Large and non-specific somatic disease burdens among ageing, long-term opioid maintenance treatment patients

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.

Organ pathologies detected post‐mortem in patients receiving opioid agonist treatment for opioid use disorder: a nation‐wide 2‐year cross‐sectional study

“…This result is in common with studies reporting excess mortality, particularly for respiratory disease in individuals with OUD or SUD compared with the general population [29,30]. Although we lacked information on smoking habits, the reported prevalence of smoking among Norwegian OAT patients is 91% [44], similar to other OAT populations [45][46][47]. Spirometry and volumetric computerized tomography (CT) screening may be appropriate for long-term heavy smokers for early diagnosis of chronic obstructive pulmonary disease and lung cancer, while smoking harm reduction interventions such as the use of snus (smokeless tobacco) [48] or e-cigarettes might be relevant for some if smoking cessation is difficult or not wanted.…”

Perceived healthcare stigma among patients in opioid substitution treatment: a qualitative study

“…People with substance use disorders (SUD) in general, and opioid use disorder (OUD) in particular, are at risk of a range of adverse health effects. These negative effects include increased drug related and non-drug related mortality [ 1 , 2 ]; physical morbidity such as hepatitis C, chronic obstructive pulmonary disease and self-reported somatic symptoms [ 3 , 4 ]; and under-utilization of healthcare [ 3 , 5 , 6 ]. In addition, people with SUD also face stigma and discrimination.…”

Healthcare utilization for somatic conditions among Swedish patients in opioid substitution treatment, with and without on-site primary healthcare

“…al. [ 20 ] showed that 81% of long-term OST patients reported that they had utilized PHC during the past six months, and 51% reported that they had utilized other healthcare than PHC during the same period. In a study by Saitz et al [ 42 ], which assessed factors associated with PHC, 41% of almost 6,000 people in addiction treatment reported that they did not have a PHC physician.…”

“…In addition, side effects from opioids suggest that patients in OST might have a high prevalence of constipation, sleeping apnea and sexual dysfunction/hypogonadism. Previous research from Scandinavia and North America has also shown that patients in OST have poor self-rated health and a heavy burden of physical symptoms [19][20][21]. Medved et al [20] showed that almost three-quarters of Norwegian OST patients reported at least one chronic somatic condition, with hepatitis C (53%) and asthma (21%) being the most frequently reported.…”

“…Previous research from Scandinavia and North America has also shown that patients in OST have poor self-rated health and a heavy burden of physical symptoms [19][20][21]. Medved et al [20] showed that almost three-quarters of Norwegian OST patients reported at least one chronic somatic condition, with hepatitis C (53%) and asthma (21%) being the most frequently reported.…”