKGROUND: Substance use disorders are associated with poorer clinical outcomes in patients with schizophrenia. There is no specific treatment for amphetamine or cannabis use disorder, but methadone and buprenorphine are used as replacement therapy in the treatment of opioid dependence. Our aim was to study whether patients with schizophrenia have received opioid replacement therapy for their opioid use disorder. METHODS: The study sample consisted of 148 individuals diagnosed with schizophrenia who were in involuntary psychiatric treatment as forensic patients in Finland in 2012. The proportion of the study sample with comorbid opioid use disorder having received opioid replacement therapy prior to their forensic psychiatric treatment was compared to the available information of opioid dependent patients in general. The data were collected from forensic examination statements, patient files and other medical registers retrospectively. RESULTS: Of the study sample, 15.6% (23/148) had a history of opioid use disorder, of whom 8.7% (2/23) had received opioid replacement treatment (95% confidence interval (Cl): 1.1-28.0), even though opioid use disorder had been diagnosed in the treatment system. According the available information the corresponding proportion among patients with opioid use disorder and using substance use disorder services was 30.4% (565/1860, 95% Cl: 28.3-32.5). The fraction of patients receiving opioid replacement therapy was significantly lower among patients with schizophrenia (p = 0.022). CONCLUSIONS: Opioid replacement therapy was seldom used among schizophrenia patients who were later ordered to involuntary forensic psychiatric treatment. More attention should be paid to the possible use of opioids when planning treatment for patients with schizophrenia. TRIAL REGISTRATION: Our study is not a randomized controlled trial (but a register-based study); thus the trial registration is not applicable.
AD - Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Niuvankuja 65, FI-70240, Kuopio, Finland. kristiina.kivimies@niuva.fi.; Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Niuvankuja 65, FI-70240, Kuopio, Finland.; Department of General Practice, Unit of Primary Health Care, Helsinki University Central Hospital, University of Helsinki, PO Box 20, Helsingin yliopisto, FI-00014, Helsinki, Finland.; Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Niuvankuja 65, FI-70240, Kuopio, Finland.; Department of Clinical Neuroscience, Karolinska Institutet, Byggnad R5, SE-171 76, Stockholm, Sweden.
BT - Substance abuse treatment, prevention, and policy
C5 - Healthcare Disparities; Opioids & Substance Use
CP - 1
DO - 10.1186/s13011-018-0177-y
IS - 1
JF - Substance abuse treatment, prevention, and policy
LA - eng
M1 - Journal Article
N2 - BACKGROUND: Substance use disorders are associated with poorer clinical outcomes in patients with schizophrenia. There is no specific treatment for amphetamine or cannabis use disorder, but methadone and buprenorphine are used as replacement therapy in the treatment of opioid dependence. Our aim was to study whether patients with schizophrenia have received opioid replacement therapy for their opioid use disorder. METHODS: The study sample consisted of 148 individuals diagnosed with schizophrenia who were in involuntary psychiatric treatment as forensic patients in Finland in 2012. The proportion of the study sample with comorbid opioid use disorder having received opioid replacement therapy prior to their forensic psychiatric treatment was compared to the available information of opioid dependent patients in general. The data were collected from forensic examination statements, patient files and other medical registers retrospectively. RESULTS: Of the study sample, 15.6% (23/148) had a history of opioid use disorder, of whom 8.7% (2/23) had received opioid replacement treatment (95% confidence interval (Cl): 1.1-28.0), even though opioid use disorder had been diagnosed in the treatment system. According the available information the corresponding proportion among patients with opioid use disorder and using substance use disorder services was 30.4% (565/1860, 95% Cl: 28.3-32.5). The fraction of patients receiving opioid replacement therapy was significantly lower among patients with schizophrenia (p = 0.022). CONCLUSIONS: Opioid replacement therapy was seldom used among schizophrenia patients who were later ordered to involuntary forensic psychiatric treatment. More attention should be paid to the possible use of opioids when planning treatment for patients with schizophrenia. TRIAL REGISTRATION: Our study is not a randomized controlled trial (but a register-based study); thus the trial registration is not applicable.
PY - 2018
SN - 1747-597X; 1747-597X
SP - 018
EP - y
EP - 39+
T1 - Comorbid opioid use is undertreated among forensic patients with schizophrenia
T2 - Substance abuse treatment, prevention, and policy
TI - Comorbid opioid use is undertreated among forensic patients with schizophrenia
U1 - Healthcare Disparities; Opioids & Substance Use
U2 - 30400965
U3 - 10.1186/s13011-018-0177-y
VL - 13
VO - 1747-597X; 1747-597X
Y1 - 2018
Y2 - Nov 6
ER -