title: Increased somatic morbidity in the first year after leaving opioid maintenance treatment: results from a Norwegian cohort study.
abstract: OBJECTIVE
  Some patients on opioid maintenance treatment (OMT) leave treatment temporarily or permanently. This study investigated whether patients interrupting their OMT differed from non-interrupters in sociodemographic and drug-use characteristics and examined acute/sub-acute somatic morbidity among the interrupters, prior to, during, and after OMT.
  
  
  METHODS
  Cohort design. OBSERVATION PERIOD: 5 years prior to, up to first 5 years during, and up to 5 years after interruption of OMT.
  
  
  METHODS
  The sample (n = 200) comprised 51 OMT interrupters and 149 non-interrupters. Data on patient characteristics were obtained from interviews and OMT register information. Data on somatic morbidity were gathered from hospital records.
  
  
  METHODS
  Key patient characteristics among OMT interrupters and non-interrupters. Incidence rates of acute and sub-acute somatic disease incidents leading to hospital treatment (drug-related/non-drug-related/injuries) prior to/during/after OMT.
  
  
  RESULTS
  Interrupters and non-interrupters did not differ in sociodemographic characteristics, while longer duration of amphetamine and benzodiazepine dependence predicted OMT interruption. Interrupters scored significantly higher on drug-taking and overdose during OMT but still had a significant 41% reduction in drug-related treatment, episodes. After interruption of treatment, such episodes increased markedly and were 3.6 times more frequent during the first post-OMT year compared to the pre-OMT period (p < 0.001). This increase was highest during the first months after OMT interruption. 2-5 years after interruption there was no significant increase.
  
  
  CONCLUSIONS
  Increased somatic morbidity was found among OMT interrupters during the first year after OMT, and especially during the immediate post-treatment period.
authors.affiliation: Centre for Addiction Treatment, Oslo University Hospital, Oslo, Norway. ivar.skeie@gmail.com
authors.forename: I
authors.initials: I
authors.lastname: Skeie
authors.forename: M
authors.initials: M
authors.lastname: Brekke
authors.forename: T
authors.initials: T
authors.lastname: Clausen
authors.forename: M
authors.initials: M
authors.lastname: Gossop
authors.forename: M
authors.initials: M
authors.lastname: Lindbaek
authors.forename: E
authors.initials: E
authors.lastname: Reinertsen
authors.forename: M
authors.initials: M
authors.lastname: Thoresen
authors.forename: H
authors.initials: H
authors.lastname: Waal
mesh_terms: D000328:Adult; D002047:Buprenorphine / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D009664:Norway / Q000453:epidemiology; D058850:Opiate Substitution Treatment / Q000523:psychology*; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000523:psychology*; D010349:Patient Compliance / Q000523:psychology; D019966:Substance-Related Disorders / Q000453:epidemiology*; D013997:Time Factors
chemical_list: D002047:Buprenorphine; D008691:Methadone