Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

No obvious effect on mortality from a patient choice reform expanding access to opioid disorder treatment – results from a natural experiment of policy change in Sweden

Håkansson, Anders LU ; Janfada-Baloo, Sahar and Berge, Jonas LU (2023) In Substance Abuse: Treatment, Prevention, and Policy 18(1).
Abstract

Background: Opioid-related overdose deaths remain a common cause of death in many settings, and opioid maintenance treatment is evidence-based for the treatment of opioid use disorders. However, access to such treatment varies and is limited in many settings. Methods: The present study examines the longitudinal effects of a regional patient choice reform which substantially increased availability to opioid maintenance treatment in one Swedish county, starting from 2014. A previous follow-up, limited in time, indicated a possible effect on mortality from this intervention, demonstrating a lower increase in overdose deaths than in counties without this reform. The present study follows overdose deaths through 2021, and compares the... (More)

Background: Opioid-related overdose deaths remain a common cause of death in many settings, and opioid maintenance treatment is evidence-based for the treatment of opioid use disorders. However, access to such treatment varies and is limited in many settings. Methods: The present study examines the longitudinal effects of a regional patient choice reform which substantially increased availability to opioid maintenance treatment in one Swedish county, starting from 2014. A previous follow-up, limited in time, indicated a possible effect on mortality from this intervention, demonstrating a lower increase in overdose deaths than in counties without this reform. The present study follows overdose deaths through 2021, and compares the intervention county to the remaining parts in the country, using death certificate statistics from the national causes of death register. Results: The present study does not demonstrate any significant difference in the development of overdose mortality in the county where this reform substantially expanded treatment access, compared to other counties in the country. Conclusions: The study underlines the importance to maintain extensive efforts against overdose deaths over and above the treatment of opioid use disorders, such as low-threshold provision of opioid antidotes or other interventions specifically addressing overdose risk behaviors.

(Less)
Please use this url to cite or link to this publication:
author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Mortality, Opioid maintenance treatment, Opioid use disorders, Overdose
in
Substance Abuse: Treatment, Prevention, and Policy
volume
18
issue
1
article number
64
publisher
BioMed Central (BMC)
external identifiers
  • pmid:37932776
  • scopus:85175875381
ISSN
1747-597X
DOI
10.1186/s13011-023-00577-4
language
English
LU publication?
yes
id
9472ea88-fc61-4f9b-8d4b-7c84fce87684
date added to LUP
2023-11-23 12:28:39
date last changed
2024-04-20 15:54:31
@article{9472ea88-fc61-4f9b-8d4b-7c84fce87684,
  abstract     = {{<p>Background: Opioid-related overdose deaths remain a common cause of death in many settings, and opioid maintenance treatment is evidence-based for the treatment of opioid use disorders. However, access to such treatment varies and is limited in many settings. Methods: The present study examines the longitudinal effects of a regional patient choice reform which substantially increased availability to opioid maintenance treatment in one Swedish county, starting from 2014. A previous follow-up, limited in time, indicated a possible effect on mortality from this intervention, demonstrating a lower increase in overdose deaths than in counties without this reform. The present study follows overdose deaths through 2021, and compares the intervention county to the remaining parts in the country, using death certificate statistics from the national causes of death register. Results: The present study does not demonstrate any significant difference in the development of overdose mortality in the county where this reform substantially expanded treatment access, compared to other counties in the country. Conclusions: The study underlines the importance to maintain extensive efforts against overdose deaths over and above the treatment of opioid use disorders, such as low-threshold provision of opioid antidotes or other interventions specifically addressing overdose risk behaviors.</p>}},
  author       = {{Håkansson, Anders and Janfada-Baloo, Sahar and Berge, Jonas}},
  issn         = {{1747-597X}},
  keywords     = {{Mortality; Opioid maintenance treatment; Opioid use disorders; Overdose}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Substance Abuse: Treatment, Prevention, and Policy}},
  title        = {{No obvious effect on mortality from a patient choice reform expanding access to opioid disorder treatment – results from a natural experiment of policy change in Sweden}},
  url          = {{http://dx.doi.org/10.1186/s13011-023-00577-4}},
  doi          = {{10.1186/s13011-023-00577-4}},
  volume       = {{18}},
  year         = {{2023}},
}