Comorbid opioid use is undertreated among forensic patients with schizophrenia
Abstract Background Substance use disorders are associated with poorer clinical outcomes in patients with schizophrenia. There is no specific treatment for amphetamine or cannabis use disorder, but methadone and buprenorphine are used as replacement therapy in the treatment of opioid dependence. Our...
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| Format: | Article |
| Language: | English |
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BMC
2018-11-01
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| Series: | Substance Abuse Treatment, Prevention, and Policy |
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| Online Access: | http://link.springer.com/article/10.1186/s13011-018-0177-y |
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| author | Kristiina Kivimies Eila Repo-Tiihonen Hannu Kautiainen Jari Tiihonen |
| author_facet | Kristiina Kivimies Eila Repo-Tiihonen Hannu Kautiainen Jari Tiihonen |
| author_sort | Kristiina Kivimies |
| collection | DOAJ |
| description | Abstract Background Substance use disorders are associated with poorer clinical outcomes in patients with schizophrenia. There is no specific treatment for amphetamine or cannabis use disorder, but methadone and buprenorphine are used as replacement therapy in the treatment of opioid dependence. Our aim was to study whether patients with schizophrenia have received opioid replacement therapy for their opioid use disorder. Methods The study sample consisted of 148 individuals diagnosed with schizophrenia who were in involuntary psychiatric treatment as forensic patients in Finland in 2012. The proportion of the study sample with comorbid opioid use disorder having received opioid replacement therapy prior to their forensic psychiatric treatment was compared to the available information of opioid dependent patients in general. The data were collected from forensic examination statements, patient files and other medical registers retrospectively. Results Of the study sample, 15.6% (23/148) had a history of opioid use disorder, of whom 8.7% (2/23) had received opioid replacement treatment (95% confidence interval (Cl): 1.1–28.0), even though opioid use disorder had been diagnosed in the treatment system. According the available information the corresponding proportion among patients with opioid use disorder and using substance use disorder services was 30.4% (565/1860, 95% Cl: 28.3–32.5). The fraction of patients receiving opioid replacement therapy was significantly lower among patients with schizophrenia (p = 0.022). Conclusions Opioid replacement therapy was seldom used among schizophrenia patients who were later ordered to involuntary forensic psychiatric treatment. More attention should be paid to the possible use of opioids when planning treatment for patients with schizophrenia. Trial registration Our study is not a randomized controlled trial (but a register-based study); thus the trial registration is not applicable. |
| first_indexed | 2024-12-20T07:06:29Z |
| format | Article |
| id | doaj.art-f0ff74b895484698b9a666063c45c409 |
| institution | Directory Open Access Journal |
| issn | 1747-597X |
| language | English |
| last_indexed | 2024-12-20T07:06:29Z |
| publishDate | 2018-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Substance Abuse Treatment, Prevention, and Policy |
| spelling | doaj.art-f0ff74b895484698b9a666063c45c4092022-12-21T19:49:03ZengBMCSubstance Abuse Treatment, Prevention, and Policy1747-597X2018-11-011311610.1186/s13011-018-0177-yComorbid opioid use is undertreated among forensic patients with schizophreniaKristiina Kivimies0Eila Repo-Tiihonen1Hannu Kautiainen2Jari Tiihonen3Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi HospitalDepartment of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi HospitalDepartment of General Practice, Unit of Primary Health Care, Helsinki University Central Hospital, University of HelsinkiDepartment of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi HospitalAbstract Background Substance use disorders are associated with poorer clinical outcomes in patients with schizophrenia. There is no specific treatment for amphetamine or cannabis use disorder, but methadone and buprenorphine are used as replacement therapy in the treatment of opioid dependence. Our aim was to study whether patients with schizophrenia have received opioid replacement therapy for their opioid use disorder. Methods The study sample consisted of 148 individuals diagnosed with schizophrenia who were in involuntary psychiatric treatment as forensic patients in Finland in 2012. The proportion of the study sample with comorbid opioid use disorder having received opioid replacement therapy prior to their forensic psychiatric treatment was compared to the available information of opioid dependent patients in general. The data were collected from forensic examination statements, patient files and other medical registers retrospectively. Results Of the study sample, 15.6% (23/148) had a history of opioid use disorder, of whom 8.7% (2/23) had received opioid replacement treatment (95% confidence interval (Cl): 1.1–28.0), even though opioid use disorder had been diagnosed in the treatment system. According the available information the corresponding proportion among patients with opioid use disorder and using substance use disorder services was 30.4% (565/1860, 95% Cl: 28.3–32.5). The fraction of patients receiving opioid replacement therapy was significantly lower among patients with schizophrenia (p = 0.022). Conclusions Opioid replacement therapy was seldom used among schizophrenia patients who were later ordered to involuntary forensic psychiatric treatment. More attention should be paid to the possible use of opioids when planning treatment for patients with schizophrenia. Trial registration Our study is not a randomized controlled trial (but a register-based study); thus the trial registration is not applicable.http://link.springer.com/article/10.1186/s13011-018-0177-yOpioid replacement treatmentSchizophreniaForensic psychiatry |
| spellingShingle | Kristiina Kivimies Eila Repo-Tiihonen Hannu Kautiainen Jari Tiihonen Comorbid opioid use is undertreated among forensic patients with schizophrenia Substance Abuse Treatment, Prevention, and Policy Opioid replacement treatment Schizophrenia Forensic psychiatry |
| title | Comorbid opioid use is undertreated among forensic patients with schizophrenia |
| title_full | Comorbid opioid use is undertreated among forensic patients with schizophrenia |
| title_fullStr | Comorbid opioid use is undertreated among forensic patients with schizophrenia |
| title_full_unstemmed | Comorbid opioid use is undertreated among forensic patients with schizophrenia |
| title_short | Comorbid opioid use is undertreated among forensic patients with schizophrenia |
| title_sort | comorbid opioid use is undertreated among forensic patients with schizophrenia |
| topic | Opioid replacement treatment Schizophrenia Forensic psychiatry |
| url | http://link.springer.com/article/10.1186/s13011-018-0177-y |
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