Long-Term Opioid Agonist Treatment Participation after First Treatment Entry is Similar across 4 European Regions but Lower in Non-Nationals
Language English Country Switzerland Media print-electronic
Document type Journal Article
PubMed
30016806
DOI
10.1159/000490529
PII: 000490529
Knihovny.cz E-resources
- Keywords
- Buprenorphine, Drug policy, Heroin, Methadone, Opioids, Public health, Treatment monitoring,
- MeSH
- Databases, Factual trends MeSH
- Adult MeSH
- Emigrants and Immigrants * MeSH
- Middle Aged MeSH
- Humans MeSH
- Opiate Substitution Treatment methods trends MeSH
- Analgesics, Opioid administration & dosage MeSH
- Opioid-Related Disorders diagnosis epidemiology therapy MeSH
- Drug Administration Schedule MeSH
- Treatment Outcome MeSH
- Patient Participation methods trends MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic epidemiology MeSH
- Netherlands epidemiology MeSH
- Spain epidemiology MeSH
- Switzerland epidemiology MeSH
- Names of Substances
- Analgesics, Opioid MeSH
Heroin users in opioid agonist treatment (OAT) show markedly reduced heroin consumption, less crime and a lower mortality rate. However, the extent of long-term OAT participation over subsequent treatment episodes remains unclear. We analysed the annual proportion of patients in treatment (at least 1 day) since the start of first OAT in 4 European regions: Barcelona (BA) 1996-2012: 8,602 patients; Czech -Republic (CZ) 2000-2014: 4,377 patients; Netherlands (NL) 1994-2014: 33,235 patients, Zurich (ZU) 1992-2015: 11,795. We estimated the long-term decline of treatment need due to mortality or abstinence and also a "nuisance" short-term decline until the equilibrium level of cycling in and out of OAT is reached to obtain the adjusted treatment participation value. The adjusted treatment participation was around 50% (BA: 47.4-51.4%; CZ: 49.8-53.9%; NL: 52.3-54.0%; ZU: 46.4-49.3%), and the annual decline of treatment need was close to 4%. Non-nationals (NL patients with a migrant background) showed substantial lower adjusted treatment participation (rate ratio BA: 0.059-0.343; NL: 0.710-0.751; ZU: 0.681-0.797; CZ: n.a.). Our method may provide a policy-relevant indicator of long-term provision, quality and access to OAT following first treatment.
Agència de Salut Pública de Barcelona Barcelona Spain
Center for Addictive Disorders Psychiatric Hospital University of Zurich Zürich Switzerland
CIBER de Epidemiologia y Salud Pública Madrid Spain
European Monitoring Centre for Drugs and Drug Addiction Lisbon Portugal
Institute of Health Information and Statistics of the Czech Republic Prague Czech Republic
National Institute of Mental Health Klecany Czech Republic
Psychiatric Hospital University of Zurich Zürich Switzerland
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