Carlsen Siv-Elin Leirvaag, Lunde Linn-Heidi, Torsheim Torbjørn
Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.
Department of Clinical Psychology, University of Bergen, Bergen, Norway.
Subst Abuse Rehabil. 2020 Jan 29;11:9-18. doi: 10.2147/SAR.S221618. eCollection 2020.
Opioid maintenance treatment reduces a person's use of heroin. However, frequent substance use in treatment is a problem.
To examine the association between opioid maintenance treatment and opioid/polydrug use, and whether social factors, adverse experiences, social resources, and quality of life are associated with opioid/polydrug use during the first 12 months in treatment.
Forty-seven participants from treatment units in Bergen, Norway participated in five waves of data collection. Every third month, a structured face-to-face interview collected self-reported data on sociodemographic characteristics, opioid/polydrug use, participants' social resources or adverse experiences, and quality of life. Data were collected as part of KVARUS, the National Quality Register for Substance Abuse Treatment. A multilevel binary logistic regression analysis was conducted to examine the association of opioid/polydrug use and time in current treatment. The analysis included regressions of opioid/polydrug use on time-invariant baseline adverse experiences and social resources, and time-varying reports of quality of life.
There was a significant negative association between time in treatment and use of opioids, =-0.89, = 0.19, = <0.01. Furthermore, a negative association of age at substance use on polydrug use was found, =-0.40, =0.19, = 0.03. A higher overall quality of life was significantly associated with lower odds of opioid use during opioid maintenance treatment, = -0.62, = 0.23, = < 0.01. Social dimensions, participants' adverse experiences, and social resources were not associated with polydrug or opioid use.
Opioid maintenance treatment is associated with lowered opioid use, but to a lesser degree with polydrug use. Our findings add quality of life as an important factor that should be given particular attention because it can offer insight to aspects that can affect the patients' opioid use.
阿片类药物维持治疗可减少个人对海洛因的使用。然而，治疗期间频繁使用药物是一个问题。
研究阿片类药物维持治疗与阿片类药物/多种药物使用之间的关联，以及社会因素、不良经历、社会资源和生活质量是否与治疗的前12个月内阿片类药物/多种药物使用相关。
来自挪威卑尔根治疗单位的47名参与者参加了五轮数据收集。每三个月进行一次结构化面对面访谈，收集关于社会人口学特征、阿片类药物/多种药物使用、参与者的社会资源或不良经历以及生活质量的自我报告数据。这些数据是作为国家药物滥用治疗质量登记处KVARUS的一部分收集的。进行了多层次二元逻辑回归分析，以研究阿片类药物/多种药物使用与当前治疗时间的关联。分析包括阿片类药物/多种药物使用对时间不变的基线不良经历和社会资源以及生活质量的随时间变化报告的回归。
治疗时间与阿片类药物使用之间存在显著负相关，β=-0.89，标准误=0.19，P=<0.01。此外，发现开始使用药物时的年龄与多种药物使用呈负相关，β=-0.40，标准误=0.19，P=0.03。较高的总体生活质量与阿片类药物维持治疗期间较低的阿片类药物使用几率显著相关，β=-0.62，标准误=0.23，P=<0.01。社会层面、参与者的不良经历和社会资源与多种药物或阿片类药物使用无关。
阿片类药物维持治疗与阿片类药物使用减少有关，但与多种药物使用的关联程度较小。我们的研究结果表明生活质量是一个应特别关注的重要因素，因为它可以为影响患者阿片类药物使用的方面提供见解。
