Francesca Melis, Thomas Clausen, Charlotte Castel, Omid Dadras, Silvana De Pirro, Lars Henrik Myklebust, Ann Oldervoll, Linda Elise Wüsthoff, Desiree Eide
{"title":"挪威首家海洛因辅助治疗诊所的患者特征。","authors":"Francesca Melis, Thomas Clausen, Charlotte Castel, Omid Dadras, Silvana De Pirro, Lars Henrik Myklebust, Ann Oldervoll, Linda Elise Wüsthoff, Desiree Eide","doi":"10.1177/29767342241271991","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Heroin-assisted treatment (HAT) is an evidence-based treatment option for opioid use disorder (OUD), available in a limited number of countries. Norway implemented a 5-year HAT project in 2022, aiming to assess its effectiveness and its potential integration into the country's OUD treatment system. This study describes and compares patients' baseline characteristics from the Oslo and Bergen HAT clinics, providing a comprehensive picture of the unique population and the real-world application of HAT.</p><p><strong>Methods: </strong>This cross-sectional study examines the baseline characteristics of consenting HAT patients within the first 2 years of operation (<i>n</i> = 86). Self-reported questionnaires gathered sociodemographics, previous treatment experiences, self-reported crime, and substance use, as well as motivations and expectations for treatment. Comparisons between the clinics were carried out using <i>t</i>-tests, Mann-Whitney <i>U</i> tests, Chi-square, and Fisher's exact test.</p><p><strong>Results: </strong>The majority of the patients were enrolled at the Oslo clinic (76%) and were male (80%). At admission, the average age was 45.9, with a significantly younger group in Bergen (42.5 vs 47.3, <i>P</i> < .05). While no patients reported being unhoused, 17% noted unstable housing within the preceding month. Unemployment was prevalent (91%) alongside previous treatment experiences (95%), with a median of 2 prior medication types. In the 3 months preceding HAT initiation, 78% of patients reported being victims of crime, and 44% committed at least one crime. Over their lifetime, 2 in 5 participants (41%) had experienced an unwanted overdose and 43% had shared syringes and equipment.</p><p><strong>Conclusion: </strong>This study reveals a cohort experiencing societal marginalization, including unstable housing, unsatisfactory prior OUD treatment, high-risk behaviors, and frequent interactions with criminal activities, predominantly as victims. While the Oslo and Bergen clinics serve a similar patient profile, notable differences emerged in the reasons for discontinuing past OUD treatment and crime-related factors.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"13-24"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Patient Characteristics From Norway's First Heroin-Assisted Treatment Clinics.\",\"authors\":\"Francesca Melis, Thomas Clausen, Charlotte Castel, Omid Dadras, Silvana De Pirro, Lars Henrik Myklebust, Ann Oldervoll, Linda Elise Wüsthoff, Desiree Eide\",\"doi\":\"10.1177/29767342241271991\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Heroin-assisted treatment (HAT) is an evidence-based treatment option for opioid use disorder (OUD), available in a limited number of countries. Norway implemented a 5-year HAT project in 2022, aiming to assess its effectiveness and its potential integration into the country's OUD treatment system. This study describes and compares patients' baseline characteristics from the Oslo and Bergen HAT clinics, providing a comprehensive picture of the unique population and the real-world application of HAT.</p><p><strong>Methods: </strong>This cross-sectional study examines the baseline characteristics of consenting HAT patients within the first 2 years of operation (<i>n</i> = 86). Self-reported questionnaires gathered sociodemographics, previous treatment experiences, self-reported crime, and substance use, as well as motivations and expectations for treatment. Comparisons between the clinics were carried out using <i>t</i>-tests, Mann-Whitney <i>U</i> tests, Chi-square, and Fisher's exact test.</p><p><strong>Results: </strong>The majority of the patients were enrolled at the Oslo clinic (76%) and were male (80%). At admission, the average age was 45.9, with a significantly younger group in Bergen (42.5 vs 47.3, <i>P</i> < .05). While no patients reported being unhoused, 17% noted unstable housing within the preceding month. Unemployment was prevalent (91%) alongside previous treatment experiences (95%), with a median of 2 prior medication types. In the 3 months preceding HAT initiation, 78% of patients reported being victims of crime, and 44% committed at least one crime. Over their lifetime, 2 in 5 participants (41%) had experienced an unwanted overdose and 43% had shared syringes and equipment.</p><p><strong>Conclusion: </strong>This study reveals a cohort experiencing societal marginalization, including unstable housing, unsatisfactory prior OUD treatment, high-risk behaviors, and frequent interactions with criminal activities, predominantly as victims. While the Oslo and Bergen clinics serve a similar patient profile, notable differences emerged in the reasons for discontinuing past OUD treatment and crime-related factors.</p>\",\"PeriodicalId\":516535,\"journal\":{\"name\":\"Substance use & addiction journal\",\"volume\":\" \",\"pages\":\"13-24\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Substance use & addiction journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/29767342241271991\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/9/23 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Substance use & addiction journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/29767342241271991","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/23 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景:海洛因辅助治疗(HAT)是治疗阿片类药物使用障碍(OUD)的一种循证治疗方案,仅在少数国家使用。挪威于2022年实施了一项为期5年的海洛因辅助治疗项目,旨在评估其有效性以及将其纳入该国阿片类药物使用障碍治疗系统的可能性。本研究描述并比较了奥斯陆和卑尔根 HAT 诊所的患者基线特征,全面介绍了 HAT 的独特人群和实际应用情况:这项横断面研究调查了开业两年内获得同意的 HAT 患者(n = 86)的基线特征。自我报告问卷收集了社会人口统计、以往的治疗经历、自我报告的犯罪情况和药物使用情况,以及治疗动机和期望。采用 t 检验、曼-惠特尼 U 检验、卡方检验和费雪精确检验对各诊所进行比较:大多数患者在奥斯陆诊所登记(76%),男性(80%)。入院时的平均年龄为 45.9 岁,卑尔根的患者明显更年轻(42.5 岁对 47.3 岁,P 结论:这项研究揭示了一个社会边缘群体:本研究揭示了这一群体的社会边缘化问题,包括住房不稳定、之前的 OUD 治疗效果不理想、高风险行为以及与犯罪活动的频繁互动(主要是作为受害者)。虽然奥斯陆和卑尔根诊所服务的患者情况相似,但在中断以往 OUD 治疗的原因和犯罪相关因素方面出现了显著差异。
Patient Characteristics From Norway's First Heroin-Assisted Treatment Clinics.
Background: Heroin-assisted treatment (HAT) is an evidence-based treatment option for opioid use disorder (OUD), available in a limited number of countries. Norway implemented a 5-year HAT project in 2022, aiming to assess its effectiveness and its potential integration into the country's OUD treatment system. This study describes and compares patients' baseline characteristics from the Oslo and Bergen HAT clinics, providing a comprehensive picture of the unique population and the real-world application of HAT.
Methods: This cross-sectional study examines the baseline characteristics of consenting HAT patients within the first 2 years of operation (n = 86). Self-reported questionnaires gathered sociodemographics, previous treatment experiences, self-reported crime, and substance use, as well as motivations and expectations for treatment. Comparisons between the clinics were carried out using t-tests, Mann-Whitney U tests, Chi-square, and Fisher's exact test.
Results: The majority of the patients were enrolled at the Oslo clinic (76%) and were male (80%). At admission, the average age was 45.9, with a significantly younger group in Bergen (42.5 vs 47.3, P < .05). While no patients reported being unhoused, 17% noted unstable housing within the preceding month. Unemployment was prevalent (91%) alongside previous treatment experiences (95%), with a median of 2 prior medication types. In the 3 months preceding HAT initiation, 78% of patients reported being victims of crime, and 44% committed at least one crime. Over their lifetime, 2 in 5 participants (41%) had experienced an unwanted overdose and 43% had shared syringes and equipment.
Conclusion: This study reveals a cohort experiencing societal marginalization, including unstable housing, unsatisfactory prior OUD treatment, high-risk behaviors, and frequent interactions with criminal activities, predominantly as victims. While the Oslo and Bergen clinics serve a similar patient profile, notable differences emerged in the reasons for discontinuing past OUD treatment and crime-related factors.