Large and non-specific somatic disease burdens among ageing, long-term opioid maintenance treatment patients
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(2020) 15:87
RESEARCH
Open Access
Large and non-specific somatic disease burdens among ageing, long-term opioid maintenance treatment patients David Medved1,2, Thomas Clausen1, Anne Bukten1,2* , Ronny Bjørnestad3 and Ashley Elizabeth Muller1,4
Abstract Objectives: To describe and explore somatic disease burdens of ageing long-term patients in opioid maintenance treatment (OMT), a unique population emerging in countries offering OMT as a long-term treatment. Methods: We used data from the Norwegian Cohort of Patient in Opioid Maintenance Treatment and Other Drug Treatment Study (NorComt). 156 patients enrolled for at least three of the past five years provided data during structured interviews, including on chronic conditions, somatic treatment received, mental distress (SCL-25), and treatment satisfaction. A somatic disease burden was calculated from a list measuring the recent severity of 16 somatic complaints. A hierarchical multiple linear regression analysis identified correlates of somatic disease burden. Results: Over half of patients reported at least seven somatic complaints. Reported somatic disease burden was associated with higher mental distress, more chronic conditions, fewer years in OMT, and treatment dissatisfaction. Age was unrelated, and there were few gender differences. These five variables explained 43.6% of the variance in disease burden. Conclusion: Long-term OMT patients experience a large range of somatic complaints, and at non-acute levels. As OMT secures longevity for opioid-dependent persons, the clinical focus must be adjusted from acute to chronic care. Providers must address how to optimize health and quality of life while in treatment, as treatment may last for many years. Keywords: Opioid maintenance treatment, Opioids, Somatic disease burden, Ageing, Chronic disease, Mental distress
Introduction The general population is aging and so are opioid users [1]. Opioid use accounts for a significant amount of the global disease burden, and in 2016 there were 34 million opioid users worldwide [2]. In Norway, the gold standard treatment for opioid * Correspondence: [email protected] 1 Norwegian Centre for Addiction Research, Institute for Clinical Medicine, University of Oslo, Bygg 45, Ullevål sykehus, Kirkeveien 166, 0450 Oslo, Norway 2 Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway Full list of author information is available at the end of the article
dependence, opioid maintenance treatment (OMT), is free and publicly provided, has no waiting lists, and is a life-long treatment for many. The mean age of OMT patients is therefore steadily increasing, while the intake of young patients is low, with nearly one third of patients now more than 50 years old [3]. The fact that the population of patients in OMT is ageing is a clear indicator of treatment stability and success [3, 4]. One recent qualitative study has reported that many long-term OMT patients in Norway attribute their survival to an older age to OMT [5].
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