A prospective cohort of treatment-seeking patients with problematic use of prescription narcotic drugs: study protocol and baseline characteristics.

BACKGROUND

There is limited knowledge on long-term outcomes of tapering treatment for individuals with problematic use of prescription narcotics, including opioids and benzodiazepines. The overall aim of the study is to investigate clinical trajectories and treatment outcomes of patients seeking treatment in addiction care.

METHODS

This paper presents the study protocol and baseline characteristics of a cohort of patients seeking treatment for problematic use of prescription narcotic drugs at specialized outpatient addiction services. Treatment for addiction at the clinic includes drug tapering and treatment for underlying psychiatric disorders. Data in this prospective cohort study is collected from biomarkers, self-report questionnaires, patient medical records, and national registers at baseline and follow-up visits at 6, 12, and 24 months.

RESULTS

A clinical cohort of 405 participants were enrolled in the study between 2018 and 2023. The study population (57.5% women; 42.5% men) at baseline had a mean age of 49.2 years (SD = 14.0). Participants in the cohort had used prescription narcotics for 11 years on average before seeking treatment, with opioid analgesics (66.2%) being the most common at baseline, followed by benzodiazepines (50.9%). Most participants (75.9%) had received prescription narcotics from their health care provider, although illegal sources were common. Besides substance use disorders, many also had anxiety disorders (46.3%) and depression (40.4%) at baseline. Previous treatment for problematic alcohol or drug use were reported by 14.0% and 21.6%, respectively.

DISCUSSION

This prospective, naturalistic cohort will provide novel information on long-term outcomes of tapering treatment and identify prognostic factors for treatment success, including abstinence. Future papers will investigate individual and treatment-related characteristics of the patient population. Baseline data suggest that many patients with problematic use of prescription narcotics receive prescriptions over many years from their regular health care providers, which contradicts most clinical guidelines.

TRIAL REGISTRATION

NCT03713983 22/10/2018.