About the project
Norway is among the first countries in the world with an increasing proportion of aging patients in Medication-Assisted Rehabilitation (MAR). As of 2020, more than 2,000 Norwegian patients were older than 50 years, and the proportion is rapidly increasing.
Health services and clinicians are often not aware of the extent of the health burden and the needs of these older patients. It is expected that the service apparatus must prepare for an increase in demand and a higher degree of complexity in the health challenges experienced by this group.
As a group, aging patients with opioid-dominated substance use disorder usually experience age-related illness at a relatively lower chronological age. In addition, many of the patients have other serious health and social problems that contribute to their complexity, and with it a need to be met by competent interdisciplinary staff from both specialist and municipal services.
Because this trend with rapidly aging patients in substance use treatment is so new, we still know very little about these aging patients' health needs or use of services.
Several signs indicate that the aging MAR patient group likely needs more age-adapted additional services, and at an earlier age than otherwise expected. However, we lack the necessary knowledge to provide better age-adapted services.
Background
AgeSUD (Promoting healthy longevity among people with substance use disorders) combines qualitative and quantitative methods in a unique design that links interview data from longitudinal clinical cohort studies (from NorCOMT) to national health and social registry data, supplemented with qualitative interview data.
Registry data tied to the established clinical NorCOMT cohort will provide the opportunity to both identify risk factors for poor treatment outcomes (such as dropout from treatment), as well as identify predictors for positive treatment outcomes:
Aims
The overarching goal of the AgeSUD project is to help improve knowledge about the characteristics and needs of aging patients in substance use treatment, with a particular focus on those with opioid use disorder. The findings could have a direct impact on future treatment management and quality of life for this patient group.
To achieve the primary goal, we will investigate who the "old" MAR patients are and what their specific health problems and service needs are through these research questions:
- Does "aging" start earlier among MAR patients?
- Can we identify age-related diseases?
- Can we identify factors that contribute to long-term retention in MAR and improve treatment quality?
- How can we identify and prevent harmful prescription opioid use among older individuals?
Results
Our goal is for this updated knowledge to be used to develop recommendations aimed at treatment services for individuals with substance abuse disorders. A potential outcome of this research could be a recommendation that MAR patients with complex age-related diseases receive closer monitoring by a responsible care provider such as a case manager who coordinates the treatment alongside the patient.
Financing
- Helse Sør-Øst RHF
- SERAF, UiO
Cooperation
- proLARNett (user advocacy group)
- SERAF
- Sørlandet sykehus HF Avdeling for rus- og avhengighetsbehandling
Publications
Hatlo C. H., Clausen T., Muller A. E., and Sugahara G. Pet ownership, physical activity and mental health among people in opioid maintenance treatment: a prospective, observational study. Heroin Addiction and Related Clinical Problems, Published Ahead of Print, December 29, 2023
Rolova, Gabriela; Eide, Desiree; Gabrhelík, Roman; Odsbu, Ingvild; Clausen, Thomas & Skurtveit, Svetlana Ondrasova (2023). Gender differences in physical morbidity in opioid agonist treatment patients: population-based cohort studies from the Czech Republic and Norway. Substance Abuse Treatment, Prevention, and Policy. ISSN 1747-597X. 18(1).
Eide, Desiree; Skurtveit, Svetlana Ondrasova; Clausen, Thomas; Hesse, Morten; Mravčík, Viktor; Nechanská, Blanka; Rolova, Gabriela; Thylstrup, Birgitte; Tjagvad, Christian; Seid, Abdu Kedir; Odsbu, Ingvild & Gabrhelík, Roman (2023). Cause-Specific Mortality among Patients in Treatment for Opioid Use Disorder in Multiple Settings: A Prospective Comparative Cohort Study. European Addiction Research. ISSN 1022-6877. 29(4), s. 272–284.
Skeie, Ivar; Clausen, Thomas; Hjemsæter, Arne Jan; Landheim, Anne Signe; Monsbakken, Bent Berntsen; Thoresen, Magne & Waal, Helge (2022). Mortality, Causes of Death, and Predictors of Death among Patients On and Off Opioid Agonist Treatment: Results from a 19-Year Cohort Study. European Addiction Research. ISSN 1022-6877. 28(5), s. 358–367.
Hamina, Aleksi; Muller, Ashley Elizabeth; Clausen, Thomas; Skurtveit, Svetlana Ondrasova; Hesse, Morten; Tjagvad, Christian; Thylstrup, Birgitte; Odsbu, Ingvild; Zoega, Helga; Jónsdóttir, Harpa Lind & Taipale, Heidi (2022). Prescription opioids among older adults: ten years of data across five countries. BMC Geriatrics. ISSN 1471-2318. 22.
Bjørnestad, E., Vederhus, JK. & Clausen, T. High smoking and low cessation rates among patients in treatment for opioid and other substance use disorders. BMC Psychiatry 22, 649 (2022).
Røgeberg, Ole; Bergsvik, Daniel & Clausen, Thomas (2021). Opioid overdose deaths and the expansion of opioid agonist treatment: a population-based prospective cohort study. Addiction. ISSN 0965-2140. s. 1–9.
Bech, Anne Berit; Clausen, Thomas; Waal, Helge; Delaveris, Gerd Jorunn Møller & Skeie, Ivar (2021). Organ pathologies detected post-mortem in patients receiving opioid agonist treatment for opioid use disorder: a nation-wide 2-year cross-sectional study. Addiction. ISSN 0965-2140. s. 1–9.
Medved, D., Clausen, T., Bukten, A. et al. Large and non-specific somatic disease burdens among ageing, long-term opioid maintenance treatment patients. Subst Abuse Treat Prev Policy 15, 87 (2020).