title: Engagement with opioid maintenance treatment and reductions in crime: a longitudinal national cohort study.
abstract: OBJECTIVE
  This study investigates changes in criminal involvement among patients in opioid maintenance treatment (OMT) over a 7-year period prior to, during and after treatment, particularly in relation to differences in treatment engagement.
  
  
  METHODS
  Treatment data on all patients who started OMT in Norway between 1997 and 2003 (n = 3221) were cross-linked with national criminal records. The period of observation was divided into four phases; pre-treatment, in-treatment, between treatments and post-treatment.
  
  
  RESULTS
  During OMT, rates of criminal convictions for the cohort were reduced to fewer than half of waiting-list levels [incidence rate (IR) 0.63 versus 1.57]. Patients in continuous treatment had the fewest convictions (IR 0.47) during treatment. The highest rates were found among patients out of treatment after several treatment episodes (IR 1.52). All groups had significantly fewer criminal convictions during treatment compared to before treatment. Staying in OMT for 2 years or more was associated with significantly reduced rates of convictions during treatment. Younger age and pre-treatment criminal convictions were associated with significantly (P < 0.001) more convictions during treatment. Those who left treatment, permanently or temporarily, relapsed into high levels of convictions outside treatment.
  
  
  CONCLUSIONS
  Criminal activity appears to be reduced in Norway during opiate maintenance treatment. Younger age and prior history of criminal activity are important risk factors for continued criminal activity during treatment.
authors: SERAF-Norwegian Centre for Addiction Research, University of Oslo, Norway. anne.bukten@medisin.uio.no
authors: Anne
authors: A
authors: Bukten
authors: Svetlana
authors: S
authors: Skurtveit
authors: Michael
authors: M
authors: Gossop
authors: Helge
authors: H
authors: Waal
authors: Per
authors: P
authors: Stangeland
authors: Ingrid
authors: I
authors: Havnes
authors: Thomas
authors: T
authors: Clausen
mesh_terms: D000328:Adult; D002047:Buprenorphine / Q000627:therapeutic use*; D003415:Crime / Q000517:prevention & control / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009664:Norway; D058850:Opiate Substitution Treatment / Q000379:methods* / Q000706:statistics & numerical data; D009293:Opioid-Related Disorders / Q000534:rehabilitation*
chemical_list: D009292:Narcotic Antagonists; D002047:Buprenorphine; D008691:Methadone