Abstract
ObjectivesTo 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.MethodsWe 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.ResultsOver 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.ConclusionLong-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.
Highlights
The general population is aging and so are opioid users [1]
Research has shown that mortality in this group of aging patients in opioid maintenance treatment (OMT) is more associated with comorbid somatic conditions, rather than ongoing illicit drug use [3, 8, 9]
Somatic disease burden analysis showed that rather than patients being highly plagued by a single somatic complaint, they were bothered by a wide range of problems on a non-acute basis
Summary
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]. Research has shown that mortality in this group of aging patients in OMT is more associated with comorbid somatic conditions, rather than ongoing illicit drug use [3, 8, 9]. A Norwegian comparison of 149 patients continuously in OMT with 51 “interrupters” showed a reduction in drug-related somatic problems for the continuous patients, but no difference in the amount of non-drug-related somatic problems between the two groups [10]. On one hand, this is a testament to OMT reducing illicit drug use over time. It speaks to the growing importance of recognizing OMT patients’ additional, non-drug-related health care needs – and likely screening for and treating them at an earlier age than what is necessary in non-OMT populations
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