The influence of programme differences on crime reduction in opioid maintenance treatment. An analysis of regional patterns in Norway
Background: Reduced criminal activity is an important outcome for opioid maintenance treatment (OMT).
Investigate possible differences in criminal convictions in four health regions in Norway among a national cohort of OMT-patients before, during, and after treatment: also investigate treatment retention and other factors that may be associated with treatment outcome.
Official national criminal records were cross linked with all patients who started opioid maintenance treatment in Norway from 1997-2003 (n=3221), including patients from four different health regions in Norway; the Eastern region (n=1717), the Southern region (n=751), the Western region (n=586) and the Central-Northern region (n=167). Patients in each region were divided into separate groups according to whether they were retained or not retained in continuous treatment.
During opioid maintenance treatment, patients in all four treatment regions had a considerable reduction in criminal convictions compared to pre-treatment levels. Criminal convictions during treatment were associated with retention in treatment. Among patients in continuous treatment, significant differences were found in levels of criminal convictions among the four treatment regions during treatment. Compared to patients in the Eastern region, patients in the Southern and the Central-Northern region had respectively 44 and 81 percent less criminal convictions during treatment, and patients in the Western region had 60 percent more convictions. For patients not in continuous treatment, no statistically significant differences were found between the four regions during treatment.
Differences in criminal convictions during treatment may be related to regional differences in treatment practice within the national OMT system. In all regions, criminal convictions during OMT were higher for patients dropping out of treatment. It is suggested that clinical staff should offer more support to patients at risk of dropping out of treatment.