Clausen Thomas, Åsland Reidun, Kristensen Øistein
Avdeling for rus og avhengighetsbehandling Sørlandet sykehus og Senter for Rus- og avhengighetsforskning (SERAF) Institutt for Klinisk medisin Universitetet i Oslo.
Avdeling for rus og avhengighetsbehandling Sørlandet sykehus.
Tidsskr Nor Laegeforen. 2014 Jun 17;134(11):1146-50. doi: 10.4045/tidsskr.13.0821.
OMT tends to involve treatment over an extended period of time. Some OMT patients terminate the treatment. There is a need for more knowledge about how these persons do following treatment.
We undertook a retrospective review of patient records at Sørlandet Hospital in Kristiansand for patients who had undergone OMT in the period 1998-2009. Data from 103 discharged patients were included in the study, registered on two occasions--31 December 2009 and 30 June 2011.
Of the 469 patients who started their OMT during the period of study, altogether 103 patients (22%) terminated the treatment. One-half of the 103 patients who terminated their treatment did so because they no longer wanted OMT or failed to report to the hospital. The others terminated the treatment because they wanted medication from their GP other than OMT (n = 11), because they considered themselves to be no longer addicted and in need of treatment (n = 19) or because they maintained a considerable substance use (n = 21). Seven patients wanted a planned tapering-off of OMT drugs. The status for these 103 discharged patients as of 31 December 2009 (median 1,034 days after discharge) was: uncontrolled substance use: 30%; dead: 17%; other medication from GP: 14%; psychiatric treatment: 12%; imprisoned: 8%; OMT in another county: 2%; drug-free without maintenance treatment: 11%; unknown: 6%. Eighteen months later, altogether 36 of them had changed their status. The group with uncontrolled substance use (n = 31) had undergone the greatest change--altogether 14 were back in OMT, ten continued their substance use and four had died.
The OMT patients who terminated the treatment had a high rate of mortality. Approximately 10 % of those discharged lived stable drug-free lives without OMT medication during the period of observation.
阿片类药物维持治疗（OMT）往往需要较长时间的治疗。一些接受OMT治疗的患者会终止治疗。对于这些患者治疗后的情况，我们需要了解更多。
我们对克里斯蒂安桑的索兰德医院1998 - 2009年期间接受OMT治疗的患者病历进行了回顾性研究。研究纳入了103例出院患者的数据，分别于2009年12月31日和2011年6月30日进行登记。
在研究期间开始接受OMT治疗的469例患者中，共有103例（22%）终止了治疗。在这103例终止治疗的患者中，有一半是因为他们不再希望接受OMT治疗或未到医院报到。其他患者终止治疗的原因包括：他们希望从全科医生处获得OMT以外的药物（n = 11）；他们认为自己不再成瘾且无需治疗（n = 19）；或者他们仍大量使用药物（n = 21）。7例患者希望有计划地逐渐减少OMT药物用量。截至2009年12月31日（出院后中位数为1034天），这103例出院患者的状况如下：药物使用失控：30%；死亡：17%；从全科医生处接受其他药物治疗：14%；接受精神科治疗：12%；入狱：8%；在另一个县接受OMT治疗：2%；无维持治疗且无药物使用：11%；情况不明：6%。18个月后，他们中共有36人状况发生了变化。药物使用失控组（n = 31）变化最大——共有14人重新接受OMT治疗，10人继续使用药物，4人死亡。
终止治疗的OMT患者死亡率较高。在观察期内，约10%的出院患者在未使用OMT药物的情况下过着稳定的无药生活。
