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Substance Use, Hospitalizations, and Co-Occurring Disorders among Patients Transferred from a Needle Exchange Program to Opioid Maintenance Treatment

Bråbäck, Martin LU ; Brantefors, Anna ; Franck, Johan ; Brådvik, Louise LU ; Isendahl, Pernilla LU ; Nilsson, Suzan LU ; Troberg, Katja LU and Håkansson, Anders LU (2022) In International Journal of Environmental Research and Public Health 19(2).
Abstract

Opioid use disorders (OUD) is a relapsing condition with high mortality. Opioid maintenance treatment (OMT) reduces heroin use, and overall morbidity and mortality. The prevalence of psychiatric and substance use disorders, potential baseline predictors for psychiatric hospitalization, and psychiatric diagnoses at follow-up were investigated and may give hints about possible preventative strategies. The medical records for 71 patients were reviewed 36 months following referral to OMT from a needle exchange program (NEP). Their psychiatric diagnoses and hospitalizations were identified. Their baseline characteristics were assessed for potential differences between hospitalized versus non-hospitalized patients and between patients with... (More)

Opioid use disorders (OUD) is a relapsing condition with high mortality. Opioid maintenance treatment (OMT) reduces heroin use, and overall morbidity and mortality. The prevalence of psychiatric and substance use disorders, potential baseline predictors for psychiatric hospitalization, and psychiatric diagnoses at follow-up were investigated and may give hints about possible preventative strategies. The medical records for 71 patients were reviewed 36 months following referral to OMT from a needle exchange program (NEP). Their psychiatric diagnoses and hospitalizations were identified. Their baseline characteristics were assessed for potential differences between hospitalized versus non-hospitalized patients and between patients with and without psychiatric diagnoses in a longitudinal observational study without controls. A regression analysis was performed to identify predictors for hospitalization when controlling for OMT status. Sixty-five percent of the patients were hospitalized at least once with a psychiatric diagnosis. Substance-related reasons were prevalent, and detoxification occurred among 59% of patients, with sedative-hypnotics (benzodiazepines, zopiclone, zolpidem, and pregabalin) being the substance used by 52% of patients. Baseline use of these drugs and/or buprenorphine predicted for hospitalization when controlling for OMT status. During the follow-up period, 72% of patients met the criteria for a psychiatric diagnosis other than OUD. The prevalence of non-substance use disorders overlapping with SUD was 41%, and that overlapping with anxiety disorder was 27% of all participants. Increased attention to psychiatric co-occurring disorders in the treatment of OUD is required and the importance of addressing sedative-hypnotics use when initiating OMT is highlighted.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Opioid maintenance treatment, Polysubstance use, Psychiatric co-occurring disorders, Psychiatric hospitalization
in
International Journal of Environmental Research and Public Health
volume
19
issue
2
article number
697
publisher
MDPI AG
external identifiers
  • pmid:35055519
  • scopus:85122393455
ISSN
1661-7827
DOI
10.3390/ijerph19020697
language
English
LU publication?
yes
id
1d27b903-33e8-4c8b-8287-d3a6a2e4a350
date added to LUP
2023-01-04 15:35:57
date last changed
2024-04-04 15:21:17
@article{1d27b903-33e8-4c8b-8287-d3a6a2e4a350,
  abstract     = {{<p>Opioid use disorders (OUD) is a relapsing condition with high mortality. Opioid maintenance treatment (OMT) reduces heroin use, and overall morbidity and mortality. The prevalence of psychiatric and substance use disorders, potential baseline predictors for psychiatric hospitalization, and psychiatric diagnoses at follow-up were investigated and may give hints about possible preventative strategies. The medical records for 71 patients were reviewed 36 months following referral to OMT from a needle exchange program (NEP). Their psychiatric diagnoses and hospitalizations were identified. Their baseline characteristics were assessed for potential differences between hospitalized versus non-hospitalized patients and between patients with and without psychiatric diagnoses in a longitudinal observational study without controls. A regression analysis was performed to identify predictors for hospitalization when controlling for OMT status. Sixty-five percent of the patients were hospitalized at least once with a psychiatric diagnosis. Substance-related reasons were prevalent, and detoxification occurred among 59% of patients, with sedative-hypnotics (benzodiazepines, zopiclone, zolpidem, and pregabalin) being the substance used by 52% of patients. Baseline use of these drugs and/or buprenorphine predicted for hospitalization when controlling for OMT status. During the follow-up period, 72% of patients met the criteria for a psychiatric diagnosis other than OUD. The prevalence of non-substance use disorders overlapping with SUD was 41%, and that overlapping with anxiety disorder was 27% of all participants. Increased attention to psychiatric co-occurring disorders in the treatment of OUD is required and the importance of addressing sedative-hypnotics use when initiating OMT is highlighted.</p>}},
  author       = {{Bråbäck, Martin and Brantefors, Anna and Franck, Johan and Brådvik, Louise and Isendahl, Pernilla and Nilsson, Suzan and Troberg, Katja and Håkansson, Anders}},
  issn         = {{1661-7827}},
  keywords     = {{Opioid maintenance treatment; Polysubstance use; Psychiatric co-occurring disorders; Psychiatric hospitalization}},
  language     = {{eng}},
  month        = {{01}},
  number       = {{2}},
  publisher    = {{MDPI AG}},
  series       = {{International Journal of Environmental Research and Public Health}},
  title        = {{Substance Use, Hospitalizations, and Co-Occurring Disorders among Patients Transferred from a Needle Exchange Program to Opioid Maintenance Treatment}},
  url          = {{http://dx.doi.org/10.3390/ijerph19020697}},
  doi          = {{10.3390/ijerph19020697}},
  volume       = {{19}},
  year         = {{2022}},
}