Svetlana Ondrasova Skurtveit

• Gjesdal, Kine; Skurtveit, Svetlana Ondrasova; Djuv, Ane; Paulsen, Aksel; Rolová, Gabriela & Sevild, Cille [Vis alle 7 forfattere av denne artikkelen] (2026). Changes in health literacy following participation in a multidisciplinary primary care intervention for people with chronic pain: a longitudinal cohort study. Scandinavian Journal of Pain. ISSN 1877-8860. 26(1). doi: 10.1515/sjpain-2026-0034. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Background Chronic pain is a global public health issue, severely affecting quality of life, functional capacity, and healthcare resources. Effective management requires adequate health literacy, yet limited health literacy is associated with greater pain burden and poorer outcomes. This underlines the need for interventions that can strengthen patients’ health literacy skills. Thus, the aim of the present study was to investigate longitudinal changes in health literacy following participation in a multidisciplinary primary care pain management intervention. Methods This longitudinal study reports health literacy outcomes from a multidisciplinary, personalized pain management intervention that was developed in accordance with the Medical Research Council framework. Forty-three participants with chronic non-cancer pain completed the full intervention. Health literacy was measured using the Norwegian version of the Health Literacy Questionnaire (HLQ) at baseline, midpoint, and post-intervention. Changes over time were analyzed using paired-sample t-tests. Results Statistically significant improvements were observed in five HLQ domains from baseline to midpoint and in eight domains from baseline to post-intervention. “Having sufficient information to manage my health” showed the largest increase among Domains 1–5, whereas “Navigating the healthcare system” showed the largest increase among Domains 6–9 and improved significantly across all time-point comparisons. Conclusion Participants demonstrated improvements in several dimensions of health literacy during participation in the intervention, particularly in domains related to having sufficient information to manage health and active self-management. These findings support further investigation of tailored, multidisciplinary approaches to strengthening health literacy among people with chronic pain. Trial registration NCT05828121 Date: 04-25-2023.

• Bukten, Anne; Mehlum, Lars; Fazel, Seena; Lokdam, Nicoline Toresen; Tverborgvik, Torill & Skurtveit, Svetlana Ondrasova [Vis alle 12 forfattere av denne artikkelen] (2026). Sociodemographic, Criminological and Clinical Determinants in Suicide After Release From Prison: A 23‐Year National Cohort Study. Acta Psychiatrica Scandinavica. ISSN 0001-690X. doi: 10.1111/acps.70148. Fulltekst i vitenarkiv Vis sammendrag

  ABSTRACT Background Suicide risk is elevated after prison release, but population‐level evidence on temporal risk patterns and associated factors remains limited. We aimed to describe characteristics of individuals who die by suicide after release from Norwegian prisons, compare their suicide mortality with the general population, and examine risk factors over time. Material and Methods Data from the Norwegian Prison Release Study (nPRIS), including all people in prison in Norway (2000–2022), were linked to the Norwegian Cause of Death Registry, the Norwegian Prison Registry, the Norwegian Patient Registry, and Statistics Norway. We calculated crude mortality rates (CMR) per 100,000 person‐years, standardized mortality ratios (SMR), annual age‐standardized years of life lost rate (ASYR), and Cox proportional hazards models. Results From 2000 to 2022, 1183 suicides (9.1% of all deaths; CMR 81; 95% CI 76–85) occurred after release (90% male). The SMR was higher in women (SMR 8.64; 95% CI 7.17–10.34) than men (SMR 3.98; 95% CI 3.76–4.22). In multivariable models (2009–2022; n  = 57,034; 516 suicides), strong independent associations with suicide 6 months post‐release included self‐harm (adjusted HR [aHR] 4.76; 95% CI 2.60–8.72), severe mental illness (aHR 1.95; 95% CI 1.16–3.27), release from high‐security prisons (aHR 1.93; 95% CI 1.12–3.33), and pretrial detention (aHR 1.82; 95% CI 1.06–3.13). Conclusions Suicide risk is substantially and persistently elevated relative to the general population, peaks immediately after release, and is concentrated among people with prior self‐harm, severe mental illness, and those released from high‐security settings.

• Bodal, Elen; Olsen, Nora Marie Temte; Olsen, Thomas; Edvardsen, Hilde Marie Erøy; Clausen, Thomas & Skurtveit, Svetlana Ondrasova [Vis alle 8 forfattere av denne artikkelen] (2026). Medical and non-medical gabapentinoid use in fatal drug poisonings in Norway: Linked postmortem toxicology and prescription data. Forensic Science International. ISSN 0379-0738. 389, s. 1–8. doi: 10.1016/j.forsciint.2026.113143. Fulltekst i vitenarkiv
• Štěpánka, Ptáčková,; Skurtveit, Svetlana Ondrasova; Roman, Gabrhelík,; Odsbu, Ingvild & Rolová, Gabriela (2026). Diagnostic pathways, healthcare utilization, and mortality in children and young people with early onset substance use disorders: a nationwide registry-based cohort study | Harm Reduction Journal | Springer Nature Link. Harm Reduction Journal. doi: 10.1186/s12954-026-01533-8. Fulltekst i vitenarkiv Vis sammendrag

  Longitudinal, population-based evidence on the clinical profiles and mortality of youth with substance use disorders (SUDs) is limited, despite significant health and social risks. This study aimed to (1) characterize initial SUD diagnoses, demographic and healthcare profiles, and diagnostic trajectories, and (2) estimate all-cause and external-cause mortality relative to the general population. This nationwide cohort study included 22,449 individuals aged 6–24 newly diagnosed with SUD in the Czech Republic, 2015–2019. Sex-specific crude mortality rates (CMRs) and age-standardized mortality ratios (SMRs) were calculated for children (< 18 years) and young adults (18–29 years) to estimate mortality. The most common initial diagnoses were alcohol use disorders (55%), followed by polysubstance use (14%), and cannabis use disorders (11%). The mean age at first diagnosis was 18.7 years, lower for females (17.9) than males (19.1). Females were more often diagnosed with opioid, sedative/hypnotic, and stimulant use disorders, whereas males with cannabis and polysubstance use disorders (p < 0.001). During follow-up, 137 individuals (0.6%) died. All-cause and external-cause CMRs were 242.1 and 171.4 per 100,000 person-years, both higher in males (1.9- and 2.6-fold). Excess mortality was observed in both age groups, with all-cause SMRs of 9.5 (95% CI 5.6–16.0) for children and 5.7 (4.8–6.8) for young adults; external-cause SMRs were 19.1 (10.8–33.6) and 6.6 (5.3–8.1), respectively. Early-onset SUD in clinical populations shows substantial sex differences and markedly elevated early, premature mortality. These findings underscore the need for early detection and targeted interventions for vulnerable youth.

• Havig, Stine Marie; Høiseth, Gudrun; Thaulow, Cecilie Hasselø; Green, Henrik; Skurtveit, Svetlana Ondrasova & Edvardsen, Hilde Marie Erøy (2026). Prescription status and drug concentrations in methadone intoxications versus non-intoxications: A registry-linked study of autopsy cases. Forensic Science International. ISSN 0379-0738. 388. doi: 10.1016/j.forsciint.2026.113084. Fulltekst i vitenarkiv Vis sammendrag

  Aims Limited information exists on characteristics associated with methadone intoxication deaths. We therefore aimed to describe and explore differences in demographics, methadone prescription status, and drug concentrations in deaths with methadone, comparing intoxications with non-intoxications. Methods 1092 forensic autopsy cases with methadone detected in blood analyzed at Oslo University Hospital (2004–2021) were linked to the Norwegian Cause of Death Registry and the Norwegian Prescribed Drug Registry. Cases were grouped as methadone intoxication (n = 638), other intoxication (n = 252), and non-intoxication (n = 202). Non-parametric tests (Chi-squared, Mann–Whitney U) and logistic regression analyses were used to compare demographic variables, prescription status, and drug concentrations (opioids, benzodiazepines, stimulants, ethanol) between intoxications and non-intoxications. Results Methadone prescription was less common in methadone intoxications and other intoxications than in non-intoxications (28.8% and 27.4% vs. 59.9%, respectively; P < 0.001 for both). Methadone intoxications were associated with younger age (adjusted odds ratio [aOR] 0.96; 95% confidence interval [CI] 0.95–0.98) and no recent methadone prescription (aOR 3.01; 95% CI 2.04–4.44) compared with non-intoxications. Adjusted analyses revealed no significant difference in methadone concentration between these groups. However, among cases with prescription, methadone intoxications were associated with higher methadone concentration (aOR 1.20; 95% CI 1.09–1.32). Intoxications also involved more psychoactive drugs and more frequent detections of benzodiazepines and stimulants. Conclusion Our results support that the determination of fatal methadone intoxications cannot be based solely on interpretation of postmortem methadone concentrations in blood but is dependent on information about prescription status and degree of tolerance.

• Orangzeb, Saima; Hartz, Ingeborg; Bakken, Inger Johanne Landsjøåsen; Odsbu, Ingvild; Furu, Kari & Skurtveit, Svetlana Ondrasova [Vis alle 9 forfattere av denne artikkelen] (2026). Incidence of ADHD diagnoses and medication initiation among children and adolescents in Norway from 2016-2024. European Child and Adolescent Psychiatry. ISSN 1018-8827. doi: 10.1007/s00787-026-03116-1. Fulltekst i vitenarkiv Vis sammendrag

  Global trends show an increase in ADHD diagnoses and medication use. This study aimed to describe the incidence of ADHD among children and adolescents in Norway from 2016 to 2024, and to investigate sociodemographic factors associated with treatment initiation among newly diagnosed individuals. This nationwide longitudinal study used data from Norwegian health registers, including all incident ADHD cases (first diagnosis or medication) at ages 3–17 years between 2016 and 2024. Incidence rates were calculated per 1,000 individuals along with proportion initiating medication 0–3 months and 4–12 months post diagnosis. Logistic regression models were used to assess factors associated with initiation. The overall incidence of ADHD more than doubled between 2016 and 2024 (from 4.4 to 9.0 per 1,000), with 52,149 incident ADHD cases. The most pronounced increase was observed among adolescent females (14–17 years), where incidence rose from 3.1 to 11.4 per 1,000. Among 38,749 individuals diagnosed between 2016 and 2023, the proportion initiating medication within one year of diagnosis increased from 72.8% to 78.4%. Following a peak in 2021, proportion initiation within 0–3 months declined, while initiation at 4–12 months increased. Having a foreign-born parent was associated with lower odds, while older age at diagnosis and lower paternal education associated with higher odds of medication-initiation. This study documents a doubling in the incidence of ADHD diagnoses among children in Norway, and an even stronger increase among adolescent females. Medication initiation increased slightly but evolved toward a delayed approach. Sociodemographic factors, especially age at diagnosis, parental region of birth and father’s education influence medication-initiation.

• Rolová, Gabriela; Skurtveit, Svetlana Ondrasova; Bukten, Anne; Odsbu, Ingvild & Eide, Desiree (2026). Factors associated with changes in opioid analgesic prescribing after opioid agonist treatment initiation: A nationwide registry cohort study. Drug and Alcohol Dependence Reports. 19, s. 100426–100426. doi: 10.1016/j.dadr.2026.100426. Fulltekst i vitenarkiv
• Amundsen, Ellen Johanna; Skurtveit, Svetlana Ondrasova & Odsbu, Ingvild (2026). Risk and cause of overdose death after exposure to dispensed opioid analgesics. Scandinavian Journal of Public Health. ISSN 1403-4948. s. 1–9. doi: 10.1177/14034948261424666. Fulltekst i vitenarkiv Vis sammendrag

  Aims: Overdose deaths have been increasing in parts of Europe, including Norway, where opioid analgesics have been the leading cause since 2016. This study quantifies the risk of overdose death following exposure to dispensed opioid analgesics, stratified by sex and age, and examines associated causes of death. Methods: Nationwide data from 2010 to 2018 on overdose deaths were obtained from the Norwegian Cause of Death Registry and linked with the Norwegian Prescription Database to identify prior opioid analgesic dispensations. Aggregated prescription data and population figures from Statistics Norway were also used. Results: From 2010 to 2018, 42% of individuals who died from an overdose had been dispensed opioid analgesics in the previous year. Among those dispensed strong opioid analgesics, the overdose death rate was low but exceeded the population death rate among men aged 20–49 and women aged 20–39 years. The rate was higher in men and remained stable over time. Opioids other than heroin or methadone were listed as the cause of death in 62% of cases with prior dispensed opioid analgesics, compared with 24% among those without. Conclusions: The risk of overdose deaths following exposure to strong opioid analgesics was low but higher than population death rates for men under 50 and women under 40 years. Preventive strategies based on risk markers such as sex, age and opioid analgesic strengths, combined with other known risk markers, can help guide safer prescription of opioid analgesics and reduce overdose death.

• Skurtveit, Svetlana Ondrasova; McDonald, Rebecca Silvia; Handal, Marte; Hamina, Aleksi; Clausen, Thomas & Odsbu, Ingvild (2025). A comparison between individuals who died of intentional versus accidental overdoses. Suicidologi. ISSN 1501-6994. 30(2), s. 4–19. doi: 10.5617/suicidologi.12703. Fulltekst i vitenarkiv Vis sammendrag

  The aim of the study was to describe differences between deaths from intentional versus accidental overdoses in Norway. This data linkage study comprised six nationwide health- and population registers. During the study period from 2011 to 2019, a total of 1,818 deaths from accidental and 363 deaths from intentional overdoses were registered. Pharmaceutically available opioids were more often found in post-mortem blood samples among intentional overdose deaths compared to accidental overdoses (73.0% vs 36.0%). Decedents in the intentional overdose group were on average eight years older, more frequently women with higher education and previous suicide attempts compared to accidental overdoses. Intentional overdose deaths more frequently had a lifetime history of chronic pain, cancer, as well as depression in the year prior to death. In the 30-day period prior to their death, a larger proportion of individuals in the intentional overdose group were dispensed opioids (43.0 % vs 21.4 %) and/or enzodiazepines (51.5 % vs. 38.7 %) compared to accidental overdoses. Intentional overdose deaths typically involve prescribed medicines and are more common among older, more often female individuals with a history of somatic disorders. This knowledge needs to be integrated into new and targeted prevention interventions.

• Rolová, Gabriela; Skurtveit, Svetlana Ondrasova; Mravčík, Viktor & Gabrhelík, Roman (2025). Preexisting morbidity and 2-year treatment retention in opioid agonist treatment. A population-based data-linkage study in the Czech Republic. Addiction Research and Theory. ISSN 1606-6359. s. 1–11. doi: 10.1080/16066359.2025.2605955. Fulltekst i vitenarkiv Vis sammendrag

  Objective: Limited research exists on how preexisting comorbidities impact retention in opioid agonist treatment (OAT). This study aimed to (1) describe OAT retention and participation, and (2) examine the association of preexisting comorbidities and other patient characteristics with 24-month retention.Methods: This registry-based nationwide cohort study used linked health records of 1,553individuals newly initiating OAT in the Czech Republic between 2011 and 2017. Logistic regression assessed the relationship between mental disorders, hepatitis C (HCV), Charlson Comorbidity Index (CCI), age, sex, and type of OAT medication and retention.Results: At 24-month follow-up, less than half of patients (44.9% of men and 47.0% of women) remained in continuous treatment. Interrupted treatment occurred in 11.0% of men and 13.2% of women, while 42.0% and 39.4%, respectively, discontinued after a single episode. The mean treatment duration was 489 ± 272 days for men and 498 ± 273 days for women, corresponding to mean participation of 67.0% and 68.2%, respectively. Methadone use was associated with lower retention compared with buprenorphine (aOR ¼ 0.46,95% CI ¼ 0.35–0.62). Higher CCI (OR ¼ 0.85, 0.76–0.94) and HCV (OR ¼ 0.67, 0.53–0.86)were associated with lower retention in crude models, but lost significance after adjustment.Other comorbidities had no effect on OAT retention.Conclusions: Preexisting mental and physical comorbidities did not significantly affect OAT retention, though their high prevalence warrants clinical attention. Lower retention among patients receiving methadone raises public health, clinical, and ethical concerns regarding restrictive OAT regimes in the Czech Republic.

• Nestvold, Håkon Høydal; Haarr, Eirik; Hamina, Aleksi; Hjellvik, Vidar; Skurtveit, Svetlana Ondrasova & Odsbu, Ingvild (2025). Incidence of and Determinants for Substance Use Disorders Among Individuals With Long‐Term Prescription Opioid Use: A Population‐Based Cohort Study. Pharmacoepidemiology and Drug Safety. ISSN 1053-8569. 34(9). doi: 10.1002/pds.70212. Fulltekst i vitenarkiv Vis sammendrag

  Purpose: To assess the incidence of substance use disorders (SUDs) after long‐term prescription opioid use (LTOU) and to identify socioeconomic and clinical risk factors associated with SUD among individuals with LTOU. Methods: Cohort study using linked nationwide registers (2011–2019). We identified 114 916 individuals who used opioids for more than 3 months (LTOU) without previous LTOU or SUD diagnosis. Outcomes were any incident SUD diagnosed in primary or secondary care (ICPC‐2: P15‐P16, P18‐P19; ICD‐10: F10‐F16, F18‐F19) and opioid use‐related disorders (OUD) diagnosed in secondary care (ICD‐10: F11). We calculated age‐ and sex‐stratified incidence rates (IR), incidence rate ratios (IRR) and age‐standardized incidence rates (ASIR). Adjusted hazard ratios (aHR) were calculated using Cox proportional hazards regression. Results: In total, 5.3% (6069/114916) were diagnosed with SUD (ASIR = 28.7 per 1000 person‐years), and males had higher IRs compared to females (IRR). Males had higher risk of SUD in both the younger (aHR = 1.59, 95% CI 1.47–1.72) and older (1.66, 1.54–1.78) age group. Low education (1.87, 1.66–2.11) and unemployment (1.26, 1.15–1.38) had the strongest association with SUD in the younger age group versus low income (1.37, 1.21–1.57) and living alone (1.53, 1.41–1.65) in the older age group. Previously diagnosed mental disorders and use of benzodiazepines‐ or benzodiazepine‐related drugs (BZDRs) were associated with SUD in both age groups (1.85, 1.71–2.01; 2.37, 2.18–2.57). Being male and having used BZDRs were the covariates strongest associated with OUD. Conclusions: Being male, young, having low socioeconomic status, previous mental disorders or BZDR use were associated with SUD diagnosis among individuals with LTOU.

• Gjesdal, Kine; Skurtveit, Svetlana Ondrasova; Djuv, Ane; Paulsen, Aksel; Sevild, Cille Hagland & Lid, Torgeir Gilje (2025). A feasibility study of a co-developed, multidisciplinary, tailored intervention for chronic pain management in municipal healthcare services. Scandinavian Journal of Pain. ISSN 1877-8860. 25(1). doi: 10.1515/sjpain-2025-0028. Fulltekst i vitenarkiv Vis sammendrag

  Chronic pain represents a major public health challenge, substantially affecting daily functioning and overall well-being. While self-management strategies can be effective, they are often introduced only after pharmacological or surgical treatments have proven insufficient, highlighting the need for more personalized, accessible, and early interventions in primary care. However, the feasibility and practical implementation of such approaches remain insufficiently explored. Considering these challenges, the aims of this study were to co-create and to evaluate the feasibility of a personalized, multidisciplinary, and coordinated intervention for chronic pain management within municipal healthcare services. Methods The intervention included a generic pain management course (part one) and a personalized second part offering various group-based courses. Participants ( n = 70) were recruited through an orthopedic outpatient clinic and general practitioners. Individual consultations with course leaders were conducted before, during, and after the intervention. Questionnaires assessing health-related quality of life, alcohol consumption, medication use, and sleep were administered at baseline, midway, and post-intervention, along with a self-reported evaluation of the intervention after completion. Results Among the total participants ( n = 70), 81% completed Part 1 of the intervention, while 61% completed the entire intervention. At baseline, participants had a mean EQ-5D-5L score of 0.65 and an EQ-VAS score of 48.8. Regarding alcohol use, 47% were drinking once a month or less, and no participants were drinking alcohol four or more times a week. Insomnia was reported by 84%. Paracetamol was the most used daily medication (41%), followed by non-steroidal anti-inflammatory drugs and weak opioids (26% each). In Part 2 of the intervention, stress management courses were the most frequently selected (26%), followed closely by physical activity and body-mind activity at 23%. Most participants reported benefit, with 63% (Part 1) and 56% (Part 2) indicating good or very good benefit, and 98% would recommend it to others. Conclusion This feasibility study demonstrates the potential for addressing the complex needs of individuals with chronic pain through a personalized and multidisciplinary intervention in primary care. The high completion rates indicate feasibility and acceptability. The findings support further evaluation of resource use, implementation, and effectiveness in future controlled trials.

• Haarr, Eirik; Handal, Marte; Skurtveit, Svetlana Ondrasova & Lid, Torgeir Gilje (2025). Oxycodone and Morphine Use in Hospitals and Primary Care in Norway 2010–2021: A Nationwide Study. European Journal of Pain. ISSN 1090-3801. 29(6). doi: 10.1002/ejp.70045. Fulltekst i vitenarkiv Vis sammendrag

  Background Increasing oxycodone prescribing and its association with opioid-related harms have raised concerns. In Norway, nearly 90% of opioids are prescribed in primary care, making primary care decisions important to overall opioid exposure. In-hospital use may influence primary care practices through several mechanisms. This study analyses oxycodone and morphine use in Norwegian hospitals and its association with primary care prescribing from 2010 to 2021, alongside a review of tender agreements for these medications. Methods Morphine and oxycodone, available in all relevant formulations, served as opioid proxies to compare covariation between hospitals and their catchment areas. We analyzed 2010–2021 procurement data from hospital pharmacies and primary care dispensing data from the Norwegian Prescription Database for all hospital trusts. Correlations between hospital and primary care morphine-to-oxycodone prescribing ratios were assessed using Pearson's r. Annual tender agreements were obtained from the national Hospital Procurement Organization. Results Hospital oxycodone use increased by 67.0% and primary care prescribing rose by 86.5%. Morphine use increased by 12.6% in hospitals but decreased by 23.2% in primary care. A moderate covariation (Pearson's r = 0.48) between hospital use and primary care prescribing was observed. Hospital tender agreements for morphine declined by 80%, while those for oxycodone remained stable. Conclusions Oxycodone use substantially increased relative to morphine in Norwegian hospitals and primary care. Prescription patterns show moderate covariation, suggesting a potential link between hospital and primary care prescribing, though causality remains uncertain. Tender agreements may contribute to prescribing trends in hospitals, with possible associations in primary care. Significance This study is the first to provide quantitative evidence of covariation between in-hospital use and primary care opioid prescribing across a national healthcare system. Despite recommendations favoring morphine, oxycodone prescribing continues to rise in Norway, with marked geographical variation. By linking procurement data, prescription patterns and tender agreements, our findings highlight the need to consider hospital practices and structural factors when addressing opioid prescribing. These results offer new insights into potential levers for opioid stewardship across care levels.

• Engel, Sophia; Rosseland, Leiv Arne; Smits, Martijn Johannes Bernardus; Skurtveit, Svetlana Ondrasova; Gran, Jon Michael & Nordseth, Trond [Vis alle 8 forfattere av denne artikkelen] (2025). Population-based multistate modelling of peritraumatic opioid use among trauma patients from the Norwegian Trauma Registry. British Journal of Anaesthesia. ISSN 0007-0912. 135(2), s. 390–400. doi: 10.1016/j.bja.2025.05.008. Fulltekst i vitenarkiv
• Samuelsen, Per-Jostein; Hjellvik, Vidar; Odsbu, Ingvild; Stubhaug, Audun; Skurtveit, Svetlana Ondrasova & Vambheim, Sara Magelssen (2025). Trends in Postoperative Opioid Use in Norway 2011-2018: A Nationwide Registry-Based Study. Basic & Clinical Pharmacology & Toxicology. ISSN 1742-7835. 136(6). doi: 10.1111/bcpt.70040. Fulltekst i vitenarkiv Vis sammendrag

  Little is known about the overall trends in postoperative opioid use in a Nordic setting. We investigated the trends in Norway between 2011 and 2018. We linked the Norwegian Prescription Database, the Norwegian Patient Registry, the Cancer Registry of Norway and the Cause of Death Registry. Postoperative opioid use was defined as the first opioid dispensing per year within 14 days of a NOMESCO Classification of Surgical Procedure code. We excluded patients with cancer or opioid maintenance therapy. We calculated period prevalence (Norwegian population ≥ 15 years as the denominator), substance distribution, initial amount and proportion of long-acting formulations. Among 746 435 postoperative opioid users ≥ 15 years, the period prevalence increased from 27.0/1000 in 2011 to 30.0/1000 in 2018 (long-term use: 2.0 to 3.3/1000). Codeine was most frequent (67%) in 2011, while codeine and tramadol were equally dispensed (41% and 43%) in 2018; oxycodone increased from 3% to 12%. The initial amount increased for opioids as a group but declined for oxycodone (1236 morphine milligram equivalents [MME]/patient to 914 MME/patient) and tramadol (233 MME/patient to 219 MME/patient). Long-acting depot formulations increased from 5% to 12%. Over time, postoperative opioid use increased, with a shift toward more tramadol and oxycodone in lower initial amounts, and increased use of long-acting formulations.

• Rolová, Gabriela; Engeland, Anders; Pedersen, Line; Odsbu, Ingvild; Hamina, Aleksi & Skurtveit, Svetlana Ondrasova (2025). Mortality among patients with long-term prescription opioid use in Norway: A nationwide registry-based cohort study. Pain. ISSN 0304-3959. 166(11), s. e555–e562. doi: 10.1097/j.pain.0000000000003653. Fulltekst i vitenarkiv Vis sammendrag

  The aim was to estimate all-cause and cause-specific mortality in long-term prescription opioid users compared to the general population. This nationwide registry–based cohort study used data of patients aged 15 to 69 years with no previous cancer diagnosis and a recorded episode of long-term opioid analgesics use (anatomical therapeutic chemical [ATC] group N02A; N = 116,006) in Norway between 2011 and 2019. Sex-specific crude mortality rates (CMR) and age-standardized mortality ratios (SMRs) were calculated for all-cause and cause-specific mortality, ie, natural and unnatural causes for the whole study population and for different age groups (15-34, 35-54, and 55-69 years). Overall, 4.6% (2491/54,535) of men and 2.7% (1680/61,471) of women died during the follow-up period. Crude mortality rates for all-cause mortality were 1194 and 724 deaths per 100,000 person-years (PY) in men and women, respectively. Men had higher CMRs across all causes, particularly unnatural causes (221 and 101 deaths per 100,000 PY in men and women, respectively). Patients with long-term opioid use had a 4 times higher all-cause mortality (SMR = 3.8 [95% CI = 3.6-3.9] in men and 3.7 [3.5-3.9] in women aged 15-69 years) compared to the general Norwegian population of the same age. Excess mortality was observed across all causes, particularly suicide, accidents, and accidental poisoning. Standardized mortality ratios decreased with age and were highest for the youngest age group (15-34 years), particularly among men. Long-term prescription opioid use is associated with an increased risk of death. Clinicians should weigh the risks of long-term opioid use against the benefits.

• Pedersen, Line; Borchgrevink, Petter Christian & Skurtveit, Svetlana Ondrasova (2025). Vedvarende bruk av høye doser opioider og andre vanedannende legemidler. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 145. doi: 10.4045/tidsskr.24.0173. Fulltekst i vitenarkiv
• Rolová, Gabriela; Skurtveit, Svetlana Ondrasova; Handal, Marte; Kurita, Geana Paula; Lid, Torgeir Gilje & Odsbu, Ingvild [Vis alle 7 forfattere av denne artikkelen] (2025). Trends in opioid prescribing in Scandinavian countries from 2010 to 2023: Insights from multi-metric evaluation. British Journal of Clinical Pharmacology. ISSN 0306-5251. 91(12), s. 3341–3352. doi: 10.1002/bcp.70177. Fulltekst i vitenarkiv Vis sammendrag

  Aims Monitoring opioid prescribing across different healthcare systems is essential to understanding population-level exposure and informing global health policies. This study examined opioid utilization in Scandinavian countries between 2010 and 2023 using multiple complementary metrics, addressing the limitations of single-metric comparisons. Methods A repeated cross-sectional study utilizing publicly available drug use statistics on opioid analgesics (ATC group N02A) dispensed in pharmacies from Denmark, Norway and Sweden. We assessed annual changes in utilization based on four metrics: 1-year prevalence (users/1000 inhabitants/year), defined daily doses (DDD)/1000 inhabitants/day (TID), morphine milligram equivalents (MMEs)/TID, and MMEs/user/year. Results Opioid use declined in Denmark and Sweden—in both 1-year user prevalence and volumes of MMEs—while stabilizing in Norway. Norway consistently had a higher and stable prevalence of opioid users. Denmark led in total amounts of MMEs dispensed, likely due to more frequent morphine and oxycodone use, whereas Norway ranked highest in DDDs. Denmark and Sweden showed increasing preference for “strong opioids”, while codeine-paracetamol and tramadol remained predominant in Norway. The prevalence of oxycodone users increased in Norway and Sweden, with Sweden having the highest prevalence of users but the lowest annual average volumes per user. Conclusions This study found major differences in total opioid use and substance-specific prescribing patterns, reflecting diverse pain management strategies across Scandinavia. Changing use patterns suggest evolving prescribing strategies and possible shifts in the target group for opioid pain therapy. In addition, metric-dependent variation underscores the need for using multiple complementary metrics to accurately interpret opioid utilization trends.

• Edvardsen, Hilde Marie Erøy; Clausen, Thomas; Bogstrand, Stig Tore & Skurtveit, Svetlana Ondrasova (2025). The role of prescribed opioids in Norwegian overdose deaths in 2005-2021. European Journal of Clinical Pharmacology. ISSN 0031-6970. 81, s. 1633–1641. doi: 10.1007/s00228-025-03897-5. Fulltekst i vitenarkiv
• Ekholm, Ola; Herling, Suzanne Forsyth; Lykke, Camilla; Skurtveit, Svetlana Ondrasova; Hamina, Aleksi & Sjøgren, Per [Vis alle 7 forfattere av denne artikkelen] (2025). Monitoring Chronic Non-Cancer Pain in Denmark Over Two Decades: Prevalence, Mental Health and Loneliness. European Journal of Pain. ISSN 1090-3801. 29(2). doi: 10.1002/ejp.4776. Fulltekst i vitenarkiv
• Rolová, Gabriela; Skurtveit, Svetlana Ondrasova; Gabrhelik, Roman; Mravčík, Viktor & Odsbu, Ingvild (2024). Exploring dual diagnosis in opioid agonist treatment patients: a registry-linkage study in Czechia and Norway. Addiction science & clinical practice. ISSN 1940-0632. 19(37). doi: 10.1186/s13722-024-00467-5. Fulltekst i vitenarkiv Vis sammendrag

  Background Knowledge of co-occurring mental disorders (termed ‘dual diagnosis’) among patients receiving opioid agonist treatment (OAT) is scarce. This study aimed (1) to estimate the prevalence and structure of dual diagnoses in two national cohorts of OAT patients and (2) to compare mental disorders between OAT patients and the general populations stratified on sex and standardized by age. Methods A registry-linkage study of OAT patients from Czechia (N = 4,280) and Norway (N = 11,389) during 2010– 2019 was conducted. Data on mental disorders (F00-F99; ICD-10) recorded in nationwide health registers were linked to the individuals registered in OAT. Dual diagnoses were defined as any mental disorder excluding substance use disorders (SUDs, F10-F19; ICD-10). Sex-specific age-standardized morbidity ratios (SMR) were calculated for 2019 to compare OAT patients and the general populations. Results The prevalence of dual diagnosis was 57.3% for Czechia and 78.3% for Norway. In Czechia, anxiety (31.1%) and personality disorders (25.7%) were the most prevalent, whereas anxiety (33.8%) and depression (20.8%) were the most prevalent in Norway. Large country-specific variations were observed, e.g., in ADHD (0.5% in Czechia, 15.8% in Norway), implying differences in screening and diagnostic practices. The SMR estimates for any mental disorders were 3.1 (females) and 5.1 (males) in Czechia and 5.6 (females) and 8.2 (males) in Norway. OAT females had a significantly higher prevalence of co-occurring mental disorders, whereas SMRs were higher in OAT males. In addition to opioid use disorder (OUD), other substance use disorders (SUDs) were frequently recorded in both countries. Conclusions Results indicate an excess of mental health problems in OAT patients compared to the general population of the same sex and age in both countries, requiring appropriate clinical attention. Country-specific differences may stem from variations in diagnostics and care, reporting to registers, OAT provision, or substance use patterns.

• Høibo, Trond; Skurtveit, Svetlana Ondrasova & Lid, Torgeir Gilje (2024). Is general practitioner involvement in the initiation of opioids for chronic non-cancer pain associated with opioid dose and concurrent drug use? Scandinavian Journal of Primary Health Care. ISSN 0281-3432. 43(1), s. 96–99. doi: 10.1080/02813432.2024.2404053. Fulltekst i vitenarkiv Vis sammendrag

  Objective Is the involvement of the regular general practitioner (GP) in the decision to initiate opioid treatment for chronic non-cancer pain (CNCP) associated with two main risk factors for serious adverse events: increased opioid dose and the concomitant use of prescribed benzodiazepines or benzodiazepine-related medications? Design and setting An anonymous web-based survey was conducted in the county of Rogaland, Norway, during the spring of 2021. Subjects GPs who self-reported applying at least once for reimbursement of opioids prescribed to treat CNCP. They were asked to answer the survey based on the last patient for whom they recalled submitting a reimbursement application. Main outcome measures 1) Total opioid dose in daily oral morphine equivalents (OMEQ). 2) Concurrent use of benzodiazepines and/or benzodiazepine-related drugs. Results The daily opioid dose was lower when the surveyed GPs initiated the opioid treatment (36 OMEQ, n = 25), than when others had initiated the treatment (108 OMEQ, n = 31, p = 0.001). For concurrent use of benzodiazepine or benzodiazepine-related drugs, no significant difference was found (33%, n = 9 with GP involvement vs. 47%, n = 16, p = 0.279 with no GP involvement). Conclusions GP involvement in the initiation of opioid medication for CNCP was associated with a lower opioid dose being prescribed. Implications GP involvement in the initiation of opioid prescriptions may facilitate safer prescribing. KEY POINTS Opioid treatment against chronic non-cancer pain (CNCP) can be reimbursed in Norway. High opioid doses and the concomitant use of other medications with addictive properties, particularly benzodiazepines, increase the risk of serious adverse events. When the general practitioner (GP) in the survey had initiated the opioid treatment, this was associated with a lower opioid dose, but not with less concomitant use of benzodiazepines.

• Odsbu, Ingvild; Hjellvik, Vidar; Handal, Marte; Hamina, Aleksi; Clausen, Thomas & Lid, Torgeir Gilje [Vis alle 8 forfattere av denne artikkelen] (2024). Psykiske lidelser og plager ved vedvarende opioidbruk for langvarige ikke-kreftrelaterte smerter – en registerstudie. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 144(2), s. 1–15. doi: 10.4045/tidsskr.23.0414. Fulltekst i vitenarkiv Vis sammendrag

  Bakgrunn Kunnskap om psykiske lidelser blant pasienter med vedvarende opioidbruk for behandling av langvarige ikke-kreftrelaterte smerter er viktig, da psykiske lidelser og plager kan bidra til å forsterke eller vedlikeholde smerte og påvirke evnen til å håndtere egen sykdom. Vi har undersøkt forekomst av psykiske lidelser og plager, inkludert rusmiddellidelser, hos pasienter med vedvarende opioidbruk i 2019. Materiale og metode Personer ≥ 18 år med vedvarende opioidbruk og personer ≥ 18 år med minst én registrert psykisk lidelse i spesialisthelsetjenesten i 2019 ble inkludert. Data ble hentet fra nasjonale helseregistre. Pasienter som fikk opioider for langvarige smerter på blå resept ble sammenlignet med dem som fikk opioider utelukkende på hvit resept. Resultater Forekomsten av psykiske lidelser og plager var 34 % blant 14 403 personer som fikk opioidene forskrevet på blå resept, og 42 % blant 38 001 personer som fikk opioidene på hvit resept. Dette tilsvarer 2–3 ganger økt forekomst sammenlignet med den generelle befolkningen. Det var spesielt høyere forekomst av angstlidelser og rusmiddellidelser. Det var høyest forekomst av psykiske lidelser og plager i aldersgruppen 18–44 år (49–55 %). Fortolkning Blant pasienter med vedvarende opioidbruk var det en stor andel med psykiske lidelser og plager, som er kjente risikofaktorer for å utvikle problematisk opioidbruk og avhengighetssyndrom. HOVEDFUNN Forekomst av diagnostiserte psykiske lidelser og plager blant pasienter med vedvarende opioidbehandling av langvarige ikke-kreftrelaterte smerter i 2019 var høyest i den yngste aldersgruppen (18–44 år) og blant dem som fikk opioider utelukkende på hvit resept. Pasienter med vedvarende opioidbruk hadde 2–3 ganger høyere forekomst av psykiske lidelser, inkludert rusmiddellidelser, diagnostisert i spesialisthelsetjenesten sammenlignet med den generelle befolkningen. Rusmiddellidelser var hyppigst blant unge menn.

• Høibo, Trond; Skurtveit, Svetlana Ondrasova & Lid, Torgeir Gilje (2024). Opioider på blå resept mot langvarige smerter – en spørreundersøkelse til fastleger. Norsk Farmaceutisk Tidsskrift (NFT). ISSN 0029-1935. 8(8), s. 40–44. Fulltekst i vitenarkiv Vis sammendrag

  Hensikt: Fastleger har muligheten til å søke om individuell refusjon av opioider mot langvarige ikke-kreftrelaterte smertetilstander. Gitte kriterier skal sikre forsvarlig og god behandling. Vi ville undersøke om pasientene er sikret forsvarlig og hensiktsmessig behandling i praksis, ved å se på viktige risikofaktorer for overdose og avhengighet og fastlegens holdning til behandlingen. Materiale og metode: Alle fastleger i Rogaland som oppga å minst én gang ha søkt om individuell refusjon av opioider mot langvarig smertetilstand, ble invitert via e-post til en nettbasert, anonym spørreundersøkelse. Det ble mottatt 61 svar, responsraten var 32 %. Fastlegene besvarte spørsmålene ut fra én konkret pasient de hadde søkt refusjon for. Resultater: Gjennomsnittlig dosering per dag var 76 mg orale morfinekvivalenter (OMEQ). Samtidig bruk av legemidler fra reseptgruppe A eller B i tillegg til opioider forekom hos 53 % (n = 31) av pasientene. I gruppen der pasienten hadde slik samtidig bruk var 41 % (n = 13) av fastlegene enig eller delvis enig i at den medikamentelle behandlingen var hensiktsmessig. I gruppen der pasienten kun brukte opioider, mente 72 % av fastlegene det samme. Konklusjon: Ordningen med individuell refusjon av opioider på blå resept mot langvarige smertetilstander er ingen garanti for at pasienten er sikret forsvarlig eller hensiktsmessig medikamentell behandling.

• Nøst, Torunn Hatlen; Skurtveit, Svetlana Ondrasova; Odsbu, Ingvild; Pedersen, Line; Borchgrevink, Petter Christian & Handal, Marte (2024). Prevalence of substance use disorder diagnoses in patients with chronic pain receiving reimbursed opioids: An epidemiological study of four Norwegian health registries. Scandinavian Journal of Pain. ISSN 1877-8860. 24(1), s. 1–9. doi: 10.1515/sjpain-2024-0059. Fulltekst i vitenarkiv Vis sammendrag

  Objectives Since 2008, patients have had access to reimbursed analgesics, including opioids, for chronic pain in Norway. There is a need for knowledge on the occurrence and trends over time of substance use disorder (SUD) diagnoses among patients who receive reimbursed opioids for chronic pain. The primary aim of this study was to investigate the prevalence of SUD diagnoses in patients with chronic pain using reimbursed opioids from 2010 to 2019 in Norway. The secondary aim was to investigate the prevalence of other mental health diagnoses among those receiving reimbursed opioids in the subgroups with and without SUD diagnoses. Methods A cross-sectional design utilising data from four Norwegian nationwide registries. Results The annual number of individuals with SUD diagnoses increased from 377 to 932 from 2010 to 2019, while the annual prevalence of individuals with SUD remained relatively stable at around 5%. There was a higher prevalence for all categories of other mental health diagnoses among individuals with a SUD diagnosis, compared to those without a SUD diagnosis. Conclusion The prevalence of SUD diagnoses was low in the population using reimbursed opioids for chronic pain in Norway, but the number of patients increased in the study period because the number of individuals receiving reimbursed opioids increased. Patients with a SUD used on average twice the daily doses of opioids compared to patients without a SUD. They were also more likely to have an additional mental health diagnosis.

• Mcdonald, Rebecca Silvia; Eide, Desiree; Skurtveit, Svetlana Ondrasova & Clausen, Thomas (2024). Pills and the damage done: the opioid epidemic as man-made crisis. Frontiers in Public Health. 11. doi: 10.3389/fpubh.2023.1241404. Fulltekst i vitenarkiv Vis sammendrag

  The prescription opioid epidemic has slowly evolved over the past quarter century with increasingly detrimental consequences for public health. Man-made crises are often unforeseen and characterized by a situation without natural causes where – because of human intent, error, negligence, or the failure of manmade systems – the level of needs in the population exceeds available resources to counter the problem. This paper presents the prescription opioid epidemic as a man-made crisis and explores the public health impact of opioid manufacturers and other industries producing commodities with addictive potential as a shared vulnerability among countries. We examine this concept within the framework of the commercial determinants of health. We address three key aspects of the commercial determinants of health: (1) Cross-industry mechanisms, (2) policy inertia, and (3) the role of industry in science. Within cross-industry mechanisms, we explore parallels between prescription opioid epidemic and unhealthy commodity industries in terms of marketing, corporate use of misinformation, and diversionary tactics. Next, we examine how policy inertia has dominated the slow response to this man-made crisis. Lastly, we discuss how results from clinical trials are used as a key marketing strategy for drugs. The origins of the prescription opioid epidemic may be traced to innovations in drug development with the promise of improved pain management. However, through multiple factors, including fraudulent marketing from pharmaceutical industry and policy inertia, the resulting crisis represents a multi-system failure of regulation exploited by corporate greed.

• Ørnskov, Mark Puch; Kurita, Geana Paula; Herling, Suzanne Forsyth; Sjøgren, Per; Skurtveit, Svetlana Ondrasova & Odsbu, Ingvild [Vis alle 8 forfattere av denne artikkelen] (2024). Opioid use after surgical treatment in the Danish population—Protocol for a register-based cohort study. Acta Anaesthesiologica Scandinavica. ISSN 0001-5172. 68(10), s. 1565–1572. doi: 10.1111/aas.14506. Fulltekst i vitenarkiv Vis sammendrag

  Background: Over the past 25 years, global opioid consumption has increased. Denmark ranks fifth in opioid use globally, exceeding other Scandinavian countries. Postsurgical pain is a common reason for opioid prescriptions, but opioid use patterns after patient discharge from the hospital are unclear. This study examines trends in opioid prescription among Danish surgical patients over a year. Methods: This register-based cohort study will use data from Danish governmental databases related to patients undergoing the 10 most frequent surgical procedures in 2018, excluding cancer-related and minor procedures. The primary outcome will be the dispensed postoperative opioid prescriptions at retail pharmacies over four quar- ters. Secondary analyses will include associations with sex, age, education attainment, and oral morphine equivalent quotient. Surgical treatments and diagnoses will be identified using NOMESCO procedure codes and ICD-10 codes. Opioids will be iden- tified by ATC codes N02A and R05DA04. Subjects will be classified as preoperative opioid consumers or non-opioid consumers based on opioid prescriptions redeemed in the 6 months before surgery. Discussion: The study will use extensive national register-based data, ensuring con- sistent data collection and enhancing the generalizability of the findings to similar healthcare systems. The study may identify high-risk populations for long-term opi- oids and provide information to support opioid prescribing guidelines and public health policies.

• Kostovski, Emil; Hamina, Aleksi; Hjellvik, Vidar; Clausen, Thomas & Skurtveit, Svetlana Ondrasova (2024). Increased cancer incidence and mortality among people with opioid use-related disorders: A nation-wide cohort study. Addiction. ISSN 0965-2140. 119(9), s. 1575–1584. doi: 10.1111/add.16524. Fulltekst i vitenarkiv Vis sammendrag

  Background and aims Studies on cancer incidence and mortality among people with opioid use-related disorders are lacking. We aimed to measure cancer-specific incidence, mortality and survival among people diagnosed with opioid use-related disorders in Norway during 2010–18. Design and setting This was a cohort study conducted in Norway during 2010–18. Participants Individuals (n = 20 710) diagnosed with opioid use-related disorders. Measurements We conducted a cohort study utilizing a data-linkage of national health and population registers. Information on opioid use-related disorders was extracted from specialized healthcare, malignancies from the Cancer Registry of Norway and deaths from Cause of Death Registry. Cancer incidence and mortality were compared with the general population by calculating sex-specific age-standardized incidence (SIR) and mortality (SMR) ratios. One-year survival rates were computed. Findings Compared with the general population, people with opioid use-related disorders were at an increased risk of developing cancer overall [SIR = 1.2, 95% confidence interval (CI) = 1.1–1.3] with a higher than twofold cancer mortality rate (SMR = 2.3, 95% CI = 2.0–2.7). Excess risk was observed for liver (12.6, 95% CI = 9.1–17.0), larynx (4.7, 95% CI = 1.7–10.2), lung (3.5, 95% CI = 2.8–4.3) and pancreas cancer (2.6, 95% CI = 1.6–4.0), whereas reduced risk was found for melanoma (0.5, 95% CI = 0.3–0.9), breast (0.6, 95% CI = 0.4–0.9) and prostate cancers (0.3, 95% CI = 0.1–0.4). Site-specific SMRs were significantly elevated for liver (12.3, 95% CI = 8.5–17.2), lung (3.9, 95% CI = 3.0–5.0), pancreas (3.0, 95% CI = 1.7–4.8) and colon cancers (1.9, 95% CI = 1.1–3.1). The average 1-year survival rate after a cancer diagnosis was low in liver, pancreas and colon cancer, ranging from 10 to 15% less than that of the general population. Conclusions In Norway, cancer incidence and cancer-related mortality appear to be elevated among individuals with opioid use-related disorders.

• Bachmann, Christian J; Scholle, Oliver; Bliddal, Mette; dosReis, Susan; Odsbu, Ingvild & Skurtveit, Svetlana [Vis alle 10 forfattere av denne artikkelen] (2024). Recognition and management of children and adolescents with conduct disorder: a real-world data study from four western countries. Child and Adolescent Psychiatry and Mental Health (CAPMH). 18(1). doi: 10.1186/s13034-024-00710-6. Fulltekst i vitenarkiv
• Amundsen, Ellen Johanna; Odsbu, Ingvild; Skurtveit, Svetlana Ondrasova & Gjersing, Linn (2024). Patterns of filled prescriptions and the association with risk of drug-induced death. A population-based nested case-control register study. Pharmacoepidemiology and Drug Safety. ISSN 1053-8569. 33(2). doi: 10.1002/pds.5763. Fulltekst i vitenarkiv Vis sammendrag

  Purpose: Opioid analgesics (OA) and other pharmaceuticals have been associated with drug-induced deaths. However, there is a lack of knowledge regarding patterns of use of these pharmaceuticals in the population and regarding such associations. We identify and describe subgroups of people with different patterns of filled prescriptions of OA and other relevant pharmaceuticals and examine associations with drug-induced deaths. In addition, we estimate the proportion of drug-induced deaths with a filled OA prescription and OA as cause of death. Methods: A Norwegian population-based nested case-control register study with cases (drug-induced deaths 2010–2018, N = 2388) and population controls matched for age, gender and year of inclusion (N = 21 465). Patterns of filled prescriptions for opioid analgesics (OA), benzodiazepines and benzodiazepine-related drugs, gabapentinoids, ADHD medication and antidepressants/antipsychotics were explored by k-means cluster analysis. Associations with drug-induced deaths were estimated by conditional logistic regression adjusted for sociodemographic characteristics. Overlap of filled OA prescriptions and OA as cause of death was estimated. Results: Five clusters were identified: ‘few prescriptions’, ‘weak OA’, ‘ADHD medication’, ‘sedative/psychiatric morbidity’ and ‘strong OA’. The ‘strong OA’ cluster had higher socioeconomic status compared to the other groupings. The risk of drug-induced death was also highest in this cluster (OR = 35.5; CI 25.6–49.3) and, for 68% (CI 64–73) of cases, filled prescriptions for OA was indicated as the underlying cause of death. Conclusions: The cluster analysis identified a subgroup with filled prescriptions of OA and other pharmaceuticals and a higher socioeconomic status than othersubgroups. This subgroup had a high risk of drug-induced death that needs to be addressed.

• Nestvold, Håkon Høydal; Skurtveit, Svetlana Ondrasova; Hamina, Aleksi; Hjellvik, Vidar & Odsbu, Ingvild (2024). The risk of long-term opioid use among immigrants: a national registry-linkage study. Scandinavian Journal of Public Health. ISSN 1403-4948. doi: 10.1177/14034948241266744. Fulltekst i vitenarkiv Vis sammendrag

  Aims: We aimed to investigate the association between being an immigrant and long-term prescription opioid use in Norway in 2010–2019. Methods: Nested case–control study. The cases were all persons 18 years of age or older with long-term opioid use – that is, the use of prescription opioids longer than 3 months (N=215,642). Cases were matched to four controls who filled at least one opioid prescription, but never developed long-term opioid use in the study period (N=862,568) on sex, age and year of starting long-term/short-term opioid use. Being an immigrant was defined as being born outside of Norway to two foreign-born parents and four foreign-born grandparents. Adjusting for socioeconomic variables and clinical confounders, analyses were stratified on three age groups (18-44 years, 45-67 years and ⩾68 years). Results: For the youngest age group, being an immigrant was inversely associated with long-term opioid use (adjusted odds ratio 0.75; 95% confidence interval [0.72–0.77]) compared with being native-born people. For this age group, the odds ratio differed between people born in Africa (0.56 [0.52–0.62]), Central or South America (0.70 [0.62–0.79]), Europe outside the European Union (EU) (0.71 [0.65–0.77]), Asia including Turkey (0.80 [0.77–0.84]) and EU/European Economic Area (EEA) (0.81 [0.77–0.85]). For the middle age group, increased odds were found for immigrants versus natives (1.05 [1.02–1.08]) in particular for those born in North America (1.26 [1.13–1.40]) and the EU/EEA (1.13 [1.09–1.18]). There was no association in the oldest group. Conclusions: Compared with native-born people, immigrants had lower odds of long-term opioid use among younger adults, higher odds among middle-aged and similar odds among older adults.

• Sharikabad, Mohammad Nouri; Skurtveit, Svetlana Ondrasova; Sommerschild, Hilchen Thode; Olsen, Kristine; Hartz, Ingeborg & Wesselhoeft, Rikke [Vis alle 9 forfattere av denne artikkelen] (2024). Morbidity among Adolescent Hypnotic Drug Users in Norway: An Observational Population-Based Study. Journal of Clinical Medicine. 13(4). doi: 10.3390/jcm13041075. Fulltekst i vitenarkiv Vis sammendrag

  We have previously shown that the use of hypnotic drugs increased among young Scandinavians during 2012-2018. This study aimed to explore psychiatric and somatic morbidity among adolescent hypnotic drug users in a cohort study of 13-17-year-old individuals during 2008-2018 in Norway. Data sources were (i) prescription data from the Norwegian Prescription Database linked to specialist health care diagnoses from the Norwegian Patient Registry and (ii) sleep disorder diagnoses from the Primary Health Care Database. Hypnotic drugs were defined as the sedative antihistamine alimemazine and the ATC group "Hypnotics and Sedatives" (N05C), excluding midazolam. In 2017, 2519 girls (16.5/1000) and 1718 boys (10.7/1000) were incident (new) users of hypnotic drugs. Most of these new users (82% of girls, 77% of boys) were referred to secondary health care, where the most frequent diagnoses were mental and behavioral disorders (51.8% of girls, 46.2% of boys), while only 3.2% received a specific sleep disorder diagnosis. The most common mental and behavioral disorders were "Neurotic stress-related disorders" among girls (27.4%) and "Behavioral and emotional disorders" among boys (23.6%). In conclusion, the trend of increasing hypnotic drug use among adolescents reflects the initiation of hypnotic drugs in a subgroup of the population with a higher disease burden, mainly due to psychiatric disorders, than the general population.

• Rasmussen, Lotte; Jensen, Peter Bjødstrup; Reutfors, Johan; Furu, Kari; Skurtveit, Svetlana Ondrasova & Selmer, Randi Marie [Vis alle 9 forfattere av denne artikkelen] (2024). Treatment patterns of antidepressants in children and adolescents in Scandinavia. European Child and Adolescent Psychiatry. ISSN 1018-8827. 34, s. 159–167. doi: 10.1007/s00787-024-02433-7. Fulltekst i vitenarkiv
• Vambheim, Sara Magelssen; Hjellvik, Vidar; Odsbu, Ingvild; Skurtveit, Svetlana Ondrasova; Ekholdt, Christopher & Granan, Lars-Petter Ness [Vis alle 8 forfattere av denne artikkelen] (2024). Postoperative opioid use in Norway-a population-based observational study on patterns of long-term use. BMC Pharmacology and Toxicology. 25(1), s. 1–9. doi: 10.1186/s40360-024-00805-y. Fulltekst i vitenarkiv Vis sammendrag

  Background The utilization patterns of opioid analgesics and the proportion of long-term opioid use after surgery in Norway is largely unknown. Methods This study aimed to estimate the proportion of one-year long-term prescription opioid use among all Norwegian postoperative opioid users. Complete data from central health registries (NPR, NorPD, Statistics Norway, CoDR) were linked via the personal identification number unique to all citizens. The study period was January 1st 2010 until December 31st 2019. Long-term opioid use was defined as at least two opioid dispensings within two subsequent 90-day periods, with a minimum average use of 10 MME/day for the first 90 days. Results The study population consisted of 693 495 post-operative opioid users (53.6% women), whereof 73.2% had not used opioids the year before surgery (new users). Among the postoperative opioid users, 3.8% were one-year long-term opioid users. The corresponding figures for new and previous opioid users were 0.4% and 13.1%, respectively. The highest proportions of long-term opioid use were found after transluminal endoscopy, eye surgery and assessments related to surgical procedures. In previous opioid users, the proportion of one-year long-term use was higher among women than men in all age groups, a difference that increased with age. Conclusions The proportion of postoperative long-term opioid use in Norway is generally low. We detected higher proportions of long-term opioid use after certain types of surgery, but our crude surgery definition warrants further examination. Previous opioid users pose a particular challenge in the management of postoperative pain. Trial registration The study used national health registry data from the period 2010–2019. A pre-registered analysis plan is available at Open Science Framework.

• Torp, Henrik Andreas; Skurtveit, Svetlana Ondrasova; Gustavsen, Ingebjørg G.; Gran, Jon Michael & Rosseland, Leiv Arne (2024). Post-injury use of opioid analgesics in patients with traumatic injury: A registry-based study. European Journal of Pain. ISSN 1090-3801. 29(3). doi: 10.1002/ejp.4743. Fulltekst i vitenarkiv Vis sammendrag

  Background Opioid analgesics are commonly used to treat acute and chronic pain following traumatic injury. Psychiatric comorbidity has been reported to be associated with increased pain and persistent opioid use. Our aims were to determine the extent of post-injury opioid use and assess whether pre-injury antidepressant, benzodiazepine, and z-hypnotic drug use is associated with increased post-injury opioid use. Methods Data on trauma patients aged 15 years and older included in the Oslo University Hospital Trauma Registry between 2005 and 2014 was linked to data from the Norwegian Prescription Database. We identified opioid dispensing within the first 90 and 365 days following trauma and determined subsequent persistent use. Multivariable logistic regression was applied to examine associations between pre- and post-injury drug use. Results 3912 of 11,057 patients (35.4%) had opioids dispensed within 90 days after trauma, and 4644 (42.0%) within 365 days. Among 9800 previously opioid-naïve, the proportions were 33.0% and 39.0%, respectively. One year after the first post-injury opioid dispensing, 9.6% of all opioid users and 4.5% of new users were defined as persistent users. Pre-injury benzodiazepine use and z-hypnotic use was associated with new persistent opioid use (adjusted odds ratio [aOR] 2.25; 95% confidence interval [CI] 1.47–3.45, and aOR 2.04; 95% CI 1.33–3.13, respectively), whereas pre-injury antidepressant use was not (aOR 1.49; 95% CI 0.97–2.30). Conclusions Opioid use after trauma is widespread. Development of persistent use is limited, particularly in previously opioid-naïve patients. Pre-injury benzodiazepine or z-hypnotic use seem to increase odds of new persistent use. Significance statement This large registry-based study adds to the body of knowledge on opioid use beyond in-hospital care in patients having sustained traumatic injury, a field which is scarcely investigated and not yet fully understood. It suggests that both previous drug therapy and the nature of opioid treatment initiation may affect outcome. This will help guide clinicians in selecting the appropriate pain management in this patient group.

• Hamina, Aleksi; Odsbu, Ingvild; Hjellvik, Vidar; Lid, Torgeir Gilje; Clausen, Thomas & Skurtveit, Svetlana Ondrasova (2023). Fatal drug overdoses in individuals treated pharmacologically for chronic pain: a nationwide register-based study. British Journal of Anaesthesia. ISSN 0007-0912. 132(1), s. 86–95. doi: 10.1016/j.bja.2023.10.016. Fulltekst i vitenarkiv Vis sammendrag

  Introduction Chronic pain patients may be at an increased risk for drug overdoses as a result of comorbid psychiatric disorders and treatment with risk-increasing prescription medications, such as opioids. We aimed to characterise fatal drug overdoses and investigate factors associated with the deaths among individuals who had been treated pharmacologically for chronic pain. Methods We included all individuals who received analgesics reimbursed for chronic pain in Norway during 2010–9 (n=569 047). Among this population, we identified all individuals with drug overdoses as cause of death (cases). Extracting data from national registries on diagnoses, filled prescriptions, and socioeconomic variables, we used a nested case-control design to compare the cases with age- and sex-matched controls from the study population. Results Overall, 623 (0.11%) individuals in the study population died of an overdose. Most, 66.8%, had overdosed accidentally, and 61.9% as a result of pharmaceutically available opioids. Compared with the controls (n=62 245), overdoses overall were associated strongly with substance use disorders (adjusted odds ratio 7.78 [95% confidence interval 6.20–9.77]), use of combinations of opioids, benzodiazepines and related drugs and gabapentinoids (4.60 [3.62–5.85]), previous poisoning with pharmaceuticals (2.78 [2.20–3.51]), and with living alone the last year of life (2.11 [1.75–2.54]). Intentional overdoses had a stronger association with previous poisonings with pharmaceuticals whereas accidental overdoses were strongly associated with substance use disorders. Conclusions This study shows the need for better identification of overdose and suicide risk in individuals treated for chronic pain. Extra caution is needed when treating complex comorbid disorders, especially with overdose risk-increasing medications.

• Eide, Desiree; Mcdonald, Rebecca Silvia; Hamina, Aleksi; Clausen, Thomas; Odsbu, Ingvild & Skurtveit, Svetlana Ondrasova (2023). Prescription high-risk polysubstance use among opioid maintenance treatment patients. International journal of drug policy. ISSN 0955-3959. doi: 10.1016/j.drugpo.2023.104196. Fulltekst i vitenarkiv Vis sammendrag

  Background Among individuals receiving buprenorphine or methadone as opioid maintenance treatment (OMT), concomitant use of other central nervous system depressants, including prescription drugs, can increase risk of overdose. We aimed to 1) determine the prevalence of use of high-risk prescription drugs (opioid analgesics, benzodiazepines, benzodiazepine-related drugs, and gabapentinoids) among OMT patients, 2) calculate its associations with different mental health and pain-related diagnoses, and 3) compare prevalence of concomitant use with the general population. Methods A national sample comprising all individuals filling at least one prescription of OMT drugs in Norway in 2019 was formed. Healthcare registry data were linked to investigate high-risk prescription drug use and different diagnoses. We calculated one-year prevalence of use, amount dispensed in defined daily doses (DDDs), and the number of prescribers for the different high-risk prescription drugs. Logistic regression was used to determine associations (adjusted odds ratios; aOR, 95% confidence intervals (CIs)) between diagnoses and use. Prevalence of use was calculated both in the OMT patient sample and the general population. Results Among the OMT patient sample (n=7,299), 47.6% (n=3,476) filled prescriptions for benzodiazepines. For each high-risk prescription drug group, there was a median of 1-2 prescribers. Musculoskeletal diagnoses were the strongest factor for concomitant high-risk prescription drug use for both males (aOR 3.23, CI: 2.72-3.85) and females (aOR 3.07, CI: 2.42- 3.90). The 1-year prevalence of benzodiazepine use was 11.4 times higher for males and 7.1 times higher for females in OMT than the general population. The amount in DDDs was higher for every drug for OMT patients than the general population, particularly for benzodiazepines. Conclusions OMT patients frequently filled prescriptions for high-risk drugs, and in higher dosages than the general population. However, we found little evidence of ‘doctor shopping.’ Given that these prescription drugs carry overdose risk, particularly when combined with OMT drugs, our findings emphasize the continued need for education and caution to both prescribers and patients on their concomitant use with OMT.

• 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. 18(1). doi: 10.1186/s13011-023-00557-8. Fulltekst i vitenarkiv Vis sammendrag

  Background Physical diseases represent a significant burden for opioid agonist treatment (OAT) patients. This study described physical morbidity in two national cohorts of OAT patients focusing on gender differences. Methods This population-based cohort study linking multiple health registers investigated physical diseases (ICD-10) in patients receiving OAT in the Czech Republic (N = 4,280) and Norway (N = 11,389) during 2010–2019. Gender-stratified analysis was performed. Results Overall, we found a large burden of physical morbidity across gender groups in OAT patients. In the Czech Republic and Norway, women in OAT had a significantly higher prevalence of physical diseases across most diagnostic chapters, notably genitourinary diseases and neoplasms. Injuries/external causes and infectious/parasitic diseases were among the most common diseases in both women and men. Viral hepatitis accounted for over half of infectious morbidity in women and men in both cohorts. Conclusions Our findings support the need for early screening, detection, and treatment of diseases and conditions across organ systems and the integration of health promotion activities to reduce physical morbidity in OAT patients. The gender differences underline the need for a tailored approach to address specific medical conditions.

• Eriksen, Astrid M.A.; Melhus, Marita; Schei, Berit; Skurtveit, Svetlana Ondrasova & Broderstad, Ann Ragnhild (2023). Opioid prescriptions among Sami and non-Sami with chronic pain: The SAMINOR 2 Questionnaire Survey and the Norwegian Prescription Database. International Journal of Circumpolar Health. ISSN 1239-9736. 82(1). doi: 10.1080/22423982.2023.2241202. Fulltekst i vitenarkiv Vis sammendrag

  This study is the first to investigate the prevalence of filled opioid prescriptions among indigenous Sami people with self-reported chronic musculoskeletal pain (CMSP) and compare it with that of non-Sami living in the same area. Baseline data from the SAMINOR 2 Questionnaire Survey (2012) was linked prospectively to the Norwegian Prescription Database. Information on filled opioid prescriptions during 2012–2019 was collected for 4767 persons who reported CMSP in SAMINOR 2. Gender-stratified chi-square tests, two-sample t-tests, Kruskal – Wallis tests, and multinomial logistic regression was applied. Two out of three CMSP respondents received no or only one prescription of opioids during 2012–2019. In each year, 80% of women received no opioids, 7–10% received one prescription of ≤ 180 defined daily doses (DDD), 8–9% received in total ≤ 180 DDD in two or more prescriptions, and 2–3% received > 180 DDD of opioids. Among men, 81–83% received no opioids, 8–11% received one prescription with ≤ 180 DDD, 5–9% received ≤ 180 DDD in two or more prescriptions, and 1–2% received > 180 DDD of opioids in a single year. There were no overall ethnic differences, which indicates a similar prescription policy for opioids for Sami and non-Sami with CMSP.

• Nestvold, Håkon Høydal; Skurtveit, Svetlana Ondrasova; Hamina, Aleksi; Hjellvik, Vidar & Odsbu, Ingvild (2023). Socioeconomic risk factors for long-term opioid use: A national registry-linkage study. European Journal of Pain. ISSN 1090-3801. 28(1), s. 95–104. doi: 10.1002/ejp.2163. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Background Opioid use has increased substantially as a treatment for chronic pain, although harms from long‐term opioid therapy outweigh the benefits. More knowledge about factors associated with long‐term opioid use is needed. We aimed to investigate the association between socioeconomic status and long‐term opioid use in the period 2010–2019. Methods This was a nested case–control study in which the cases were all persons ≥18 years with long‐term opioid use, that is use of opioids for more than 3 months ( N  = 215,642). Cases were matched on gender, age and index year (first long‐term use period) with four controls who filled at least one opioid prescription, but never developed long‐term opioid use in the study period ( N  = 862,568). We performed a logistic regression analysis adjusted for relevant confounders, stratified on age groups (18–67 years and 68 years and above). Results In the younger age group, long‐term opioid use was associated with low education (adjusted odds ratio, aOR = 1.54; 95% confidence interval, CI [1.51–1.57]), low income (1.33 [1.31–1.36]), being unemployed (1.40 [1.38–1.42]) and receiving disability pension (1.36 [1.33–1.38]). Weaker associations were found for living in a single‐person household or in a dense geographical area. Similar associations were found for the older age group. Conclusion We found that low socioeconomic status was associated with long‐term opioid use both among people in working age and older people. These results indicate a need for social and financial support for non‐pharmacological treatment of chronic pain among people with lower socioeconomic status. Significance This study shows that people with low socioeconomic status are at higher risk of developing long‐term opioid use. In the clinical setting, physicians should consider socioeconomic status when prescribing opioids for chronic pain. Non‐pharmacological treatment options funded by public health services should be prioritized to those with low socioeconomic status as long‐term opioid use in chronic pain patients is not recommended.

• Odsbu, Ingvild; Handal, Marte; Hjellvik, Vidar; Hernandez-Diaz, Sonia; Kieler, Helle & Nørgaard, Mette [Vis alle 9 forfattere av denne artikkelen] (2023). Prenatal opioid exposure and risk of asthma in childhood: a population-based study from Denmark, Norway, and Sweden. Frontiers in Pharmacology. 14, s. 1–12. doi: 10.3389/fphar.2023.1056192. Fulltekst i vitenarkiv
• Baumann, Monica; Storheim, Kjersti; Stangeland, Helle; Zwart, John Anker Henrik; Wentzel-Larsen, Tore & Skurtveit, Svetlana Ondrasova [Vis alle 8 forfattere av denne artikkelen] (2023). Childhood trauma and the use of opioids and other prescription analgesics in adolescence and young adulthood. The HUNT study. Pain. ISSN 0304-3959. 165(6), s. 1317–1326. doi: 10.1097/j.pain.0000000000003131. Fulltekst i vitenarkiv
• Gabrhelík, Roman; Hesse, Morten; Nechanská, Blanka; Handal, Marte; Mravčík, Viktor & Tjagvad, Christian [Vis alle 11 forfattere av denne artikkelen] (2023). Large variations in all-cause and overdose mortality among >13,000 patients in and out of opioid maintenance treatment in different settings: a comparative registry linkage study. Frontiers in Public Health. 11. doi: 10.3389/fpubh.2023.1179763. Fulltekst i vitenarkiv Vis sammendrag

  Background Opioid maintenance treatment (OMT) has the potential to reduce mortality rates substantially. We aimed to compare all-cause and overdose mortality among OMT patients while in or out of OMT in two different countries with different approaches to OMT. Methods Two nation-wide, registry-based cohorts were linked by using similar analytical strategies. These included 3,637 male and 1,580 female patients enrolled in OMT in Czechia (years 2000–2019), and 6,387 male and 2,078 female patients enrolled in OMT in Denmark (years 2007–2018). The direct standardization method using the European (EU-27 plus EFTA 2011–2030) Standard was employed to calculate age-standardized rate to weight for age. All-cause and overdose crude mortality rates (CMR) as number of deaths per 1,000 person years (PY) in and out of OMT were calculated for all patients. CMRs were stratified by sex and OMT medication modality (methadone, buprenorphine, and buprenorphine with naloxone). Results Age-standardized rate for OMT patients in Czechia and Denmark was 9.7/1,000 PY and 29.8/1,000 PY, respectively. In Czechia, the all-cause CMR was 4.3/1,000 PY in treatment and 10.8/1,000 PY out of treatment. The overdose CMR was 0.5/1,000 PY in treatment and 1.2/1,000 PY out of treatment. In Denmark, the all-cause CMR was 26.6/1,000 PY in treatment and 28.2/1,000 PY out of treatment and the overdose CMR was 7.3/1,000 PY in treatment and 7.0/1,000 PY out of treatment. Conclusion Country-specific differences in mortality while in and out of OMT in Czechia and Denmark may be partly explained by different patient characteristics and treatment systems in the two countries. The findings contribute to the public health debate about OMT management and may be of interest to practitioners, policy and decision makers when balancing the safety and accessibility of OMT.

• Eide, Desiree; Skurtveit, Svetlana Ondrasova; Clausen, Thomas; Hesse, Morten; Mravčík, Viktor & Nechanská, Blanka [Vis alle 12 forfattere av denne artikkelen] (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. doi: 10.1159/000530822. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: Among people receiving current or previous opioid maintenance treatment (OMT), the leading cause of premature death is an opioid overdose. However, other causes of mortality remain high in this group. An understanding of causes of deaths across multiple settings can be useful in informing more comprehensive prevention responses. The aim of this study was to describe all non-overdose causes of death in three national cohorts (Czechia, Denmark, and Norway) among OMT patients and to explore associations of non-overdose mortality with age and gender. Methods: This prospective comparative cohort study used national mortality registry databases for OMT patients from Czechia (2000–2019), Denmark (2000–2018), and Norway (2010–2019). Crude mortality rates and age-standardized mortality rates (ASMRs) were calculated as deaths per 1,000 person years for cause-specific mortality. Results: In total, 29,486 patients were included, with 5,322 deaths recorded (18%). We found variations in causes of death among the cohorts and within gender and age groups. The leading non-overdose causes of death were accidents in Czechia and Denmark, and neoplasms in Norway. Cardiovascular deaths were highest in Czechia, particularly for women in OMT (ASMR 3.59 vs. 1.24 in Norway and 1.87 in Denmark). Conclusion: This study found high rates of preventable death among both genders and all age groups. Different demographic structures, variations in risk exposure, as well as variations in coding practices can explain the differences. The findings support increased efforts towards screening and preventative health initiatives among OMT patients specific to the demographic characteristics in different settings.

• Holmberg, Siril T.; Skurtveit, Svetlana; Gulati, Sasha; Salvesen, Øyvind; Nygaard, Øystein P. & Solberg, Tore K. [Vis alle 7 forfattere av denne artikkelen] (2023). Persistent Use of Prescription Opioids Before and After Lumbar Spine Surgery: Observational Study With Prospectively Collected Data From Two Norwegian National Registries. Spine. ISSN 0362-2436. 48(14), s. 969–977. doi: 10.1097/BRS.0000000000004710. Fulltekst i vitenarkiv Vis sammendrag

  Study design. Prospective pharmacoepidemiologic study Objective. To investigate clinical and sociodemographic factors associated with persistent opioid use in the years following spine surgery among patients with persistent opioid use preceding lumbar spine surgery. Summary of background data. It is unknown whether successful spine surgery leads to a cessation of preoperative persistent opioid use. Methods. Data from the Norwegian Registry for Spine Surgery and the Norwegian Prescription Database were linked for patients operated for degenerative lumbar spine disorders between 2007 and 2017. The primary outcome measure was persistent opioid use in the second year after surgery. Functional disability was measured with the Oswestry Disability Index (ODI). Factors associated with persistent opioid use in the year before, and two years following, surgery were identified using multivariable logistic regression analysis. The variables included in the analysis were selected based on their demonstrated role in prior studies. Results. The prevalence of persistent opioid use was 8.7% in the year before surgery. Approximately two-thirds of patients also met the criteria for persistent opioid use the second year after surgery. Among patients who did not meet the criteria for persistent opioid use the year before surgery, 991 (3.3%) patients developed persistent opioid use in the second year following surgery. The strongest association was exhibited by high doses of benzodiazepines in the year preceding surgery (OR 1.7, 95% CI 1.26 to 2.19, P

• Espnes, Ketil Arne; Nøst, Torunn Hatlen; Handal, Marte; Skurtveit, Svetlana Ondrasova & Langaas, Harald Chr. (2023). Can academic detailing reduce opioid prescriptions in chronic non‑cancer pain? BMC Primary Care. 24. doi: 10.1186/s12875-023-02040-6. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Background One measure to support optimal opioid prescription is academic detailing (AD) with one-to-one visits by trained professionals (academic detailers) to general practitioners (GPs). Objective: To investigate the usefulness of AD visits on GPs’ opioid prescribing patterns in Norway, and academic detailers’ experiences with AD visits to GPs on opioid prescription. Methods Design: A quantitative registry study on opioid prescriptions and a qualitative focus group interview study with academic detailers. Participants: For the registry study, municipalities where more than 75% of the GPs had received an AD visit were considered intervention municipalities, whereas in the non-intervention municipalities no GPs had received AD-visits. In the focus groups, academic detailers who had conducted three or more AD-visits were invited to participate. Intervention: A campaign on opioid prescription with AD visits using a brochure with key messages based on the national guideline for treatment of chronic non-cancer pain and updated evidence on the potential benefts and risks of prescribing opioids. The AD visits in the campaign were planned for 20–25 min in a one-to-one setting in the GP’s ofce. Main Measures: The Norwegian Prescription Database (NorPD) was utilized for registry data. Data on amount of drugs dispensed are recoded as Defned Daily Doses (DDDs). Results Compared to non-intervention, the intervention resulted in a decrease in the number of prevalent and incident users of opioids and incident users of reimbursed opioids for chronic non-cancer pain in municipalities in Central Norway. The results from the focus group interviews were categorized into the themes: “To get in position”, “Adjusting messages”, “What did the GPs struggle with, in relation to opioid prescription?” and “Did we reach the right recipients with the visits?”. Conclusions In Central Norway, the intervention resulted in a desired efect on number of opioid users. According to the academic detailers, the GPs’ length of working experience and familiarity with the topic gave diferent presumptions for making use of the information presented in the AD-visits. Keywords Chronic non-cancer pain, Academic detailing, Primary care, Opioids

• Gjerde, L. C.; Skurtveit, S.; Handal, M.; Nesvåg, R.; Clausen, T. & Lid, T. G. [Vis alle 9 forfattere av denne artikkelen] (2023). Mental disorder prevalence in chronic pain patients using opioid versus non-opioid analgesics: A registry-linkage study. European Journal of Pain. ISSN 1090-3801. 27(7), s. 884–895. doi: 10.1002/ejp.2121. Fulltekst i vitenarkiv Vis sammendrag

  Background Chronic pain and mental disorders are leading causes of disability worldwide. Individuals with chronic pain are more likely to experience mental disorders compared to individuals without chronic pain, but large-scale estimates are lacking. We aimed to calculate overall prevalence of mental health diagnoses from primary and secondary care among individuals treated for chronic pain in 2019 and to compare prevalence among chronic pain patients receiving opioid versus non-opioid analgesics, according to age and gender. Methods It is a population-based cohort study. Linked data from nationwide health registers on dispensed drugs and diagnoses from primary (ICPC-2) and secondary (ICD-10) health care. Chronic pain patients were identified as all patients over 18 years of age filling at least one prescription of an analgesic reimbursed for non-malignant chronic pain in both 2018 and 2019 (N = 139,434, 69.3% women). Results Prevalence of any mental health diagnosis was 35.6% (95% confidence interval: 35.4%–35.9%) when sleep diagnoses were included and 29.0% (28.8%–29.3%) when excluded. The most prevalent diagnostic categories were sleep disorders (14% [13.8%–14.2%]), depressive and related disorders (10.1% [9.9%–10.2%]) and phobia and other anxiety disorders (5.7% [5.5%–5.8%]). Prevalence of most diagnostic categories was higher in the group using opioids compared to non-opioids. The group with the highest overall prevalence was young women (18–44 years) using opioids (50.1% [47.2%–53.0%]). Conclusions Mental health diagnoses are common in chronic pain patients receiving analgesics, particularly among young individuals and opioid users. The combination of opioid use and high psychiatric comorbidity suggests that prescribers should attend to mental health in addition to somatic pain. Significance This large-scale study with nation-wide registry data supports previous findings of high psychiatric burden in chronic pain patients. Opioid users had significantly higher prevalence of mental health diagnoses, regardless of age and gender compared to users of non-opioid analgesics. Opioid users with chronic pain therefore stand out as a particularly vulnerable group and should be followed up closely by their physician to ensure they receive sufficient care for both their mental and somatic symptoms.

• Tiger, Mikael; Wesselhoeft, Rikke; Karlsson, Pär; Handal, Marte; Bliddal, Mette & Cesta, Carolyn E. [Vis alle 8 forfattere av denne artikkelen] (2022). Utilization of antidepressants, anxiolytics, and hypnotics during the COVID-19 pandemic in Scandinavia. Journal of Affective Disorders. ISSN 0165-0327. 323, s. 292–298. doi: 10.1016/j.jad.2022.11.068. Fulltekst i vitenarkiv Vis sammendrag

  Objective To study patterns of antidepressant, anxiolytic, and hypnotic drug utilization in Denmark, Norway, and Sweden during the first year of the COVID-19 pandemic. Methods The monthly observed number of prescription fills of antidepressants, benzodiazepines and benzodiazepine-related hypnotics (BZ), and other anxiolytics and hypnotics (OAH) per population in 2020 were compared with predicted numbers based on analysis of covariance of prescription fills during 2015–2019. Results In March 2020, there was an increased number of prescription fills for antidepressants, anxiolytics, and hypnotics in youths and adults aged 20–59 years in Denmark, Norway, and Sweden. Antidepressant prescription fills increased between 13.5 % and 31.3 % at the end of 2020 in all age groups in Denmark and 17.4 % in youths in Norway. BZ drug prescription fills increased by 20.8 % at the end of 2020 in the 20–59 year age group in Denmark and decreased by 16.7 % in youths in Sweden. A general increase of prescription fills of OAH at the end of 2020 was observed in all countries (range 24.0–80.0 % in Denmark, 11.5–30.8 % in Norway, and 9.1–12.1 % in Sweden). Increases of prescription fills of OAH occurred earlier in Denmark. Limitations Aggregated data with lack of information on indications. Conclusions Peaks of utilization of antidepressants, anxiolytics, and hypnotics observed in March 2020 may reflect medication stock piling. Increased antidepressant drug utilization in Denmark and in Norwegian youths together with the general increase in OAH utilization in the Scandinavian countries in late 2020 may indicate an increase of symptoms of depression and anxiety, as well as disturbed sleep.

• Gabrhelík, Roman; Skurtveit, Svetlana Ondrasova; Nechanská, Blanka; Mravčík, Viktor & Handal, Marte (2022). Morbidity through 3 Years of Age in Children of Women Using Methamphetamine during Pregnancy: A National Registry Study. European Addiction Research. ISSN 1022-6877. doi: 10.1159/000527238. Fulltekst i vitenarkiv Vis sammendrag

  Background: There is a lack of studies on methamphetamine (MA) exposure and morbidity in children beyond the perinatal period. Objectives: We compared morbidity in children (0–3 years) with prenatal MA exposure to opioid-exposed and to non-exposed children. Methods: We used data from a Czech nationwide, registry-based cohort study (2000–2014). Children, who reached 3 years of age, of mothers hospitalized with (i) MA use disorder during pregnancy (MA; n = 194), (ii) opioid use disorder during pregnancy (opioids; n = 166), and (iii) general population (GP; n = 1,294,349) with no recorded history of substance use disorder (SUD). Information on inpatient contacts, length of stay, and diagnoses (International Statistical Classification of Diseases and Related Health Problems 10th Revision [ICD-10]) were assessed. Crude and adjusted odds ratios (aOR), 95% confidence interval (CI) for the risk of hospitalization, and for getting diagnosis from the ICD-10 diagnosis chapters were calculated using binary logistic regression. A stratified analysis on hospitalizations with SUD of mothers was performed. Results: No significant differences were found in the measures of hospitalization between the MA and opioid groups. Children prenatally exposed to MA and opioids had higher numbers of hospitalizations and diagnoses and longer stays in hospital than children in the GP. Increased risks of certain infectious and parasitic diseases were found in both MA (aOR = 1.6; CI: 1.1–2.3) and opioid (aOR = 1.9; 1.3–2.8) groups as compared to the GP group. The most pronounced difference in stratified analysis on maternal hospitalizations related to SUD after birth was observed for injury, poisoning, and certain other consequences of external causes in the strata of the MA group who had hospitalized mothers (aOR 6.3, 1.6–24.6) compared to the strata without maternal hospitalizations (aOR 1.4, 0.9–2.3). Conclusion: This study suggests that children born to mothers using MA during pregnancy have similar morbidity during the first 3 years of life but higher than the GP. The excess of risk was primarily due to infections and injuries in the MA group.

• Heger, Katrine; Skipsfjord, Julia; Kiselev, Yury; Burns, Margrete Larsen; Aaberg, Kari Modalsli & Johannessen, Svein Ivar [Vis alle 8 forfattere av denne artikkelen] (2022). Changes in the use of antiseizure medications in children and adolescents in Norway, 2009–2018. Epilepsy Research. ISSN 0920-1211. 181(181). doi: 10.1016/j.eplepsyres.2022.106872. Fulltekst i vitenarkiv Vis sammendrag

  Background: The use of antiseizure medications (ASMs) in the pediatric population is poorly studied. The purpose of this study was to investigate changes in the use of ASMs in children and adolescents compared to adults, and to elucidate safety considerations of certain drugs. Method: In this population-based pharmacoepidemiological study we used the Norwegian Prescription Database (NorPD), 2009–2018. The use of ASMs is presented as 1-year prevalence per 1000: number of ASM users in a year * 1000 / number of inhabitants that year. Variables included predetermined 5-year age groups, gender, ASMs, diagnosis-specific reimbursement codes, user, and population numbers. Selected ASMs used for specific indications or subgroups included ethosuximide, sulthiame, rufinamide, stiripentol, and clobazam. Gender differences in the use of valproate was examined due to safety considerations in girls/women. Results: The total number of ASM users (all indications) for the age groups 0–19 and 20–59 years was 5807 and 47,481 respectively in 2009, and 5906 and 61,447 respectively in 2018. The 1-year prevalence for children/ adolescents (0–19 years) using ASMs in epilepsy remained stable from 2008 to 2018, 4.3–4.2/1000 inhabitants, as compared to 8.2–7.6/1000 in adults (20–59 years). Valproate, lamotrigine, and levetiracetam were the three most used ASMs in epilepsy in children/adolescents, similar to adults. The selected ASMs were mainly used in children/ adolescents, accounting for 0.74/1000 in 2018 versus 0.17/1000 in adults. A significant increase was seen for sulthiame (8-fold), ethosuximide (4-fold), clobazam (3-fold), and stiripentol (2-fold). The use of ASMs in non-epilepsy indications was limited and stable (17% in 2018); mainly lamotrigine in psychiatry in adolescents (15–19 years). This finding was in contrast to extensive non-epilepsy use in adults (71% in 2018). Conclusion: Changes in the use of ASMs in children/adolescents differ as compared to adults, most notably extensive and increasing use of selected ASMs and limited non-epilepsy. This is an important part of pharmacovigilance and patient safety evaluations.

• Stangeland, Helle; Handal, Marte; Skurtveit, Svetlana Ondrasova; Aakvaag, Helene Flood; Dyb, Grete Anita & Wentzel-Larsen, Tore [Vis alle 10 forfattere av denne artikkelen] (2022). Killing pain?: a population-based registry study of the use of prescription analgesics, anxiolytics, and hypnotics among all children, adolescents and young adults in Norway from 2004 to 2019. European Child and Adolescent Psychiatry. ISSN 1018-8827. s. 1–12. doi: 10.1007/s00787-022-02066-8. Fulltekst i vitenarkiv Vis sammendrag

  The ongoing opioid epidemic has been a global concern for years, increasingly due to its heavy toll on young people’s lives and prospects. Few studies have investigated trends in use of the wider range of drugs prescribed to alleviate pain, psychological distress and insomnia in children, adolescents and young adults. Our aim was to study dispensation as a proxy for use of prescription analgesics, anxiolytics and hypnotics across age groups (0–29 years) and sex over the last 15 years in a large, representative general population. The study used data from a nationwide prescription database, which included information on all drugs dispensed from any pharmacy in Norway from 2004 through 2019. Age-specific trends revealed that the prevalence of use among children and adolescents up to age 14 was consistently low, with the exception of a substantial increase in use of melatonin from age 5. From age 15–29, adolescents and young adults used more prescription drugs with increasing age at all time points, especially analgesics and drugs with higher potential for misuse. Time trends also revealed that children from age 5 were increasingly dispensed melatonin over time, while adolescents from age 15 were increasingly dispensed analgesics, including opioids, gabapentinoids and paracetamol. In contrast, use of benzodiazepines and z-hypnotics slightly declined in young adults over time. Although trends were similar for both sexes, females used more prescription drugs than their male peers overall. The upsurge in use of prescription analgesics, anxiolytics and hypnotics among young people is alarming.

• Hamina, Aleksi; Muller, Ashley Elizabeth; Clausen, Thomas; Skurtveit, Svetlana Ondrasova; Hesse, Morten & Tjagvad, Christian [Vis alle 11 forfattere av denne artikkelen] (2022). Prescription opioids among older adults: ten years of data across five countries. BMC Geriatrics. 22(429). doi: 10.1186/s12877-022-03125-0. Fulltekst i vitenarkiv Vis sammendrag

  Background Opioid use has increased globally in the recent decade. Although pain remains a significant problem among older adults, susceptibility to opioid-related harms highlights the importance of careful opioid therapy monitoring on individual and societal levels. We aimed to describe the trends of prescription opioid utilisation among residents aged ≥65 in all Nordic countries during 2009–2018. Methods We conducted cross-sectional measurements of opioid utilisation in 2009–2018 from nationwide registers of dispensed drugs in Denmark, Finland, Iceland, Norway, and Sweden. The measures included annual opioid prevalence, defined daily doses (DDDs) per 1000 inhabitants per day (DIDs), and morphine milligram equivalents (MMEs) per user per day. Results From 2009 to 2018, an average of 808,584 of adults aged ≥65 used opioids yearly in all five countries; an average annual prevalence of 17.0%. During this time period, the prevalence decreased in Denmark, Norway, and Sweden due to declining codeine and/or tramadol use. Iceland had the highest opioid prevalence in 2009 (30.2%), increasing to 31.7% in 2018. In the same period, DIDs decreased in all five countries, and ranged from 28.3 in Finland to 58.5 in Denmark in 2009, and from 23.0 in Finland to 54.6 in Iceland in 2018. MMEs/user/day ranged from 4.4 in Iceland to 19.6 in Denmark in 2009, and from 4.6 in Iceland to 18.8 in Denmark in 2018. In Finland, Norway, and Sweden, MMEs/user/day increased from 2009 to 2018, mainly due to increasing oxycodone utilisation. Conclusions The stable or decreasing opioid utilisation prevalence among a majority of older adults across the Nordic countries coincides with an increase in treatment intensity in 2009–2018. We found large cross-national differences despite similarities across the countries’ cultures and healthcare systems. For the aged population, national efforts should be placed on improving pain management and monitoring future trends of especially oxycodone utilisation.

• Hamina, Aleksi; Odsbu, Ingvild; Borchgrevink, Petter Chr.; Chen, Li-Chia; Clausen, Thomas & Espnes, Ketil Arne [Vis alle 18 forfattere av denne artikkelen] (2022). Cohort Description: Preventing an Opioid Epidemic in Norway – Focusing on Treatment of Chronic Pain (POINT) – A National Registry-Based Study. Clinical Epidemiology. 14, s. 1477–1486. doi: 10.2147/CLEP.S382136. Fulltekst i vitenarkiv Vis sammendrag

  Aim: The POINT project aims to provide evidence to optimise chronic pain management, prevent adverse consequences of opioids, and improve chronic pain patients’ pain relief, functional capacity, and quality of life. We describe the outline of the project and its work packages. More specifically, we describe a cohort of persons with chronic pain and a cohort of long-term opioid users identified from a national registry linkage. Data Sources: The project utilises data from nationwide healthcare and population registers in Norway. Using the Norwegian Prescription Database, we identified a cohort of persons who have been dispensed drugs reimbursed for chronic pain and a cohort of persons who used opioids long term from 2010 to 2019. Data from the Norwegian Registry for Primary Health Care and the Norwegian Patient Registry (2008– 2019), Cancer Registry (1990– 2018) Cause of Death Registry (2010– 2019) and demographic and socioeconomic registers from Statistics Norway (2010– 2019) were linked to the cohorts. Study Population: There were 568,869 participants with chronic pain. Sixty-three percent of the cohort was women, and the mean age was 57.1 years. There were 336,712 long-term opioid users (58.6% women; 60.9 years). In chronic pain and long-term opioid user cohorts, the most frequent musculoskeletal diagnosis was back pain diagnosed in primary care (27.6% and 30.7%). Psychiatric diagnoses were also common. Main Variables: Upcoming studies will utilise psychiatric and somatic diagnoses from the patient registers, drug use from the prescription register, causes of death, demographics, and socioeconomic status (eg, education, income, workability, immigrant status) as exposures or outcomes. Conclusion and Future Plans: The two cohorts have numerous pain-related diagnoses, especially in the musculoskeletal system, and noticeably frequent somatic and psychiatric morbidity. The POINT project also includes later work packages that explore prescriber and patient perspectives around safe and effective treatment of chronic pain.

• Skurtveit, Svetlana Ondrasova; Odsbu, Ingvild; Gjersing, Linn; Handal, Marte; Lid, Torgeir Gilje & Clausen, Thomas [Vis alle 7 forfattere av denne artikkelen] (2022). Individuals Dying of Overdoses Related to Pharmaceutical Opioids Differ from Individuals Dying of Overdoses Related to Other Substances: A Population-Based Register Study. European Addiction Research. ISSN 1022-6877. 28(6). doi: 10.1159/000526145. Fulltekst i vitenarkiv Vis sammendrag

  Background: Pharmaceutical opioid (PO) overdose deaths have increased in many Western countries. There are indications that those dying from a PO overdose differ from those dying from other types of overdoses. These differences might pose a challenge as the majority of current preventive measures are tailored toward those with the characteristics of "conventional" overdose deaths. Objective: We investigated differences in the characteristics of persons who died from PO overdoses compared to all other overdoses. Material and methods: Using the Norwegian Cause of Death Registry, we retrieved information on overdoses classified according to ICD-10 and identified PO overdoses (T40.2; T40.4) and all other overdoses (T40.X; T43.6) in 2010-2019. By linking data from nationwide registers, we analyzed data on opioid dispensations and the history of mental and behavioral disorders. 1,224 persons were registered with PO overdoses and 1,432 persons with other overdoses. Results: Persons in the PO overdose group were older and were more frequently women (35.0% vs. 20.5%) than persons with other overdoses. They had a higher prevalence of chronic pain (35.8% vs. 13.2%), history of cancer (8.1% vs. 1.8%), filled prescriptions of analgetic opioids more frequently the month before death (38.8% vs. 12.0%), and used threefold higher doses of prescribed opioids compared to individuals in all other overdose group (66 vs. 26 oral morphine equivalents/day). In the PO overdose group, oxycodone and fentanyl were more frequently dispensed, while codeine was more frequently dispensed in the other overdose groups. A lower proportion of those in the PO overdose group had recorded diagnoses of substance use disorders, schizophrenia, and hyperkinetic disorder compared to the other overdose groups. Conclusion: Persons dying from overdoses on POs often differ from the population targeted by existing prevention strategies, as they are more frequently older women with chronic pain and using high doses of prescription opioids.

• Hamina, Aleksi; Hjellvik, Vidar; Handal, Marte; Odsbu, Ingvild; Clausen, Thomas & Skurtveit, Svetlana Ondrasova (2022). Describing long-term opioid use utilizing Nordic Prescription Registers - A Norwegian example. Basic & Clinical Pharmacology & Toxicology. ISSN 1742-7835. 130(4), s. 481–491. doi: 10.1111/bcpt.13706. Fulltekst i vitenarkiv Vis sammendrag

  Previous studies have defined long-term opioid use in varying ways, decreasing comparability, reproducibility and clinical applicability of the research. Based on recommendations from recent systematic reviews, we aimed to develop a methodology to estimate the prevalence of use persisting more than three months utilizing one of the Nordic prescription registers. We used the Norwegian Prescription Register (NorPD) to extract data on all opioid dispensations between 1 January 2004 and 31 October 2019. New users of opioids (washout 365 days) were defined as long-term users if they fulfilled two criteria: (1) they had ≥2 dispensations of opioids, 91–180 days apart; (2) days 0–90 included ≥90 dispensed administration units (e.g., tablets) of opioids. Overall, there were 2,543,224 new users of opioids during the study period. Of these, 354,666 (13.9%) fulfilled the criteria for long-term opioid use at least once. Compared with those who did not fulfil the criteria (short-term users), long-term users were older, more likely women and used tramadol, oxycodone and buprenorphine more frequently as their first opioid. In conclusion, we found that 1/7 of opioid users continued use longer than 3 months. Future outcome research should identify the clinically most important dose requirements for long-term opioid use criteria.

• Lund, Ingunn Olea; Andersen, Njål; Handal, Marte; Ask, Helga; Skurtveit, Svetlana Ondrasova & Ystrøm, Eivind [Vis alle 7 forfattere av denne artikkelen] (2022). Parental drinking, mental health and education, and extent of offspring’s healthcare utilisation for anxiety/depression: A HUNT survey and registry study. Scandinavian Journal of Public Health. ISSN 1403-4948. s. 1–9. doi: 10.1177/14034948221076212. Fulltekst i vitenarkiv Vis sammendrag

  Aims: Certain risk constellations of parental drinking, mental health and years of education are prospectively associated with offspring’s risk for a diagnosis of anxiety/depression, but it remains unknown how they may relate to other aspects of offspring’s mental health. We examined whether such risk constellations were also prospectively associated with the extent of offspring’s utilisation of healthcare services for anxiety/depression. Methods: The sample included 8773 adolescent offspring of 6696 two-parent families who participated in the Nord-Trøndelag Health Study in Norway. The exposures consisted of five parental risk constellations characterised by drinking frequencies and quantities, years of education and mental health previously derived based on the parental self-reports using latent profile analysis. The outcomes were the number of years in contact, and the total number of consultations/visits, with healthcare services for anxiety/depression in adolescents and young adults as recorded in healthcare registries in the period 2008–2014. Associations were examined using zero-inflated negative binomial regression models, accounting for demographics and offspring’s early mental health. Results: Parental risk constellations were not significantly associated with the extent of offspring’s healthcare utilisation for anxiety/depression during the seven-year study period, neither in respect of number of years nor in number of contacts. Conclusions: Offspring of four risky constellations were no more likely to use healthcare services for longer time periods or have more consultations/visits than offspring of the lowest-risk constellation. Parental risk constellations appear more informative for understanding disorder aetiology than for understanding management and treatment of anxiety and depression during adolescence and early adulthood.

• Sundbakk, Lene Maria; Gran, Jon Michael; Wood, Mollie; Handal, Marte; Skurtveit, Svetlana Ondrasova & Nordeng, Hedvig Marie Egeland (2022). Association of Prenatal Exposure to Benzodiazepines and Z-Hypnotics With Risk of Attention-Deficit/Hyperactivity Disorder in Childhood. JAMA Network Open. 5(12), s. 1–15. doi: 10.1001/jamanetworkopen.2022.46889. Fulltekst i vitenarkiv Vis sammendrag

  Importance Evidence is limited regarding the safety of prenatal benzodiazepine and z-hypnotic exposure and its association with long-term neurodevelopment in childhood. Objective To quantify the associations of the timing and number of intervals of prenatal exposure to benzodiazepines and/or z-hypnotics with the risk of attention-deficit/hyperactivity disorder (ADHD) in childhood. Design, Setting, and Participants This cohort study used data from the 1999 to 2008 population-based Norwegian Mother, Father and Child Cohort Study, which are linked to the Medical Birth Registry of Norway, Norwegian Patient Registry, and Norwegian Prescription Database. Two populations of participants were created: a full sample and a mental health sample. The full sample included mothers and their live-born singletons, whereas the mental health sample was restricted to offspring of mothers who reported anxiety, depression, or sleeping problems during pregnancy or 6 months before pregnancy. Data were analyzed from September 2021 to February 2022. Exposures Maternal self-report of benzodiazepine and/or z-hypnotic use during pregnancy was grouped into early pregnancy exposure and middle and/or late pregnancy exposure for analysis of the association with timing of exposure, and number of 4-week intervals of exposure was classified (single [1] vs multiple [≥2]) for analysis of the association with number of exposed intervals. Main Outcome and Measures The outcome was ADHD, defined as time to ADHD diagnosis or filled prescription for ADHD medication. To control for confounding, inverse probability of treatment–weighted Cox proportional hazards regression models were used. Hazard ratios and 95% CIs were estimated. The weights were derived from propensity score modeling of the probability of benzodiazepine and/or z-hypnotic exposure as a function of potential confounders between the exposure and the outcome, including maternal symptoms of depression and anxiety. Results The full sample comprised 82 201 pregnancies, and the mental health sample included 19 585 pregnancies. In total, 681 offspring (0.8%) in the full sample and 468 offspring (2.4%) in the mental health sample were prenatally exposed to benzodiazepines and/or z-hypnotics. After weighting, exposure in early (hazard ratio, 0.74; 95% CI, 0.39-1.94) and middle and/or late (hazard ratio, 0.76; 95% CI, 0.35-1.61) pregnancy was not associated with increased risk of childhood ADHD. There was no evidence of substantial association between the number of exposed intervals during pregnancy and childhood ADHD. Conclusions and Relevance Results of this study suggest that there may be no increased risk of childhood ADHD associated with prenatal exposure to benzodiazepines and/or z-hypnotics, regardless of timing of exposure and number of exposed intervals. However, these findings should be interpreted with caution due to low study power.

• Odsbu, Ingvild; Handal, Marte; Hjellvik, Vidar; Borchgrevink, Petter Chr.; Clausen, Thomas & Nesvåg, Ragnar [Vis alle 7 forfattere av denne artikkelen] (2022). Vedvarende bruk av opioider og samtidig bruk av andre vanedannende legemidler. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 142(3), s. 1–8. doi: 10.4045/tidsskr.21.0659. Fulltekst i vitenarkiv Vis sammendrag

  BAKGRUNN<p> Vedvarende bruk av opioider kan ha uheldige konsekvenser. Vi har undersøkt vedvarende opioidbruk i pasientgruppersom fikk forskrevet opioider på ulike indikasjoner(langvarig smerte, palliativ behandling, andre (hvitresept)),samt gruppenessamtidige bruk av enkelte andre vanedannende legemidler.<p> MATERIALE OG METODE<p> <p>Personer med minst én utlevering av et opioid i Reseptregisteret i perioden 2011–19 ble inkludert. Vedvarende bruk i et kalenderår ble definertsom uthenting av > 180 definerte døgndoser eller > 4 500 mg orale morfinekvivalenterfordelt på minst tre kvartaler.<p> <p>RESULTATER Antall vedvarende opioidbrukere var 50 422 i 2011 og 59 996 i 2019 (10,1 % og 10,7 % av alle opioidbrukere). I perioden økte antalletsom fikk opioider på blå resept forlangvarige smerter, med 9 952 personer, men flertallet (n = 38 006, 63,3 %) fikk fortsa utlevert opioider utelukkende på hvitresept i 2019. Henholdsvis15 623 (41,1 %) og 14 881 (39,2 %) av de vedvarende opioidbrukerne som fikk utlevert opioider kun på hvitresept i 2019, fikk også utlevert benzodiazepiner og z-hypnotika samme år. Av de 23 967 vedvarende brukerne som også fikk utlevert benzodiazepiner, fikk 88 % utlevert opioider og benzodiazepiner på samme dag minst én gang i løpet av 2019.<p> <p>FORTOLKNING Vedvarende forskrivning av opioider på hvitresept og samtidig forskrivning av andre vanedannende legemidler kan tyde på uheldig bruk uten klarindikasjon.

• Højlund, Mikkel; Gudmundsson, Larus S.; Andersen, Jacob H.; Saastamoinen, Leena K.; Zoega, Helga & Skurtveit, Svetlana Ondrasova [Vis alle 9 forfattere av denne artikkelen] (2022). Use of benzodiazepines and benzodiazepine-related drugs in the Nordic countries between 2000 and 2020. Basic & Clinical Pharmacology & Toxicology. ISSN 1742-7835. 132(1), s. 60–70. doi: 10.1111/bcpt.13811. Fulltekst i vitenarkiv
• Torp, Henrik Andreas; Skurtveit, Svetlana Ondrasova; Skaga, Nils Oddvar; Gustavsen, Ingebjørg; Gran, Jon Michael & Rosseland, Leiv Arne (2021). Pre-injury dispensing of psychoactive prescription drugs in a ten years trauma population: a retrospective registry analysis. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 29(1). doi: 10.1186/s13049-021-00939-6. Fulltekst i vitenarkiv
• Trønnes, Johanne Naper; Lupattelli, Angela; Handal, Marte; Skurtveit, Svetlana Ondrasova; Ystrom, Eivind & Nordeng, Hedvig Marie Egeland (2021). Association of Timing and Duration of Prenatal Analgesic Opioid Exposure with Attention-Deficit/Hyperactivity Disorder in Children. JAMA Network Open. 4(9), s. 1–14. doi: 10.1001/jamanetworkopen.2021.24324. Fulltekst i vitenarkiv Vis sammendrag

  Importance Prior studies have reported that the use of illicit opioids during pregnancy is associated with increased risk of attention-deficit/hyperactivity disorder (ADHD) in offspring; however, evidence regarding the association of analgesic opioids is limited. Objective To examine the association of timing and duration of prenatal analgesic opioid exposure with ADHD in children. Design, Setting, and Participants This cohort study uses data from the Norwegian Mother, Father and Child Cohort study (1999-2008), a nationwide birth cohort study linked to national health registries, with a mean (SD) follow-up of 10.8 (2.2) years. A total of 73 784 live-born singleton children born to 62 013 mothers who reported a pain-related condition before and/or during pregnancy were included, with 2 comparator groups: (1) mothers who did not use any opioids and (2) mothers who used opioids before pregnancy only. Data were analyzed from June to December 2020. Exposures Maternal self-report of analgesic opioid use during pregnancy, by timing (early and middle and/or late) and duration (≥5 weeks vs ≤4 weeks). Main Outcomes and Measures Diagnosis of ADHD or filled prescription for ADHD medication in children and symptoms of ADHD at child age 5 years, measured by Conners’ Parent Rating Scale–Revised. Inverse probability of treatment weights were used to control for measured confounding. Cox regression was used to estimate hazard ratios (HRs) and 95% CIs. Results The analyses of ADHD diagnosis and ADHD symptoms included 73 480 children (35 996 [49.0%] girls; mean [SD] maternal age, 30.0 [4.6] years) and 31 270 children (15 377 [49.2%] girls; mean [SD] maternal age, 30.5 [4.4] years), respectively. Overall, 1726 children in the ADHD diagnosis sample (2.3%) and 667 children in the ADHD symptom sample (2.1%) were exposed to an analgesic opioid at least once during gestation. No associations between timing of prenatal analgesic opioid exposure and ADHD diagnosis or symptoms was found. Exposure for 5 or more weeks was associated with an increased risk of ADHD diagnosis (HR, 1.60, 95% CI, 1.04-2.47) compared with exposure for 4 weeks or less; however, there was no such association for the risk of ADHD symptoms. Conclusions and Relevance In this cohort study, a slightly elevated risk of ADHD diagnosis after prenatal analgesic opioid exposure for 5 or more weeks was found compared with exposure for 4 weeks or less. This result may be driven by longer duration of use; however, the role of residual or unmeasured confounding cannot be excluded. This finding needs to be replicated in other studies.

• Aas, Christer Frode; Vold, Jørn Henrik; Gjestad, Rolf; Skurtveit, Svetlana; Lim, Aaron G. & Gjerde, Kristian Varden [Vis alle 9 forfattere av denne artikkelen] (2021). Substance use and symptoms of mental health disorders: a prospective cohort of patients with severe substance use disorders in Norway. Substance Abuse Treatment, Prevention, and Policy. 16(20). doi: 10.1186/s13011-021-00354-1. Fulltekst i vitenarkiv Vis sammendrag

  Background:There is high co-occurrence of substance use disorders (SUD) and mental health disorders. We aimedto assess impact of substance use patterns and sociodemographic factors on mental health distress using the ten-item Hopkins Symptom Checklist (SCL-10) over time.Methods:Nested prospective cohort study of 707 participants with severe SUD across nine opioid-agonist-therapyoutpatient clinics and low-threshold municipality clinics in Norway, during 2017–2020. Descriptive statistics werederived at baseline and reported by means and standard deviation (SD). A linear mixed model analysis was used toassess the impact of substance use patterns and sociodemographic factors on SCL-10 sum score with betacoefficients with 95% confidence intervals (CI).Results:Mean (SD) SCL-10 score was 2.2 (0.8) at baseline with large variations across patients. We observed moresymptoms of mental health disorders among people with frequent use of benzodiazepines (beta 3.6, CI:2.4;4.8),cannabis (1.3, CI:0.2;2.5), opioids (2.7, CI:1.1;4.2), and less symptoms among people using frequent stimulant use (−2.7, CI:-4.1;-1.4) compared to no or less frequent use. Females (1.8, CI:0.7;3.0) and participants with debt worries (2.2,CI:1.1;3.3) and unstable living conditions (1.7, CI:0.0;3.3) had also higher burden of mental health symptoms. Therewere large individual variations in SCL-10 score from baseline to follow-up, but no consistent time trends indicatingchange over time for the whole group. 65% of the cohort had a mean score > 1.85, the standard reference score.Conclusions:People with SUD have a considerable burden of mental health symptoms. We found no associationbetween substance use patterns and change in mental health symptoms over time. This could suggest that thedifferences observed were indicating flattening of effects or self-medication to a larger degree than medication-related decline in mental health. This call for better individualized mental health assessment and patient care. Keywords: Substance use disorder, Substance abuse, Mental disorder, Psychological distress, Mental healthproblems, Opioid substitution treatment, Opioid dependence

• Wesselhoeft, Rikke; Rasmussen, Lotte; Jensen, Peter Bjødstrup; Jennum, Poul Jørgen; Skurtveit, Svetlana Ondrasova & Hartz, Ingeborg [Vis alle 10 forfattere av denne artikkelen] (2021). Use of hypnotic drugs among children, adolescents, and young adults in Scandinavia. Acta Psychiatrica Scandinavica. ISSN 0001-690X. 144(2), s. 100–112. doi: 10.1111/acps.13329. Fulltekst i vitenarkiv Vis sammendrag

  Background Hypnotic use in children and adolescents is controversial. Objective To describe the use of hypnotic drugs (melatonin, z-drugs, and sedating antihistamines) among 5- to 24-year-old Scandinavians during 2012 to 2018. Methods Aggregate-level data were obtained from public data sources in Sweden, Norway, and Denmark. We calculated annual prevalence (users/1000 inhabitants) stratified by age group, sex, and country. Quantity of use (Defined Daily Dose (DDD)/user/day) was estimated for Norway and Denmark. Results Melatonin was the most commonly used hypnotic, and its use increased markedly from 2012 to 2018, particularly among females and 15- to 24-year-old individuals. Sweden had the highest increase in use (6.5 to 25/1000) compared with Norway (10–20/1000) and Denmark (5.7–12/1000). The annual prevalence of sedating antihistamine use was also highest in Sweden, reaching 13/1000 in 2018 in comparison to 7.5/1000 in Norway and 2.5/1000 in Denmark. Z-drug use decreased in all countries toward 2018, dropping to 3.5/1000 in Sweden, 4.4/1000 in Norway, and 1.7/1000 in Denmark. The quantity of hypnotic use in Norway and Denmark was 0.8–1.0 DDD/user/day for melatonin in 2018, as compared to 0.1–0.3 for z-drugs and antihistamines. Conclusion The use of melatonin and sedating antihistamines increased among young Scandinavians during 2012–2018, and the increase was twice as high in Sweden compared with Norway and Denmark. In addition, Sweden had the highest use of sedating antihistamines. The Scandinavian variation of hypnotic use could reflect differences in frequency of sleep problems between populations or variation of healthcare access or clinical practice between countries.

• Odsbu, Ingvild; Mahic, Milada; Skurtveit, Svetlana Ondrasova; Lund, Ingunn Olea & Handal, Marte (2021). An 11-year nationwide registry-linkage study of opioid maintenance treatment in pregnancy in Norway. Norsk Epidemiologi. ISSN 0803-2491. 29(1-2), s. 63–70. doi: 10.5324/nje.v29i1-2.4047. Fulltekst i vitenarkiv Vis sammendrag

  Aim: We aimed to describe opioid maintenance treatment (OMT) to pregnant women in Norway and study the background characteristics of the pregnant women compared to the general population of pregnant women and to a previous clinical cohort study of OMT in pregnancy. Methods: Population-based cohort study with linked data from the Norwegian Medical Birth Registry, the Norwegian Prescription Database, the Norwegian Patient Registry, and Statistics Norway. The study population consisted of women giving birth between 2005-2015 in Norway. We defined OMT pregnancies as pregnancies where the woman was dispensed OMT medications (methadone, buprenorphine, or buprenorphine/ naloxone) at least once during pregnancy. Results: The study population consisted of 420,808 women with 645,440 pregnancies ending in a live birth in Norway in 2005-2015 (the general pregnant population). Of these, 261 women (0.6‰) had altogether 306 OMT pregnancies. The mean number of pregnancies was 28 OMT pregnancies per year and quite stable during the study period. Women with OMT pregnancies were older, smoked tobacco more frequently, had lower education, and fewer of them had a partner, compared to the general population of pregnant women. In most pregnancies, the women were treated with buprenorphine (n=183 (59.8%)), while in 120 (39.2%) pregnancies, the woman received methadone. From 2008, buprenorphine replaced methadone as the most frequently used drug. In only 38 (12.4%) pregnancies, OMT treatment was initiated in pregnancy. In 201 (66%) pregnancies, the woman used OMT medications in all trimesters. For these women, the mean amount of dispensed drug was 3.4 DDD/day (85 mg/day) in pregnancy for methadone and 1.9 DDD/day (15.2 mg/day) for buprenorphine. Conclusion: The number of OMT pregnancies per year has been low and stable in the period 2005-2015. Following Norwegian recommendations, there has been a shift from treatment with methadone towards buprenorphine. The women receiving OMT during pregnancy had more risk factors for adverse outcomes than the general pregnant population but were quite similar to the previous clinical cohort.

• Odsbu, Ingvild; Handal, Marte; Hjellvik, Vidar; Borchgrevink, Petter Chr.; Clausen, Thomas & Hamina, Aleksi [Vis alle 9 forfattere av denne artikkelen] (2021). Bruk av andre vanedannende legemidler blant opioidbrukere med langvarige smerter. Norsk Epidemiologi. ISSN 0803-2491. 29(1-2), s. 45–53. doi: 10.5324/nje.v29i1-2.4045. Fulltekst i vitenarkiv Vis sammendrag

  Bakgrunn: Opioider for behandling av langvarige smerter kan forskrives på blå resept, men bør ikke brukes samtidig med andre vanedannende legemidler. Hensikt: Å undersøke bruk av opioider på blå resept i perioden 2009-2019, samt å studere bruk av andre vanedannende legemidler (benzodiazepiner og z-hypnotika) blant dem som fikk opioider på blå resept i 2019. Metode: Data ble hentet fra Reseptregisteret. En prevalent opioidbruker i 2019 ble definert som en person med minst én utlevering av et smertestillende opioid på blå resept for langvarige smerter også i 2018. Bruk av andre vanedannende legemidler ble definert som minst én utlevering av et annet vanedannende legemiddel i løpet av samme år. Resultater: Totalt 18 443 personer (67% kvinner) fikk utlevert opioider på blå resept i 2019, en økning fra 5 568 i 2009 via 10 693 i 2016 og 16 133 i 2017. Av de 18 443 var 14 202 (77%) prevalente opioidbrukere. Blant de prevalente brukerne fikk 88% utlevert 100 mg orale morfinekvivalenter (OMEQ) eller mindre per dag. Totalt fikk 54% av de prevalente opioidbrukerne utlevert minst ett annet vanedannende legemiddel i 2019. Z-hypnotika var oftest forekommende blant de som brukte 100 mg OMEQ eller mindre per dag, mens benzodiazepiner alene eller i kombinasjon med z-hypnotika dominerte blant opioidbrukerne som fikk utlevert mer enn 100 mg OMEQ per dag. Mengden utlevert av andre vanedannende legemidler økte med mengden opioider brukt per dag. En større andel kvinner enn menn fikk utlevert andre vanedannende legemidler i 2019. Konklusjon: Studien indikerer at bruk av andre vanedannende legemidler forekommer hos en stor andel av dem som får forskrevet opioider på blå resept. Dette er tegn på et uheldig forskrivningsmønster som bør studeres nærmere.

• Hamina, Aleksi; Handal, Marte; Fredheim, Olav; Clausen, Thomas; Chen, Li-Chia & Skurtveit, Svetlana Ondrasova (2021). Filled prescriptions for opioids among children and adolescents – A nationwide study from 2010 to 2018. Acta Anaesthesiologica Scandinavica. ISSN 0001-5172. 65(10), s. 1475–1483. doi: 10.1111/aas.13968. Fulltekst i vitenarkiv Vis sammendrag

  Objectives Treatment-free remission (TFR) has emerged as a treatment goal in chronic myeloid leukemia in the chronic phase (CML-CP). Attempts to increase proportion of patients achieving TFR include combination of tyrosine kinase inhibitors (TKI) and other drugs. Interferon-α in addition to TKI has shown promising efficacy but with dose-dependent toxicity and discontinuations. NordCML007 was initiated to study the efficacy and safety of low dose pegylated IFN-α (PegIFN-α) in combination with dasatinib (DAS) in CML-CP. Methods Forty patients with newly diagnosed CML-CP were given DAS upfront. After month 3 (M3) 15 μg/wk of PegIFN-α was added and increased to 25 μg/wk from M7 until M15. DAS treatment was continued and adverse events and BCR-ABL1 qRT-PCR values were reported yearly after M24. Results from M1 to M18 have previously been published, and here we present long-term data. Results After 5 years of follow-up, there were no suspected unexpected serious adverse reactions, no increase in serosal effusions, no disease progressions and no CML-related deaths. Rates of MR3.0 (MMR), MR4.0 and MR4.5 were 84.6%, 64.1% and 51.3% respectively at M60, and 95% of patients reached MMR at some point during the study. Conclusion Initial addition of PegIFN-α to DAS shows good long-term efficacy without increased toxicity.

• Burdzovic, Jasmina; Torvik, Fartein Ask; Ystrøm, Eivind; Skurtveit, Svetlana; Handal, Marte & Martinez, Priscilla [Vis alle 8 forfattere av denne artikkelen] (2021). Parental Risk Constellations and Future Alcohol Use Disorder (AUD) in Offspring: A Combined HUNT Survey and Health Registries Study. Psychology of Addictive Behaviors. ISSN 0893-164X. 36(4), s. 375–386. doi: 10.1037/adb0000681. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Objective: We examined the risk of developing a future alcohol use disorder (AUD) among offspring of families with different constellations of parental risk factors. Method: We analyzed a sample of 8,774 offspring (50.2% male) from 6,696 two-parent families who participated in the Nord-Trøndelag Health Study in Norway when offspring were 13–19 years old in 1995–1997 or 2006–2008. Based on population registry information and parental Nord-Trøndelag Health Study self-reports, families were classified via Latent Profile Analysis into fiver risk constellations reflecting parents’ education, drinking quantities and frequencies, and mental health. Information about AUD-related diagnoses, treatments, and prescriptions for all offspring in the period between 2008 and 2016 was obtained from 3 national health registries and pooled to reflect any AUD. The likelihood of AUD in offspring was examined with a set of nested logistic regression models. Results: Registry records yielded 186 AUD cases (2.1%). Compared with the lowest-risk constellation, offspring from two constellations were more likely to present with AUD in unadjusted analyses. After adjusting for all covariates, including offspring’s alcohol consumption and witnessing parental intoxication during adolescence, AUD risk remained elevated and statistically significant (adjusted odds ratio = 2.34, 95% confidence interval = 1.14, 4.85) for offspring from the constellation characterized by at least weekly binge drinking, low education, and poor mental health in both parents. Conclusion: Weekly binge drinking by both parents was associated with future AUD risk among community offspring in Norway when clustered with additional parental risks such as poor mental health and low educational attainment.

• Fredheim, Olav Magnus; Skurtveit, Svetlana Ondrasova; Sjøgren, Per; Aljabri, Mohammad Belal & Hjellvik, Vidar (2021). Prescriptions of analgesics during chronic cancer disease trajectories: A complete national cohort study. Pharmacoepidemiology and Drug Safety. ISSN 1053-8569. 30(11), s. 1504–1513. doi: 10.1002/pds.5329. Fulltekst i vitenarkiv Vis sammendrag

  Purpose Pain management principles vary considerably between chronic noncancer, acute and cancer pain. Cancer patients responding to oncological treatment may live with low tumor burden for years. Opioid treatment should reflect that the ratio between benefits and risks in these patients is different from patients with a rapidly progressive disease. Our study investigated the prescription patterns of analgesics in patients who died 6 to 9 years after cancer diagnosis. Patients and methods A pharmaco-epidemiological study based on the Norwegian Prescription Database and Cancer Registry of Norway. The 1-year periodic prevalence of receiving different analgesics and of persistent opioid use were analyzed. Persistent opioid use was defined as >365 Defined Daily Doses or >9000 mg Oral Morphine Equivalents during 365 days with prescriptions in all quarters of the 365 days period. Data were reported for the first 7 years for patients who lived 8–9 years after cancer diagnosis (N = 1502), while for patients who lived 6–7 years (N = 3817) data was reported for the first 5 years after diagnosis. Results Compared to age- and gender adjusted general population, the 1-year periodic prevalence of opioid prescription was doubled the first year after diagnosis and remained raised with approximately 50%. The prevalence of persistent opioid use was threefold of the general population. Approximately 55% of patients with persistent opioid use 4 years after a cancer diagnosis were co-medicated with high doses of benzodiazepines and/or benzodiazepine-related hypnotics. Conclusion The findings of increased opioid use raise concerns regarding whether the benefits outweigh risks and side effects in this population.

• Fadnes, Lars T.; Aas, Christer Frode; Vold, Jørn Henrik; Leiva, Rafael Alexander Mo; Ohldieck, Christian & Chalabianloo, Fatemeh [Vis alle 13 forfattere av denne artikkelen] (2021). Integrated treatment of hepatitis C virus infection among people who inject drugs: A multicenter randomized controlled trial (INTRO-HCV). PLoS Medicine. ISSN 1549-1277. 18(6). doi: 10.1371/journal.pmed.1003653. Fulltekst i vitenarkiv Vis sammendrag

  Background The standard pathways of testing and treatment for hepatitis C virus (HCV) infection in tertiary healthcare are not easily accessed by people who inject drugs (PWID). The aim of this study was to evaluate the efficacy of integrated treatment of chronic HCV infection among PWID. Methods and findings INTRO-HCV is a multicenter, randomized controlled clinical trial. Participants recruited from opioid agonist therapy (OAT) and community care clinics in Norway over 2017 to 2019 were randomly 1:1 assigned to the 2 treatment approaches. Integrated treatment was delivered by multidisciplinary teams at opioid agonist treatment clinics or community care centers (CCCs) for people with substance use disorders. This included on-site testing for HCV, liver fibrosis assessment, counseling, treatment, and posttreatment follow-up. Standard treatment was delivered in hospital outpatient clinics. Oral direct-acting antiviral (DAA) medications were administered in both arms. The study was not completely blinded. The primary outcomes were time-to-treatment initiation and sustained virologic response (SVR), defined as undetectable HCV RNA 12 weeks after treatment completion, analyzed with intention to treat, and presented as hazard ratio (HR) and odds ratio (OR) with 95% confidence intervals. Among 298 included participants, 150 were randomized to standard treatment, of which 116/150 (77%) initiated treatment, with 108/150 (72%) initiating within 1 year of referral. Among those 148 randomized to integrated care, 145/148 (98%) initiated treatment, with 141/148 (95%) initiating within 1 year of referral. The HR for the time to initiating treatment in the integrated arm was 2.2 (1.7 to 2.9) compared to standard treatment. SVR was confirmed in 123 (85% of initiated/83% of all) for integrated treatment compared to 96 (83% of initiated/64% of all) for the standard treatment (OR among treated: 1.5 [0.8 to 2.9], among all: 2.8 [1.6 to 4.8]). No severe adverse events were linked to the treatment. Conclusions Integrated treatment for HCV in PWID was superior to standard treatment in terms of time-to-treatment initiation, and subsequently, more people achieved SVR. Among those who initiated treatment, the SVR rates were comparable. Scaling up of integrated treatment models could be an important tool for elimination of HCV.

• Bramness, Jørgen G.; Hjellvik, Vidar; Stubhaug, Audun & Skurtveit, Svetlana (2021). Possible opioid-saving effect of cannabis-based medicine using individual-based data from the Norwegian Prescription Database. Basic & Clinical Pharmacology & Toxicology. ISSN 1742-7835. s. 1–9. doi: 10.1111/bcpt.13660. Fulltekst i vitenarkiv Vis sammendrag

  Some ecological studies have shown that areas with higher use of cannabis may have lower opioid use and fewer opioid-related problems. Newer studies are questioning this finding. Few individually based studies have been performed. Using data from the Norwegian Prescription Database, this study investigated the individual level effect of prescribed cannabis extract (Sativex®) in prescription opioid users on their opioid use in the following year. Looking at all those filling a prescription for Sativex®, opioid use was only marginally lowered in the follow-up period. Some Sativex® users, however, filled more prescriptions for Sativex® and were able to reduce their opioid use substantially. Further studies are needed to elucidate more details on these patients, so as to know who can benefit from such cannabis-based extracts in reducing their opioid use.

• Holmberg, Siril Therese; Fredheim, Olav Magnus; Skurtveit, Svetlana Ondrasova; Salvesen, Øyvind; Nygaard, Øystein Petter & Gulati, Agnete Malm [Vis alle 8 forfattere av denne artikkelen] (2021). Persistent Use of Prescription Opioids Following Lumbar Spine Surgery: Observational Study with Prospectively Collected Data from Two Norwegian Nationwide Registries. Spine. ISSN 0362-2436. 47(8), s. 607–614. doi: 10.1097/BRS.0000000000004275. Fulltekst i vitenarkiv Vis sammendrag

  Study Design. Prospective pharmacoepidemiological study Objective. To investigate the use of prescription opioids two years following degenerative lumbar spine surgery. Summary of Background Data. There are limited data providing details to evaluate patterns of opioid use. The number of patients is often limited and data on opioid use followign some of the most common surgical procedures are lacking. Methods. Data from the Norwegian Registry for Spine Surgery and the Norwegian Prescription Database were linked on an individual level. The primary outcome measure was persistent opioid use the second year after surgery. Functional disability was measured with the Oswestry disability index (ODI). Study participants were operated between 2007 and 2017. Results. Among 32886 study participants, 2754 (8.4%) met criteria for persistent opioid use the second year after surgery. Among persistent opioid users in the second year after surgery, 64% met the criteria for persistent opioid use the year preceding surgery. Persistent opioid use the year preceding surgery (OR 31.10, 95% CI 26.9-36.0, P = .001), use of high doses of benzodiazepines (OR 1.62, 95% CI 1.30-2.04, P = .001), and use of high doses of z-hypnotics (OR 1.90, 95% CI 1.58-2.22, P = .001) the year before surgery were associated with increased risk of persistent opioid use the second year after surgery. A higher ODI score at one year was observed in persistent opioid users compared to non-persistent users (41.5 vs 18.8 points) and there was a significant difference in ODI change (-13.7 points). Patients with persistent opioid use in the year preceding surgery were less likely to achieve a minimal clinically important ODI change at one year compared to non-persistent users (37.7% vs 52.6%, P = .001). Conclusion. Patients with or at risk of developing persistent opioid should be identified and provided counseling and support to taper off opioid treatment.

• Skjærvø, Ingeborg; Clausen, Thomas; Skurtveit, Svetlana Ondrasova & Bukten, Anne (2021). Desistance from crime following substance use treatment: the role of treatment retention, social network and self-control. BMC Psychiatry. 21(1), s. 1–12. doi: 10.1186/s12888-021-03518-2. Fulltekst i vitenarkiv Vis sammendrag

  Background Reductions in crime are often reported following substance use treatment. We explore the relationship between desistance from crime, treatment type, treatment retention and positive changes in known risk factors for crime. Methods We used data from the NorComt-study; a longitudinal study of substance users (n = 341) enrolled in comprehensive treatment in Norway (2012–2015). At treatment initiation (T0) and 1 year later (T1), we collected self-reported data on criminal involvement, treatment, substance use, social network and self-control. We calculated adjusted odds ratios (aOR) and 95% confidence intervals (CI) with multinomial logistic regression analysis. Results Overall, 1 year following treatment initiation 69% reported desistance from crime, 18% reported continued crime and 12% reported no crime at all in the study period. Desistance was high for OMT patients in ongoing treatment (79% desisted) and for inpatients regardless of treatment status (79–93% desisted), while not as high among OMT patients with interrupted treatment (47% desisted). For participants that continued crime during follow-up, the average number of criminal acts per month was reduced (p < 0.001). Desistance at follow-up was associated with being older (aOR: 1.05, CI: 1.00–1.10), inpatient treatment (aOR: 3.71, CI: 1.12–12.29), being in ongoing treatment (inpatient or OMT) (aOR: 2.90, CI: 1.01–8.36), having no stimulant use in the study period (aOR: 4.86, CI: 1.72–13.70), leaving a substance using social network (aOR 2.87, CI: 1.15–7.18) and improvement in self-control score (aOR: 1.08, CI: 1.04–1.13). Conclusions Retention in treatment is particularly important for crime outcomes among OMT patients. Positive changes in social network and self-control are potential contributors to desistance from crime. Targeted interventions towards crime reduction are recommended for patients with stimulant use, which appears to be a persistent risk factor for crime over time.

• Torp, Henrik Andreas; Skurtveit, Svetlana Ondrasova; Skaga, Nils Oddvar; Gustavsen, Ingebjørg G.; Gran, Jon Michael & Rosseland, Leiv Arne (2021). Pre-injury dispensing of psychoactive prescription drugs in a ten years trauma population: a retrospective registry analysis. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 29. doi: 10.1186/s13049-021-00939-6. Fulltekst i vitenarkiv Vis sammendrag

  Background The use of psychoactive prescription drugs is associated with increased risk of traumatic injury, and has negative impact on clinical outcome in trauma patients. Previous studies have focused on specific drugs or subgroups of patients. Our aim was to examine the extent of psychoactive drug dispensing prior to injury in a comprehensive population of trauma patients. Methods The Oslo University Hospital Trauma Registry provided data on all trauma patients admitted to the trauma centre between 2005 and 2014. We linked the data to Norwegian Prescription Database data from 2004. Opioids, benzodiazepines, z-hypnotics, gabapentinoids, and centrally acting sympathomimetics dispensed during the year before trauma of each patient were identified. We determined the pre-trauma annual prevalence of dispensing and mean annual cumulative defined daily doses (DDD) for each drug class, and compared results with corresponding figures in the general population, using standardised ratios. For each drug class, dispensing 14 days preceding trauma was analysed in patients sustaining severe injury and compared with patients sustaining non-severe injury. Results 12,713 patients (71% male) were included. Median age was 36 years. 4891 patients (38%) presented with severe injury (Injury Severity Score > 15). The ratio between annual prevalence of dispensed prescriptions for trauma patients and the general population, adjusted for age and sex, was 1.5 (95% confidence interval 1.4–1.6) for opioids, 2.1 (2.0–2.2) for benzodiazepines, 1.7 (1.6–1.8) for z-hypnotics, 1.9 (1.6–2.2) for gabapentinoids, and 1.9 (1.6–2.2) for centrally acting sympathomimetics. Compared with the general population, mean annual cumulative DDD of opioids and benzodiazepines dispensed to trauma patients were more than two and three times as high, respectively, in several age groups below 70 years. The prevalence of dispensing 14 days pre-trauma was higher in severely injured patients for opioids, benzodiazepines, and z-hypnotics compared with patients without severe injury. Conclusions Our results support previous findings that the prevalence of psychoactive drug use is high among trauma patients. In terms of both frequency and amounts, the pre-injury dispensing of psychoactive drugs to trauma patients supersedes that of the general population, especially in younger patients.

• Lindstad, Marianne; Skurtveit, Svetlana & Bukten, Anne (2021). For mye eller for lite medisiner? En nasjonal studie av forskrevne psykofarmaka blant innsatte i norske fengsler. Norsk Epidemiologi. ISSN 0803-2491. 29(1-2), s. 85–95. doi: 10.5324/nje.v29i1-2.4049. Fulltekst i vitenarkiv Vis sammendrag

  Bakgrunn: Legemiddelbruk i den norske befolkningen er økende. Kunnskap om omfang, hvem brukerne er og bruksmønster er en forutsetning for optimalisering av legemiddelbruk i alle grupper av befolkningen. Samtidig finnes det ingen oppdaterte studier som viser bruk av forskrevne legemidler blant innsatte i Norge. Hensikten med denne studien er derfor å beskrive bruk av forskrevne psykofarmaka blant innsatte i fengsel før og under soning, samt undersøke hvilke faktorer som er assosiert med legemiddelbruk.Material og metode: Datamaterialet er fra «The Norwegian Offender Mental Health and Addiction Study», NorMA-studien, som ble gjennomført i perioden 2013-2014 ved 57 fengselsenheter i Norge. Totalt svarte 1495 innsatte (96 kvinner) på spørreskjema. Vi undersøkte selvrapportert bruk av psykofarmaka knyttet til sovemedisin,beroligendelegemidler,antidepressiva,LAR-legemidler,smertestillendelegemidlerogADHD-legemidler.Vibruktelogistiskeregresjonerforåundersøkesammenhenger mellom ulike bakgrunnsfaktorer og bruk av ulike legemidler under soning.Resultater: Sovemedisin varmest brukt, både før og under soning. Tjue prosent av innsatte brukte sove-medisin daglig under soning. Innsatte brukte mer psykofarmaka enn den generelle befolkningen, med unntak av smertestillende legemidler. Under soning var bruk av de fleste undersøkte psykofarmaka assosiert med betydelige psykiske plager, skadelig rusbruk, å motta økonomiske sosiale ytelser samt å ha hatt en oppvekst preget av rus og psykiske problemer.Konklusjon:Våre funn viser at innsattes psykiske helse og russituasjon bør ha høyprioritet under soning. Det er forventet at innsatte bruker mer forskrevne psykofarmaka enn den generelle befolkningen. At den generelle befolkningen bruker mer smertestillende enn innsatte, bør derfor undersøkes nærmere.

• Stenehjem, Jo Steinson; Røise, Olav; Nordseth, Trond; Clausen, Thomas; Natvig, Bård & Skurtveit, Svetlana Ondrasova [Vis alle 10 forfattere av denne artikkelen] (2021). Injury Prevention and long-term Outcomes following Trauma - The IPOT project: a protocol for prospective nationwide registry-based studies in Norway. BMJ Open. 11(5). doi: 10.1136/bmjopen-2020-046954. Fulltekst i vitenarkiv Vis sammendrag

  Introduction Traumatic injuries constitute a major cause of mortality and morbidity. Still, the public health burden of trauma in Norway has not been characterised using nationwide registry data. More knowledge is warranted on trauma risk factors and the long-term outcomes following trauma. The Injury Prevention and long-term Outcomes following Trauma project will establish a comprehensive research database. The Norwegian National Trauma Registry (NTR) will be merged with several data sources to pursue the following three main research topics: (1) the public health burden of trauma to society (eg, excess mortality and disability-adjusted life-years (DALYs)), (2) trauma aetiology (eg, socioeconomic factors, comorbidity and drug use) and (3) trauma survivorship (eg, survival, drug use, use of welfare benefits, work ability, education and income). Methods and analysis The NTR (n≈27 000 trauma patients, 2015–2018) will be coupled with the data from Statistics Norway, the Norwegian Patient Registry, the Cause of Death Registry, the Registry of Primary Health Care and the Norwegian Prescription Database. To quantify the public health burden, DALYs will be calculated from the NTR. To address trauma aetiology, we will conduct nested case–control studies with 10 trauma-free controls (drawn from the National Population Register) matched to each trauma case on birth year, sex and index date. Conditional logistic regression models will be used to estimate trauma risk according to relevant exposures. To address trauma survivorship, we will use cohort and matched cohort designs and time-to-event analyses to examine various post-trauma outcomes.

• Gabrhelík, Roman; Handal, Marte; Mravčík, Viktor; Nechanská, Blanka; Tjagvad, Christian & Thylstrup, Birgitte [Vis alle 12 forfattere av denne artikkelen] (2021). Opioid maintenance treatment in the Czech Republic, Norway and Denmark: a study protocol of a comparative registry linkage study. BMJ Open. 11(5), s. 1–8. doi: 10.1136/bmjopen-2020-047028. Fulltekst i vitenarkiv Vis sammendrag

  Introduction Opioid maintenance treatment (OMT) varies across settings and between countries. We plan to use data from several nationwide health and population registers to further improve the knowledge base established from earlier studies. Our aim is to study OMT adherence trajectories and to identify factors associated with improved outcomes for OMT patients across the Czech Republic, Norway and Denmark, in order to further improve OMT and our understanding of the key elements of treatment success. Methods and analysis The registry-based cohort approach across the three countries allows us to link data from a range of registers on the individual level, by using personal identifiers in nationwide cohorts of OMT and non-OMT patients and the general non-using populations. A total of ~21 500 OMT patients over the last two decades in all three countries will be included in the study. The following outcome variables (based on the International Classification of Diseases, 10th Revision codes) will be obtained from relevant registers: treatment adherence to OMT, comorbidity (somatic and mental health), and all-cause and cause-specific mortality. Outcomes of the country-specific analyses will be pooled. Ethics and dissemination The national OMT cohorts have been approved by the ethics committees in the respective countries. Data will be stored according to national and local guidelines and treated confidentially, and all data will be analysed separately for each country and compared across countries. Findings will be disseminated in peer-reviewed scientific journals, national and international conferences, and in briefings to inform clinical decision-making.

• Aas, Christer Frode; Vold, Jørn Henrik; Skurtveit, Svetlana; Odsbu, Ingvild; Chalabianloo, Fatemeh & Lim, Aaron G. [Vis alle 8 forfattere av denne artikkelen] (2020). Uptake and predictors of direct-acting antiviral treatment for hepatitis C among people receiving opioid agonist therapy in Sweden and Norway: a drug utilization study from 2014 to 2017. Substance Abuse Treatment, Prevention, and Policy. 15(1):44. doi: 10.1186/s13011-020-00286-2. Fulltekst i vitenarkiv Vis sammendrag

  Background Treatment with direct-acting antiviral agents (DAAs) offers an opportunity to eliminate hepatitis C virus (HCV) endemic among people who inject drugs (PWID) and people enrolled in opioid agonist therapy (OAT) programs. The objective of this study was to estimate and to compare HCV treatment uptake after the introduction of DAAs among patients receiving OAT in Sweden and Norway. We also aimed to evaluate predictors of DAAs treatment among OAT patients in both countries. Methods This observational study was conducted with data from The Swedish Prescribed Drug Register and The Norwegian Prescription Database. We studied dispensed medications to calculate HCV treatment among OAT patients from 2014 to 2017 in Sweden and Norway. HCV prevalence was estimated from primary and secondary sources. Dispensations of medicines from different therapeutic areas, which served as proxy for co-morbidities in 2017, were conditionally adjusted for age, gender, and OAT medications. Logistic regression was used to evaluate these parameters. Results In total 3529 individuals were identified with dispensed OAT in the Swedish cohort and 7739 individuals in the Norwegian cohort. HCV treatment was utilized by 407 persons in Sweden and 920 in Norway during the study period. Annual HCV and DAA treatment uptake increased in both countries. The estimated cumulative HCV treatment uptake at the end of 2017 was 31% in Norway and 28% in Sweden. DAA treatment was associated with increased age (aOR 1.8; 95% CI 1.0–3.2) and the dispensation of drugs used for diabetes (aOR 3.2; 95% CI 1.8–5.7) in Sweden. In Norway, lipid modifying agents and antibacterials were associated with decreased odds (aOR 0.4; 95%CI 0.2–0.9, aOR 0.8; 95%CI 0.6–1.0). Conclusions An increase in DAA treatment and HCV treatment uptake was observed among Swedish and Norwegian OAT patients whilst introducing new direct-acting antiviral treatment regimens. However, more than two thirds of the OAT population in Norway and Sweden were untreated at the beginning of 2018. A further scale-up is crucial in order to control and eliminate the HCV endemic among OAT patients.

• Fredheim, Olav Magnus; Skurtveit, Svetlana; Loge, Jon Håvard; Sjøgren, Per; Handal, Marte & Hjellvik, Vidar (2020). Prescription of analgesics to long-term survivors of cancer in early adulthood, adolescence and childhood in Norway: a national cohort study. Pain. ISSN 0304-3959. 161(5), s. 1083–1091. doi: 10.1097/j.pain.0000000000001800. Fulltekst i vitenarkiv Vis sammendrag

  Increasing numbers survive cancers in childhood and adolescence. Long-term survivors of cancers in adulthood have increased prevalence of pain and consumption of analgesics. It is not established whether long-term survivors of cancers in childhood and adolescence also have an increased use of analgesics. However, based on increased use of antidepressants and anxiolytics in long-term survivors of cancers in childhood and adolescence, we hypothesized that this group also had increased use of analgesics. Based on data from the 2 nationwide registers, the Cancer Registry of Norway and the Norwegian Prescription Database, a cohort of 5585 (52% males) long-term survivors of cancers in childhood, adolescence, and early adult life was established. Age- and sex-adjusted comparisons were made to the general population. The age-adjusted one-year periodic prevalence of receiving prescriptions of opioids, benzodiazepines, and benzodiazepine-related hypnotics in the study population was increased by 20% to 50%, and the one-year periodic prevalence of receiving prescriptions of gabapentinoids was approximately increased 2-fold compared to the general population. For paracetamol and nonsteroidal anti-inflammatory drugs, no difference was found. For those survivors, who were persistent or high-dose users of opioids, comedication with high doses of benzodiazepines and/or benzodiazepine-related hypnotics was far more common than among persistent and high-dose opioid users in the general population. The high prevalence of gabapentinoids may indicate increased prevalence of neuropathic pain in this group. The high degree of comedication with benzodiazepines and/or benzodiazepine-related hypnotics in survivors on persistent and high-dose opioids might be an indication of problematic opioid use or addiction.

• Vold, Jørn Henrik; Skurtveit, Svetlana; Aas, Christer Frode; Chalabianloo, Fatemeh; Kloster, Pia Synnøve & Johansson, Kjell Arne [Vis alle 7 forfattere av denne artikkelen] (2020). Dispensations of benzodiazepines, z-hypnotics, and gabapentinoids to patients receiving opioid agonist therapy; A prospective cohort study in Norway from 2013 to 2017. BMC Health Services Research. 20, s. 1–12. doi: 10.1186/s12913-020-05195-5. Fulltekst i vitenarkiv Vis sammendrag

  Background Dispensations of benzodiazepines, z-hypnotics, and gabapentinoids to patients on opioid agonist therapy (OAT) are common and have pros and cons. The objectives of the current study are to define the dispensation rates of these potentially addictive drugs, and whether the number and the mean daily doses of dispensed OAT opioids and discontinuing OAT, are associated with being dispensed benzodiazepines, z-hypnotics and gabapentinoids among patients on OAT in Norway in the period 2013 to 2017. Methods Information about all dispensed opioids, benzodiazepines, z-hypnotics and gabapentinoids were recorded from the Norwegian Prescription Database (NorPD). A total of 10,371 OAT patients were included in the study period. The dispensation rates were defined as the number of patients who were dispensed at least one of the potentially addictive drugs divided among the number of patients who have dispensed an OAT opioid per calendar year. Mean daily doses were calculated, and for benzodiazepines and z-hypnotics, stated in diazepam equivalents. The association between dispensed potentially addictive drugs, and the number and the type of dispensed OAT opioids were calculated by using logistic regression models. Results Half of the OAT patients received at least one dispensation of a benzodiazepine or z-hypnotic, and 11% were dispensed at least a gabapentinoid in 2017. For dispensed benzodiazepines or z-hypnotics, the mean daily dose was reduced from 21 mg (95% confidence interval (CI): 20–23) diazepam equivalents in 2013 to 17 mg (95% CI: 16–17) in 2017. The mean daily dose of pregabalin increased from 365 mg (95% CI: 309–421) in 2013 to 386 mg (95% CI: 349–423) in 2017. Being dispensed a gabapentinoid (adjusted odds ratio (aOR) = 2.5, 95% CI: 2.1–3.0) or a non-OAT opioid (aOR = 3.0, 95% CI: 2.6–3.5) was associated with being dispensed a benzodiazepine or z-hypnotic. Discontinuing OAT did not affect the number of dispensations and the doses of potentially addictive drugs. Conclusion The dispensation rates of potentially addictive drugs are high in the OAT population. Treatment indications, as well as requirements for prescription authority, need to be debated and made explicit. Randomized controlled trials evaluating the benefits and risks of such co-prescription are required.

• Gabrhelik, Roman; Mahic, Milada; Lund, Ingunn Olea; Bramness, Jørgen; Selmer, Randi Marie & Skovlund, Eva [Vis alle 8 forfattere av denne artikkelen] (2020). Cannabis Use during Pregnancy and Risk of Adverse Birth Outcomes: A Longitudinal Cohort Study. European Addiction Research. ISSN 1022-6877. doi: 10.1159/000510821. Fulltekst i vitenarkiv Vis sammendrag

  Background: With recent changes in legislation regulating recreational and medical cannabis use around the globe, increased use in pregnancy is to be expected. Objectives: To investigate the association between cannabis use during pregnancy and birth outcomes. Method: Data from the Norwegian Mother and Child Cohort Study (MoBa), a prospective pregnancy cohort, were used. Participants were recruited from all over Norway between 1999 and 2008: 9,312 women with 10,373 pregnancies who reported use of cannabis before or in pregnancy. Women reported on their illegal drug use before pregnancy and at pregnancy weeks 17/18 and 30 and at 6 months postpartum. Linear regression was used to estimate crude and adjusted effects of prenatal cannabis exposure on birth outcomes. Results: In 10,101 pregnancies, women had used cannabis before pregnancy but not during pregnancy. In 272 pregnancies, women had used cannabis during pregnancy, and among these, in 63 pregnancies, women had used cannabis in at least 2 periods. In adjusted analyses for potential confounders, only cannabis use during at least 2 periods of pregnancy showed statistically significant effects on birth weight. The effect was observed in the complete cohort (B = −228 g, 95% CI = −354 to −102, p < 0.001) and for the subgroup where information about the child’s father was available (B = −225 g, 95% CI = −387 to −63, p = 0.01). Our results may indicate that prolonged use causes more harm, whereas short-term use did not indicate adverse effects on birth outcomes. Conclusions: There was a statistically significant and clinically relevant association between the use of cannabis during pregnancy and reduced birth weight. Clinicians should screen not only for cannabis use but also for the length and intensity of use as part of a comprehensive substance use screening

• Welle-Strand, Gabrielle; Skurtveit, Svetlana; Clausen, Thomas; Sundal, Christine & Gjersing, Linn (2020). COVID-19 survey among people who use drugs in three cities in Norway. Drug and Alcohol Dependence. ISSN 0376-8716. 217, s. 1–4. doi: 10.1016/j.drugalcdep.2020.108302. Fulltekst i vitenarkiv
• Mravčík, Viktor; Nechanská, Blanka; Gabrhelík, Roman; Handal, Marte; Mahic, Milada & Skurtveit, Svetlana (2020). Socioeconomic characteristics of women with substance use disorder during pregnancy and neonatal outcomes in their newborns: A national registry study from the Czech Republic. Drug and Alcohol Dependence. ISSN 0376-8716. 209. doi: 10.1016/j.drugalcdep.2020.107933. Fulltekst i vitenarkiv
• Mahic, Milada; Hernandez-Diaz, Sonia; Wood, Mollie; Kieler, Helle; Odsbu, Ingvild & Nørgaard, Mette [Vis alle 11 forfattere av denne artikkelen] (2020). In utero opioid exposure and risk of infections in childhood: A multinational Nordic cohort study. Pharmacoepidemiology and Drug Safety. ISSN 1053-8569. 29(12), s. 1596–1604. doi: 10.1002/pds.5088. Fulltekst i vitenarkiv
• Vold, Jørn Henrik; Skurtveit, Svetlana; Aas, Christer; Johansson, Kjell Arne & Fadnes, Lars Thore (2020). Too much or too little opioids to patients receiving opioid agonist therapy in Norway (2013-2017): a prospective cohort study. BMC Health Services Research. 20(1). doi: 10.1186/s12913-020-05504-y. Fulltekst i vitenarkiv Vis sammendrag

  Background Dispensations of opioid analgesics to patients on opioid agonist therapy (OAT) may increase the risk of overdoses. The current study’s objectives are to investigate the dispensation rates and mean daily doses of dispensed opioid analgesics among patients who received OAT opioids in Norway during 2013–2017 and evaluate whether discontinuing OAT opioids affects the dispensed dose of opioid analgesics. Methods Information on opioids was collected from the Norwegian Prescription Database. Dispensation rates were calculated by dividing the number of patients who were dispensed at least one opioid analgesic by the number of patients who were dispensed an OAT opioid. We calculated the mean daily dose of opioid analgesics in oral morphine equivalents. The OAT opioid dose was defined as a ratio between the dispensed doses divided by the mean recommended dose. We used logistic regression to estimate the association between the dispensation of an opioid analgesic, a dose of OAT opioids, having chronic pain, and being on palliative care. Results A total of 10,371 patients were dispensed at least one OAT opioid during the study period. In 2017, 18% were dispensed an opioid analgesic with a mean daily dose of 29 mg of oral morphine equivalents. Being dispensed an opioid analgesic was associated with having chronic pain (adjusted odds ratio (aOR): 3.6, 95% confidence interval: 3.2–4.2), being on palliative care (aOR: 6.1, 4.7–7.9), and receiving an OAT opioid dose below half of the recommended OAT dose (aOR: 1.7, 1.4–2.0). Similar results were seen in 2013–2016. The discontinuation of OAT opioids could increase the dose of dispensed opioid analgesics. Conclusion Reducing the dispensation of opioid analgesics can be achieved by increasing the OAT opioid dose for patients on a low OAT dose, and by extending the period needed to taper off the OAT opioid dose at discontinuation.

• Huitfeldt, Anders; Sundbakk, Lene Maria; Skurtveit, Svetlana; Handal, Marte & Nordeng, Hedvig Marie Egeland (2020). Associations of Maternal Use of Benzodiazepines or Benzodiazepine-like Hypnotics During Pregnancy With Immediate Pregnancy Outcomes in Norway. JAMA Network Open. 3(6). doi: 10.1001/jamanetworkopen.2020.5860. Fulltekst i vitenarkiv Vis sammendrag

  Importance Understanding the safety profile of medications used in pregnancy is crucial for clinical decision-making. Few studies exist on the associations of exposure to benzodiazepines and benzodiazepine-like hypnotic drugs (z-hypnotics) in pregnancy with pregnancy outcomes. Objective To determine whether exposure to benzodiazepines or z-hypnotics in pregnancy is associated with greater risk of negative immediate pregnancy outcomes compared with nonexposure. Design, Setting, and Participants This questionnaire-based cohort study used data from the Norwegian Mother, Father and Child cohort study (MoBa), which also includes data from the Medical Birth Registry of Norway. Pregnant women were recruited from all over Norway from 1999 and 2008. The first child was born in October 1999 and the last in July 2009. This analysis included women who completed 3 questionnaires, twice during pregnancy and once 6 months after delivery. Data analyses were conducted from September to November 2019. Exposures Self-reported exposure to benzodiazepines or z-hypnotics during pregnancy, characterized in terms of any exposure, timing (ie, early, middle, or late), and duration of exposure. Main Outcomes and Measures The main outcomes were gestational age at delivery, risk of preterm delivery, birth weight, birth weight relative to gestational age and sex, risk of being small for gestational age, head circumference, Apgar score less than 7 at 5 minutes, and risk of neonatal respiratory distress. Continuous outcomes are reported using effect estimates as mean differences, and binary outcomes are reported using risk ratios. Results The MoBa study included 114 234 mother-child dyads. This analysis of MoBa data includes 82 038 singleton pregnancies among 69 434 unique women. Mean (SD) maternal age was 30.2 (4.5) years, and 37 641 pregnancies (45.9%) were in primiparous women. Exposure to benzodiazepines or z-hypnotics was reported in 679 pregnancies (0.8%). After adjusting for all measured baseline and postbaseline confounders, benzodiazepine or z-hypnotic use during pregnancy was associated with lower birth weight (mean difference, −79.3 [95% CI, −126.7 to −31.9] g), lower gestational age at birth (mean difference, −2.1 [95% CI, −3.3 to −0.9] days), and higher risk of preterm birth (risk ratio, 1.41 [95% CI, 1.03 to 1.94]). We found no significant association of exposure to benzodiazepines or z-hypnotics with the child’s birth weight relative to gestational age and sex (z score), or any of the other immediate birth outcomes. Conclusions and Relevance These findings suggest that the magnitude of the association of exposure to benzodiazepines or z-hypnotics with gestational age is not necessarily clinically significant. The absence of an association of exposure to benzodiazepines or z-hypnotics with z score for birth weight relative to gestational age and sex suggests that association of exposure to benzodiazepines or z-hypnotics with birth weight could be explained by earlier delivery rather than impaired intrauterine growth.

• Gabrhelik, Roman; Skurtveit, Svetlana; Nechanská, Blanka; Handal, Marte; Mahic, Milada & Mravčík, Viktor (2020). Prenatal methamphetamine exposure and adverse neonatal outcomes: A nationwide cohort study. European Addiction Research. ISSN 1022-6877. doi: 10.1159/000509048. Fulltekst i vitenarkiv Vis sammendrag

  Background: There is limited knowledge on the adverse outcomes in newborns after maternal methamphetamine (MA) use during pregnancy. Objectives: To compare neonatal outcomes in newborns exposed to MA with the newborns of opioid-exposed mothers and of mothers from the general population (GP). Method: A cohort study using nationwide registries in Czechia (2000–2014). Women hospitalized with a main diagnosis of MA use disorder during pregnancy (n = 258) and their newborns were defined as MA-exposed. The comparison groups consisted of women (n = 199) diagnosed with opioid use disorder during pregnancy, defined as opioid-exposed, and women (n = 1,511,310) with no substance use disorder diagnosis (GP). The neonatal outcomes studied were growth parameters, gestational age, preterm birth, and Apgar score. To explore the associations between MA exposure and neonatal outcomes, regression coefficients (b) and odds ratios from multivariable linear and binary logistic regression were estimated. Results: MA-exposed women had similar socio-economic characteristics to opioid-exposed, both of which were worse than in the GP. After adjustment, MA exposure was associated with a more favourable birthweight when compared to the opioid-exposed (adjusted mean differences [aMD] b = 122.3 g, 95% CI: 26.0–218.5) and length (aMD b = 0.6 cm, 0.0–1.1). Unadjusted results from the comparison with the GP showed that the MA group had poorer neonatal outcomes, especially in the growth parameters. Adjustment for background characteristics had a profound effect on the comparison with the GP. After adjustment, MA exposure was associated only with a slightly reduced birthweight (aMD b = −63.0 g, −123.0 to −3.1) and birth length (aMD b = −0.3 cm, −0.6 to 0.0). Conclusions: Although the observed negative outcomes were large in the MA-exposed newborns, the adjustment had a profound effect on the comparison with the GP, indicating the large influence of lifestyle and socio-economic factors in these high-risk pregnancies. MA-exposed newborns had better neonatal outcomes compared to opioids-exposed.

• Aas, Christer Frode; Vold, Jørn Henrik; Skurtveit, Svetlana; Lim, Aaron G.; Ruths, Sabine & Islam, Kamrul [Vis alle 10 forfattere av denne artikkelen] (2020). Health-related quality of life of long-term patients receiving opioid agonist therapy: a nested prospective cohort study in Norway. Substance Abuse Treatment, Prevention, and Policy. 15(68), s. 1–12. doi: 10.1186/s13011-020-00309-y. Fulltekst i vitenarkiv Vis sammendrag

  Background Opioid dependence carries the highest disease burden of all illicit drugs. Opioid agonist therapy (OAT) is an evidence-based medical intervention that reduces morbidity and mortality. There is limited knowledge on the health-related quality of life (HRQoL) of long-term patients in OAT. This study measures HRQoL and self-perceived health of long-term patients on OAT, compares the scores to a Norwegian reference population, and assesses changes in these scores at 1-year follow up. Methods We conducted a nested prospective cohort study among nine OAT outpatient clinics in Norway. 609 OAT patients were included, 245 (40%) followed-up one year later. Data on patient characteristics, HRQoL, and self-perceived health was collected. HRQoL was assessed with the EQ-5D-5L, which measures five dimensions (mobility, self-care, usual activities, pain/discomfort and anxiety/depression) on a five-point Likert scale (from “no problems” to “extreme problems”). An UK value set was applied to calculate index values (from 0 to 1) for the EQ-5D-5L and compare them to a Norwegian reference population. Self-perceived health was measured with EQ-VAS (from 0 to 100). Results Mean (standard deviation (SD)) EQ-5D-5L index value at baseline was 0.699 (0.250) and EQ-VAS 57 (22) compared to 0.848 (0.200) and 80(19) for the Norwegian reference population. There were large variations in EQ-5D-5L index values, where 43% had > 0.8 and 5% had

• Ask, Helga; Handal, Marte; Hauge, Lars Johan; Reichborn-Kjennerud, Ted & Skurtveit, Svetlana (2020). Incidence of diagnosed pediatric anxiety disorders and use of prescription drugs: a nation-wide registry study. European Child and Adolescent Psychiatry. ISSN 1018-8827. doi: 10.1007/s00787-019-01419-0. Fulltekst i vitenarkiv
• Welle-Strand, Gabrielle; Skurtveit, Svetlana; Abel, Eli Kristine Fiksdal; Chalabianloo, Fatemeh & Sarfi, Monika (2020). Living a normal life? Follow-up study of women who had been in opioid maintenance treatment during pregnancy. Journal of Substance Abuse Treatment. ISSN 0740-5472. 113. doi: 10.1016/j.jsat.2020.108004. Fulltekst i vitenarkiv
• Skovlund, Eva; Selmer, Randi Marie; Skurtveit, Svetlana Ondrasova; Brandlistuen, Ragnhild Eek & Handal, Marte (2020). In utero exposure to analgesic opioids and language development in 5-year old children. Pharmacoepidemiology and Drug Safety. ISSN 1053-8569. 29(6), s. 736–744. doi: 10.1002/pds.5009. Fulltekst i vitenarkiv Vis sammendrag

  Purpose A pervasive problem in registry-based pharmacoepidemiological studies is what exposure duration to assign to individual prescriptions. The parametric waiting time distribution (WTD) has been proposed as a method to estimate such durations. However, when prescription durations vary due to seasonal stockpiling, WTD estimates will vary with choice of index date. To counter this, we propose using random index dates. Methods Within a calendar period of a given length, δ, we randomly sample individual index dates. We include the last prescription redemption prior to the index date in the analysis. Only redemptions within distance δ of the index date are included. In a simulation study with varying types and degrees of stockpiling at the end of the year, we investigated bias and precision of the reverse WTD with fixed and random index dates, respectively. In addition, we applied the new method to estimate durations of Norwegian warfarin prescriptions in 2014. Results In simulation settings with stockpiling, the reverse WTD with random index dates had low relative biases (−0.65% to 6.64%) and high coverage probabilities (92.0% to 95.3%), although when stockpiling was pronounced, coverage probabilities decreased (2.7% to 85.8%). Using a fixed index date was inferior. The estimated duration of warfarin prescriptions in Norway using random index dates was 131 (130; 132) days. Conclusions In the presence of seasonal stockpiling, the WTD with random index dates provides estimates of prescription durations, which are more stable, less biased and with better coverage when compared to using a fixed index date.

• Skurtveit, Svetlana; Hjellvik, Vidar; Sakshaug, Solveig; Borchgrevink, Petter Chr.; Larsen, Børge Myrlund & Clausen, Thomas [Vis alle 9 forfattere av denne artikkelen] (2020). Forskrivning av opioider på blå resept mot langvarige smerter. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 15. doi: 10.4045/tidsskr.20.0153. Fulltekst i vitenarkiv
• Vold, Jørn Henrik; Aas, Christer Frode; Skurtveit, Svetlana; Odsbu, Ingvild; Chalabianloo, Fatemeh & Reutfors, Johan [Vis alle 9 forfattere av denne artikkelen] (2020). Potentially addictive drugs dispensing to patients receiving opioid agonist therapy: a register-based prospective cohort study in Norway and Sweden from 2015 to 2017. BMJ Open. 10(8). doi: 10.1136/bmjopen-2020-036860. Fulltekst i vitenarkiv Vis sammendrag

  Objectives: To compare the use of benzodiazepines, z-hypnotics, gabapentinoids, opioids and centrally acting stimulants (CAS) among patients who had received opioid agonist therapy (OAT) in Norway and Sweden during the period 2015 - 2017. Design: A register-based prospective cohort study using information about dispensed drugs from the Norwegian Prescription Database and Swedish Prescribed Drug Register. Setting: Patients who were dispensed OAT opioids from pharmacies. Participants: A total of 7176 Norwegian and 3591 Swedish patients on OAT were included. Outcome measures: The number and frequency of potentially addictive drugs dispensed were calculated for the two countries. The mean daily doses of dispensed benzodiazepines and z-hypnotics were summarised by calculating benzodiazepines in diazepam equivalents and z-hypnotics in zopiclone equivalents. Results: In 2017, 46% of patients in Norway, and 15% in Sweden, were dispensed a benzodiazepine. Moreover, 14% in Norway and 26% in Sweden received z-hypnotics. Gabapentinoids were dispensed to 10% of patients in Norway and 19% of patients in Sweden. In Norway, 6% and 12% of the patients received strong and weak non-OAT opioids, respectively, whereas in Sweden 10% were dispensed strong non-OAT opioids and 5% weak non-OAT opioids . CAS were dispensed to 4% in Norway and 18% in Sweden. The mean daily doses of benzodiazepines were 16 and 17 mg diazepam equivalents in Norway and Sweden, respectively. For z-hypnotics, the mean daily dose was 8 mg zopiclone equivalents in both countries. ‘Benzodiazepines and z-hypnotics’ was the most dispensed drug combination in 2017. Similar results were found in 2015 and 2016. Conclusions: Nearly half of those patients who were dispensed an OAT opioid in Norway and Sweden were dispensed potentially addictive drugs. The differences identified between Norway and Sweden might be related to differences in eligibility guidelines and restrictions with respect to OAT.

• Vold, Jørn Henrik; Gjestad, Rolf; Aas, Christer Frode; Chalabianloo, Fatemeh; Skurtveit, Svetlana & Løberg, Else-Marie [Vis alle 8 forfattere av denne artikkelen] (2020). Impact of clinical and sociodemographic factors on fatigue among patients with substance use disorder: a cohort study from Norway for the period 2016–2020. Substance Abuse Treatment, Prevention, and Policy. 15. doi: 10.1186/s13011-020-00334-x. Fulltekst i vitenarkiv Vis sammendrag

  Background The impact of clinical and sociodemographic factors on fatigue remains unknown among patients with substance use disorders (SUD). This study aims to evaluate fatigue among patients with SUD using a nine-item fatigue severity scale (FSS-9) and identify the impact that clinical and sociodemographic factors – such as injecting substance use, chronic infectious diseases, liver fibrosis, opioid agonist therapy (OAT), debt difficulties, and housing situation – have on fatigue. Methods We used data from a cohort of patients with SUD in Norway with annual health assessments surveying FSS-9 and some clinical and sociodemographic factors. A total of 915 FSS-9 measurements were collected from 654 patients during the period 2016–2020. We defined baseline as the first annual health assessment when the health assessments were listed chronologically. Time was defined as years from baseline. We used a linear mixed model to analyse whether the clinical and sociodemographic factors affected the FSS-9 sum score, presented with beta coefficients (β) with 95% confidence intervals (CI). Results The mean sum score of the FSS-9 was 43 (standard deviation: 16) at baseline. Females compared with males (adjusted mean difference of FSS-9 sum score: 4.1, 95% CI: 1.3–7.0), having debt difficulties compared with having no debt difficulties (2.9;0.4–5.3), and frequent use of benzodiazepines (5.7;3.0–8.4) or amphetamines (-5.0;-8.0– -2.0) compared to less frequent or no use of these substances changed the FSS-9 baseline sum score. The other clinical and sociodemographic factors did not predict any clinically relevant change in the FSS-9 sum score from baseline to the following health assessments. Conclusion Patients with SUD suffer from high levels of fatigue. Female patients, patients with debt difficulties, and those with extensive use of benzodiazepines are at particular risk of being fatigued. This should be taken into consideration when planning health services.

• Vold, Jørn Henrik; Aas, Christer Frode; Skurtveit, Svetlana; Odsbu, Ingvild; Chalabianloo, Fatemeh & Halmøy, Anne [Vis alle 8 forfattere av denne artikkelen] (2020). Dispensation of attention deficit hyperactivity disorder (ADHD) medications in patients receiving opioid agonist therapy; A national prospective cohort study in Norway from 2015 to 2017. BMC Psychiatry. 20, s. 1–12. doi: 10.1186/s12888-020-02526-y. Fulltekst i vitenarkiv Vis sammendrag

  Background It is estimated that up to a third of patients on opioid agonist therapy (OAT) have attention deficit hyperactivity disorder (ADHD). Treatment by ADHD medication, including a centrally acting stimulant (CAS) or atomoxetine is one of the essential approaches. This study evaluates the use of dispensed ADHD medications in the Norwegian OAT population in the period from 2015 to 2017. Types and doses of ADHD medications, co-dispensations of other potentially addictive drugs like benzodiazepines, z-hypnotics, gabapentinoids, and non-OAT opioids, as well as direct-acting antivirals (DAA) against hepatitis C infection, are investigated. Methods Information about all dispensed ADHD medication, OAT opioids, and the defined potentially addictive drugs were recorded from the Norwegian Prescription Database. Dispensation rates, the types, and the doses of dispensed ADHD medications were estimated by summarizing the number of dispensations, and the dispensed doses. Logistic regression analyses were employed to assess the associations between ADHD medication, and OAT opioid use, and dispensations of other potentially addictive drugs and DAAs against hepatitis C infection. Results A total of 9235 OAT patients were included. The proportion of patients who were dispensed ADHD medication increased from 3.5 to 4.6% throughout the study period. The three most dispensed CAS were short- and intermediate-acting methylphenidate (55%), lisdexamphetamine (24%), and dexamphetamine (17%) in 2017. Buprenorphine, rather than methadone, as OAT opioid (adjusted odds ratio: 1.6, CI: 1.2–2.1) was associated with being dispensed ADHD medication. Among patients who received CAS and OAT opioids each calendar year, the dispensed doses of methylphenidate increased from 63 mg/day in 2015 to 76 mg/day in 2017 (p = 0.01). Sixty percent of patients receiving ADHD medications were also dispensed other addictive drugs concomitantly in 2017. Similar results were found in 2015 and 2016. Conclusion Co-prescription of ADHD medications was low among patients on OAT in Norway, considering a high prevalence of ADHD in this patient group. On the other hand, concurrent dispensations of multiple addictive drugs were common in this population. Understanding the underlying reasons for such prescribing is essential, and research on how to optimize ADHD medication of patients with ADHD receiving OAT is needed.

• Kiselev, Yury; Handal, Marte; Hjellvik, Vidar; Reichborn-Kjennerud, Ted; Stoltenberg, Camilla & Suren, Pål [Vis alle 8 forfattere av denne artikkelen] (2020). Nationwide study of neuropsychiatric comorbidity and medicines use in children with autism spectrum disorder in Norway. Frontiers in Psychiatry. 11, s. 1–8. doi: 10.3389/fpsyt.2020.596032. Fulltekst i vitenarkiv Vis sammendrag

  Purpose: Autism spectrum disorder (ASD) has a high rate of comorbidity. While many children with ASD are exposed to psychotropic medicines, their efficacy and safety in these patients are unclear. There is a need for more detailed knowledge on which medicines are most commonly used and for which disorders. We aimed to investigate (a) prevalence and incidence rate of ASD among Norwegian children, and further, among newly diagnosed ASD children in 2014, study the (b) co-occurrence of neuropsychiatric disorders, (c) use of psychotropic drugs, and (d) the relationship between co-occurring diagnoses and use of psychotropic drugs. Method: Nationwide registry-based study of children 2–17 years old in Norway. Results: The ASD prevalence was 0.76% and the incidence rate was 0.12% in 2014. Of the children who received an initial ASD diagnosis in 2014 (n = 1,234), 64.8% had one or more co-occurring neuropsychiatric diagnosis. Psychotropic medication use was moderate (∼20% used stimulants or hypnotics) in general, and low in children without comorbidity (nearly only hypnotics). There was a good accordance between co-occurring diagnoses and indication for the prescribed medications. Conclusions: Children with newly diagnosed ASD mainly received psychotropic drugs to treat co-occurring neuropsychiatric conditions.

• Handal, Marte; Skurtveit, Svetlana; Mahic, Milada; Øhman, Inger; Wikner, Birgitta Norstedt & Tjagvad, Christian [Vis alle 9 forfattere av denne artikkelen] (2020). Opioid maintenance treatment of pregnant women in the Scandinavian countries. Nordic Studies on Alcohol and Drugs (NAD). ISSN 1455-0725. doi: 10.1177/1455072520914114. Fulltekst i vitenarkiv Vis sammendrag

  Background: WHO guidelines emphasise the need for descriptions of clinical practice and observational studies on risk and benefits of pharmacotherapies in pregnancy. The aims of the present study were to: (1) Describe opioid maintenance treatment (OMT) in the Scandinavian countries in general, and specifically for pregnant women, (2) Describe a project which utilises a new approach using registry-linkage data to examine associations between prenatal exposure to OMT and child outcomes: a Scandinavian cohort study of pregnant women in OMT during pregnancy (ScopeOMT). Data: Guidelines describing the treatment of persons with opioid use disorders in general, and specifically for pregnant women. Scandinavian registry-linkage data from ScopeOMT. Results: Registry data show that approximately 800 pregnant women received OMT during pregnancy in the period of the ScopeOMT study. Similarities across the Scandinavian countries include access to free healthcare and treatment; multidisciplinary teams trained to support pregnant women in OMT; buprenorphine as the recommended drug when initiating therapy; and a holistic focus on the patients’ lives. An important difference is that Norwegian women who use illegal substances that may harm the foetus may be admitted – voluntarily, or against their will – for parts of, or the remainder of the pregnancy to inpatient treatment at specialised clinics. Conclusion: Many similarities in the treatment provided to opioid-dependent persons in the Scandinavian countries place this area in an excellent position to combine the efforts and carry out observational studies concerning the safety of OMT during pregnancy.

• Aas, Christer Frode; Vold, Jørn Henrik; Skurtveit, Svetlana; Odsbu, Ingvild; Chalabianloo, Fatemeh & Økland, Jan-Magnus [Vis alle 10 forfattere av denne artikkelen] (2020). On the path towards universal coverage of hepatitis C treatment among people receiving opioid agonist therapy (OAT) in Norway: A prospective cohort study from 2013 to 2017. BMJ Open. 10(8), s. 1–9. doi: 10.1136/bmjopen-2019-036355. Fulltekst i vitenarkiv Vis sammendrag

  Objectives We aimed to calculate cumulative hepatitis C virus (HCV) treatment coverage among individuals enrolled in opioid agonist therapy (OAT) in Norway between 2013 and 2017 and to document the treatment transition to direct-acting antiviral (DAA) agents. Moreover, we aimed to describe adherence to DAAs in the same cohort. Design Prospective cohort, registry data. Setting Specialist healthcare service (secondary) Participants and outcomes This observational study was based on data from The Norwegian Prescription Database. We studied dispensed OAT and HCV treatment annually to calculate the cumulative frequency, and employed secondary sources to calculate prevalence, incidence and HCV treatment coverage from 2013 to 2017, among the OAT population. Factors associated with adherence to DAAs were identified a priori and subject to logistic regression. Results 10 371 individuals were identified with dispensed OAT, 1475 individuals of these were identified with dispensed HCV treatment. Annual HCV treatment coverage increased from 3.5% (95% CI: 3.2 to 4.4) in 2013 to 17% (95% CI: 17 to 20) in 2017, giving a cumulative HCV coverage among OAT patients in Norway of 38.5%. A complete shift to interferon-free treatment regimens occurred, where DAAs accounting for 32% of HCV treatments in 2013 and 99% in 2017. About two-thirds of OAT patients were considered adherent to their DAA regimens across all genotypes. High level of OAT continuity was associated with improved adherence to DAAs (adjusted OR 1.4, 95% CI: 1 to 2, p=0.035). Conclusions A large increase in HCV treatment coverage attributed by a complete shift to interferon-free regimens among the Norwegian OAT population has been demonstrated. However, treatment coverage is inadmissibly too low and a further substantial scale-up in HCV treatment is required to reach the universal targets of controlling and eliminating the HCV endemic.

• Holdø, Ingvild; Bramness, Jørgen Gustav; Handal, Marte; Hansen, Berit Hjelde; Hjellvik, Vidar & Skurtveit, Svetlana (2020). Association Between Prescribed Hypnotics in Infants and Toddlers and Later ADHD: A Large Cohort Study from Norway. Child Psychiatry and Human Development. ISSN 0009-398X. doi: 10.1007/s10578-020-01039-9. Fulltekst i vitenarkiv Vis sammendrag

  As previously indicated an association may exist between early sleep problems in infants and toddlers, and a diagnosis of attention deficit hyperactivity disorder (ADHD). The aim of this study was to study if this association could be replicated in a complete nationwide cohort of children. Prospective cohort study using national registries. All children born in Norway from January 2004 to December 2010 were included (N = 410,555). Information on hypnotic drugs dispensed to children 0-3 years of age outside of institutions was collected from the Norwegian Prescription Database and used as a proxy for sleep problems. The outcome ADHD (ICD-10), as diagnosed by specialists in the Child Mental Health Service, was obtained from the Norwegian Patient Registry. Data were analysed using weighted estimation in Cox regression. The unadjusted weighted hazard ratio (wHR) for a later diagnosis of ADHD in children dispensed two or more prescriptions for any hypnotic drug, compared to zero prescriptions, was 2.30 [95% confidence interval (CI) 1.63-3.23] for girls and 1.75 (95% CI 1.48-2.07) for boys. For the sedative antihistamine trimeprazine the corresponding wHR was 3.71 (95% CI 1.83-7.52) for girls and 2.78 (95% CI 2.04-3.80) for boys. After adjusting for parental ADHD and parental education the wHR for trimeprazine users was 2.81 (95% CI 1.34-5.88) for girls and 2.33 (95% CI 1.70-3.20) for boys. Infants and toddlers who were dispensed hypnotics had an increased risk of ADHD at school age. This association was most pronounced with the use of trimeprazine, a drug traditionally prescribed to toddlers for sleep problems in Norway. After adjusting for parental ADHD and educational level the risk for ADHD among the trimeprazine users was still more than twice the risk among controls. Keywords: ADHD; Hypnotics; Infancy; Sleep disorder.

• Evandt, Jorunn; Skurtveit, Svetlana; Oftedal, Bente Margaret; Krog, Norun Hjertager; Nafstad, Per & Skovlund, Eva [Vis alle 8 forfattere av denne artikkelen] (2019). Agreement between self-reported and registry-based use of sleep medications and tranquilizers. Pharmacoepidemiology and Drug Safety. ISSN 1053-8569. 28(10), s. 1336–1343. doi: 10.1002/pds.4854. Fulltekst i vitenarkiv Vis sammendrag

  Purpose The purpose of the present study was to assess the agreement between self‐reported use of sleep medications and tranquilizers and dispensed hypnotics and anxiolytics. Methods Self‐reported medication use was obtained from the population‐based survey Health and Environment in Oslo (HELMILO) (2009‐2010) (n = 13 019). Data on dispensed hypnotics and anxiolytics were obtained from the Norwegian Prescription Database (NorPD). As measures of validity, we calculated sensitivity and specificity using both self‐reports and prescription records as the reference standard. Furthermore, we calculated Cohen's kappa. Current self‐reported medication use was compared with prescription data in time windows of both 100 and 200 days preceding questionnaire completion. Results The highest sensitivity was observed for current sleep medication use in the 100‐day time window (sensitivity = 0.76, 95% confidence interval [CI]: 0.74, 0.79) when using prescription records as the reference standard. Sensitivity was generally lower for tranquilizers compared with sleep medications. Cohen's kappa showed the highest agreement for the 200‐day time window with substantial agreement for sleep medications (kappa = 0.64; 95% CI: 0.62, 0.67) and moderate agreement for tranquilizers (kappa = 0.45; 95% CI: 0.41, 0.48). Conclusions The present study suggests moderate to substantial agreement between self‐reported use of sleep medications and tranquilizers and dispensed drugs in a general adult population. The magnitude of agreement varied according to drug category and time window. Since self‐reported and registry‐based use of these drug classes does not match each other accurately, limitations of each data source should be considered when such medications are applied as the exposure or outcome in epidemiologic studies.

• Tveito, Marit; Handal, Marte; Engedal, Knut; Smith, Robert Løvsletten; Høiseth, Gudrun & Skurtveit, Svetlana (2019). Forskrivning av antipsykotika til hjemmeboende eldre 2006–18. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 139(16), s. 1554–1558. doi: 10.4045/tidsskr.19.0233. Fulltekst i vitenarkiv
• Suren, Pål; Bakken, Inger Johanne Landsjøåsen; Skurtveit, Svetlana; Handal, Marte; Reichborn-Kjennerud, Ted & Stoltenberg, Camilla [Vis alle 8 forfattere av denne artikkelen] (2019). Tourettes syndrom hos barn i Norge. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 139(17), s. 1648–1653. doi: 10.4045/tidsskr.19.0411. Fulltekst i vitenarkiv
• Munch, Elisabeth Lobben; Skurtveit, Svetlana; Handal, Marte & Skovlund, Eva (2019). Pre conception use of cannabis and cocaine among men with pregnant partners. Nordic Studies on Alcohol and Drugs (NAD). ISSN 1455-0725. 37(1), s. 43–53. doi: 10.1177/1455072519879564. Fulltekst i vitenarkiv Vis sammendrag

  Background: Paternal lifestyle during sperm development can have an impact on foetal development. This study surveys demographic characteristics and lifestyle factors among expectant fathers who reported use of cannabis and cocaine in the six-month period before conception. We also study the associations between mothers’ and fathers’ use of cannabis and cocaine. Methods: This is a cross-sectional study from the Norwegian Mother and Child Cohort Study (MoBa) using self-reported data on demographic variables and cannabis and cocaine use six months before conception. Associations were assessed using logistic regression and chi-square tests. Results: A strong association was found between use of cannabis and cocaine and lifestyle habits such as alcohol and cigarette use. Alcohol consumption four or more times a week gave an adjusted odds ratio (aOR) of 9.7 (95% CI 7.2–13.0) for cannabis and an aOR 21.6 (95% CI 11.5–40.3) for cocaine. There was also a strong association between maternal and paternal use of cannabis and cocaine. Conclusion: Use of cannabis and cocaine close to pregnancy seems to be closely linked to other risk factors, and further studies on how paternal drug use affects the foetus are warranted. The strong association between maternal and paternal use of cannabis and cocaine may be used to inform healthcare workers to make good risk assessments.

• Muller, Ashley Elizabeth; Skurtveit, Svetlana & Clausen, Thomas (2019). Performance of the WHOQOL-BREF among Norwegian substance use disorder patients. BMC Medical Research Methodology. 19(44), s. 1–9. doi: 10.1186/s12874-019-0690-3. Fulltekst i vitenarkiv Vis sammendrag

  Background Quality of life (QoL) is an established outcome measure of substance use disorder treatment. The WHOQOL-BREF is the gold standard tool, but its appropriateness for particularly vulnerable patient populations must be further explored. This article examines the scaling qualities of the WHOQOL-BREF in a Norwegian substance use disorder population, and explores relationships with social and health variables. Methods 107 participants in a larger national treatment study provided data during structured interviews. Item responses, responsiveness, and domain scaling qualities are reported. General linear models identified correlates of impaired QoL. Results Three out of four domains exhibited acceptable scaling qualities, while the social relationships domain had low internal validity. 59% of the variance in physical health QoL was explained in our model by the negative main or interaction effects of depression, unemployment, social isolation, smoking, residential treatment, and weight dissatisfaction. 52% of the variance in psychological health QoL was explained by depression and being single. Depression also had significant main effects in social relationships QoL (R2 = .27) and environment QoL (R2 = .39), and social isolation and exercise had further interaction effects in environment QoL. Conclusions After one year in treatment, the impact of low social contact in reducing QoL, rather than specific substance use patterns, was striking. The social relationships domain is the shortest in the WHOQOL-BREF, yet social variables were important in other areas of QoL. Social support could benefit from more attention in treatment, as a lack of social support seems to be a strong risk factor for poor QoL in various domains. The WHOQOL-BREF exhibits otherwise satisfactory measurement characteristics and is an appropriate tool among this population.

• Lupattelli, Angela; Chambers, Christina D.; Bandoli, Gretchen; Handal, Marte; Skurtveit, Svetlana & Nordeng, Hedvig Marie Egeland (2019). Association of Maternal Use of Benzodiazepines and Z-Hypnotics During Pregnancy With Motor and Communication Skills and Attention-Deficit/Hyperactivity Disorder Symptoms in Preschoolers. JAMA Network Open. 2(4). doi: 10.1001/jamanetworkopen.2019.1435. Fulltekst i vitenarkiv Vis sammendrag

  Importance: The reproductive safety of benzodiazepine/z-hypnotic exposure on child longer-term developmental risks remains unresolved. Objective: To quantify the association of motor, communication, and attention-deficit/hyperactivity disorder (ADHD) symptoms in preschoolers with gestational benzodiazepine/z-hypnotic exposure by timing and duration and coexposure to opioids or antidepressants. Design, Setting, and Participants: Nationwide, population-based Norwegian Mother and Child Cohort Study, recruiting pregnant women from 1999 to 2008, with child follow-up from ages 6, 18, and 36 months to ages 5, 7, and 8 years. Follow-up of teenagers is ongoing. The study included women with depressive/anxiety (n = 4195), sleeping (n = 5260), or pain-related (n = 26 631) disorders before and/or during pregnancy. Exposures: For the timing analyses, children exposed to benzodiazepines/z-hypnotics in midpregnancy (weeks 17-28) or late pregnancy (week 29 or later) vs those born to nonmedicated women. For the duration and coexposure analyses, benzodiazepine/z-hypnotic treatment for multiple 4-week intervals vs 1 and co-use of benzodiazepine/z-hypnotic with opioids or antidepressants vs sole benzodiazepine/z-hypnotic use. Main Outcomes and Measures: Parent-reported motor and communication skills (Ages and Stages Questionnaires) and ADHD symptoms (Conners’ Parent Rating Scale–Revised) at child median age of 5.1 years (interquartile range, 5.0-5.3 years) as standardized mean scores. General linear propensity score–adjusted and marginal structural models were fitted. Analyses were stratified by maternal disorder. Results: Of 41 146 eligible pregnancy-child dyads, 36 086 children (18 330 boys and 17 756 girls) were included, of whom 283 (0.8%) were prenatally exposed to benzodiazepines/z-hypnotics (134 in the depressive/anxiety, 60 in the sleeping, and 89 in the pain-related disorders). There was no increased risk for greater ADHD symptoms or fine motor deficits after intrauterine benzodiazepine/z-hypnotic exposure at different time points. Children born to women with depressive/anxiety disorders who took benzodiazepines/z-hypnotics in late pregnancy had greater gross motor (weighted β, 0.67; 95% CI, 0.21-1.13) and communication (weighted β, 0.35; 95% CI, 0.04-0.65) deficits than unexposed children. There was no evidence for substantial duration or coexposure associations. Conclusions and Relevance: These findings suggest no substantial detrimental risk on child fine motor and ADHD symptoms after prenatal benzodiazepine/z-hypnotic exposure alone or in combination with opioids or antidepressants. Residual confounding by indication and/or a higher drug dose regimen among women with anxiety/depression may explain the moderate association of gross motor and communication deficits with late-pregnancy benzodiazepine/z-hypnotic use.

• Fredheim, Olav Magnus; Skurtveit, Svetlana; Handal, Marte & Hjellvik, Vidar (2019). A complete national cohort study of prescriptions of analgesics and benzodiazepines to cancer survivors in Norway 10 years after diagnosis. Pain. ISSN 0304-3959. 160(4), s. 852–859. doi: 10.1097/j.pain.0000000000001459. Fulltekst i vitenarkiv Vis sammendrag

  Chronic pain due to surgery, radiotherapy, or chemotherapy is prevalent in long-term cancer survivors. Chronic pain due to successful cancer treatment should be treated as chronic nonmalignant pain, primarily with nonpharmacological strategies. Based on complete national data from the Cancer Registry of Norway and the Norwegian prescription database, the aim of this study was to compare the use of nonopioid analgesics, opioids, and benzodiazepines 10 years after cancer diagnosis in long-term cancer survivors and the age- and sex-adjusted general population. The 1-year periodic prevalence of use was higher in long-term cancer survivors in all the studied drug classes: opioids (143.5 vs 129.6/1000), paracetamol (88.3 vs 80.7/1000), nonsteroidal anti-inflammatory drugs (229.1 vs 221.7), gabapentinoids (13.4 vs 10.0/1000), benzodiazepines (88.3 vs 77.9/1000), and benzodiazepine-like hypnotics (118.1 vs 97.4/1000). The prevalence of persistent and high-dose opioid use (>365 defined daily doses [DDDs] and >730 DDDs, respectively, during 365 days, and prescriptions all quarters of the year) was also higher in the cancer survivors than in the general population (6.5 vs 4.8/1000 for persistent use and 2.7 vs 1.3/1000 for high-dose use). Less than 10% of persistent and high-dose users received only long-acting opioid formulations. Furthermore, most long-term cancer survivors with persistent or high-dose opioid use were also high-dose users (>100 DDDs/year) of either benzodiazepines or benzodiazepine-like hypnotics. It is an issue of concern that most of those using opioids did not adhere to guidelines regarding opioid formulation and comedication with other drugs with addictive properties.

• Birke, Hanne; Ekholm, Ola; Sjøgren, Per; Fredheim, Olav Magnus; Clausen, Thomas & Skurtveit, Svetlana (2019). Tramadol use in Norway: A register-based population study. Pharmacoepidemiology and Drug Safety. ISSN 1053-8569. 28(1), s. 54–61. doi: 10.1002/pds.4626. Fulltekst i vitenarkiv Vis sammendrag

  Purpose Increasing use of tramadol for chronic non‐cancer pain is concerning since tramadol users may be at risk of developing recurrent opioid use with increasing opioid consumption and co‐medication. Therefore, we investigated a complete national cohort of tramadol users. Methods The study population (154 042 adult individuals in Norway, who redeemed ≥ one tramadol prescription in 2012) was stratified into four groups according to their opioid use 2 years before their first tramadol prescription in 2012 and followed until 2016. Information on all dispensed opioid analgesics, benzodiazepines (BZDs), and BZD‐related Z‐hypnotics were retrieved from the Norwegian Prescription Database. Results Six percent of opioid naïve tramadol users (no opioid use 2 years before tramadol use in 2012) became recurrent users (received opioids annually during 4‐year follow‐up), almost doubled their mean opioid consumption (66 to 108 defined daily doses [DDD]). One‐quarter proceeded to strong opioids or was co‐medicated with BZDs, one‐third with Z‐hypnotics. Among former weak opioid users, 39.8% became recurrent users, 18.7% proceeded to strong opioids, mean opioid consumption increased slightly, one‐third used BZDs, or Z‐hypnotics concurrently. Among former strong opioid and users in palliative care; 61%, 70% became recurrent users and developed a similar prescription pattern (high and increasing mean opioid consumption, 301 to 318, 413 to 430 DDD); half of them proceeded to strong opioids and/or used BZDs or Z‐hypnotics concurrently. Conclusions Many patients who developed recurrent opioid use received prescriptions which substantially conflicted with existing guidelines and might lead to problematic opioid use.

• Muller, Ashley Elizabeth; Clausen, Thomas; Sjøgren, Per; Odsbu, Ingvild & Skurtveit, Svetlana (2019). Prescribed opioid analgesic use developments in three Nordic countries, 2006-2017. Scandinavian Journal of Pain. ISSN 1877-8860. 19(2). doi: 10.1515/sjpain-2018-0307. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: While the Nordic countries have considerably stricter controls on opioid prescribing for chronic non-cancer pain than other countries, previous research has warned that prescription of strong opioids is increasing. Objectives: This study examines consumption of and developments in dispensed prescribed opioids to individuals receiving ambulatory care from 2006-2017, using publicly available data from each of three Nordic countries’ national prescription registries. Methods: Repeated, cross-sectional design. One-year prevalence of all dispensed prescribed opioids in ATC N02A group were reported for Norway, Denmark, and Sweden in the period 2006-2017 by gender. One-year prevalence of the weak opioids tramadol and codeine and the strong opioid oxycodone were then reported separately over this period for each country. The mean defined daily dose (DDD) per user per year, an estimate of the amount of opioids prescribed, was reported for each of the three opioids in 2016. Results: Patterns of dispensed prescribed opioids differ greatly between 2006 and 2017 and between countries, with tramadol increasing in Norway, codeine declining across the board, and oxycodone increasing in all three countries. Norway exceeded Sweden and Denmark in prevalence of all dispensed prescribed opioids, with 12.1% of the female Norwegian population and 9.2% of the male Norwegian population dispensed at least one prescribed opioid as an outpatient in 2016. Norway’s high overall prevalence rates are tempered by dispensing the lowest mean doses of both weak opioids compared to Sweden. Similarly, Sweden dispenses the lowest mean doses of oxycodone but to the largest proportion of its population (3.0%). Conclusion: Significant shifts have occurred in the dispensing of prescribed opioids in Norway, Sweden, and Denmark over the past twelve years. The increasing prevalence of oxycodone in all three countries should continue to be monitored. Prescription registries provide a wealth of publicly available data that can be used to monitor and to guide prescribing policies in a more knowledge-based direction.

• Skurtveit, Svetlana; Nechanská, Blanka; Handal, Marte; Mahic, Milada; Mravcik, Viktor & Gabrhelík, Roman (2019). Hospitalization of children after prenatal exposure to opioid maintenance therapy during pregnancy: a national registry study from the Czech Republic. Addiction. ISSN 0965-2140. 114(7), s. 1225–1235. doi: 10.1111/add.14576. Fulltekst i vitenarkiv Vis sammendrag

  Background and Aims Our understanding of the long‐term safety of prenatal exposure to opioid maintenance treatment (OMT) is insufficient. We compared childhood morbidity (0–3 years) between OMT‐exposed and relevant comparison groups. Design Nation‐wide, registry‐based cohort study. Registries on reproductive health, addiction treatment, hospitalization and death were linked using identification numbers. Setting The Czech Republic (2000–14). Participants Children with different prenatal exposure: (i) mother in OMT during pregnancy (OMT; n = 218), (ii) mother discontinued OMT before pregnancy (OMT‐D; n = 55), (iii) mother with opioid use disorder, but not in OMT during pregnancy (OUD; n = 85) and (iv) mother in the general population (GP) (n = 1 238 452) Measurements Episodes of hospitalization were observed as outcomes. Information on in‐patient contacts, length of stay and diagnoses (International Classification of Diseases version 10) were assessed. Binary logistic regressions were conducted to estimate the associations between OMT exposure and the outcomes, crude and adjusted for the socio‐economic status and smoking. Findings No significant differences were found in the overall proportion of hospitalization among OMT‐exposed children, children of OMT‐D and children of women with OUD [54.1%, 95% confidence interval (CI) = 47.3–60.1%; 47.3%, 95% CI = 33.9–61.1%; 51.8%, 95% CI = 40.7%–62.6%], while the proportion was significantly lower (35.8%, 95% CI = 35.7–35.8%) in the GP. There were no significant differences in risk of specific diagnoses between OMT‐exposed children, children of OMT‐D and children of women with OUD. In the adjusted analyses, differences between OMT‐exposed and children in the GP were still present for infections and parasitic diseases (OR = 2.0, 95% CI = 1.4–2.7), diseases of the digestive system (OR = 1.7, 95% CI = 1.2–2.6) and diseases of the skin and subcutaneous tissue (OR = 1.9, 95% CI = 1.2–3.2). Conclusion This study did not find clear evidence for an increase in risk of morbidity during the first 3 years of life in children with prenatal opioid maintenance treatment exposure compared with children of women who discontinued such treatment before pregnancy or suffered from opioid use disorder without this treatment. Compared the general population, there appears to be an increased risk of hospitalizations for infectious, gastrointestinal and skin diseases.

• Hoff, Mari; Skovlund, Eva; Skurtveit, Svetlana; Meyer, Haakon E; Langhammer, Arnulf & Søgaard, Anne-Johanne [Vis alle 10 forfattere av denne artikkelen] (2019). Proton pump inhibitors and fracture risk. The HUNT study, Norway. Osteoporosis International. ISSN 0937-941X. 31, s. 109–118. doi: 10.1007/s00198-019-05206-0. Fulltekst i vitenarkiv Vis sammendrag

  Summary Proton pump inhibitors (PPIs) have been linked to increased risk of fracture; the data have, however, been diverging. We did not find any increased risk of fractures among users of PPIs in a Norwegian population of 15,017 women and 13,241 men aged 50–85 years with detailed information about lifestyle and comorbidity. Introduction Proton pump inhibitors (PPIs) are widely prescribed and have been linked to increased risk of fracture. Methods We used data from the Nord-Trøndelag Health Study (HUNT3), The Fracture registry in Nord-Trøndelag, and the Norwegian Prescription Database, including 15,017 women and 13,241 men aged 50–85 years. The study population was followed from the date of participating in HUNT3 (2006–2008) until the date of first fracture (forearm or hip), death, or end of study (31 December 2012). The Cox proportional hazards model with time-dependent exposure to PPIs was applied, and each individual was considered as unexposed until the first prescriptions was filled. To be included, the prescription of PPIs should minimum be equivalent to 90 defined daily doses (DDD) in the period. Individuals were defined as exposed until 6 months after end of drug supply. Results The proportion of women and men using PPIs was 17.9% and 15.5%, respectively. During a median of 5.2 years follow-up, 266 women and 134 men had a first hip fracture and 662 women and 127 men, a first forearm fracture. The combined rate/1000 patient-years for forearm and hip fractures in women was 49.2 for users of PPIs compared with 64.1 among non-users; for men 18.6 and 19.8, respectively. The hazard ratios with 95% confidence interval for the first forearm or hip fracture among users of PPIs in the age-adjusted analysis were 0.82 (0.67–1.01) for women and 1.05 (0.72–1.52) for men. Adjusting for age, use of anti-osteoporotic drugs, and FRAX, the HR declined to 0.80 (0.65–0.98) in women and 1.00 (0.69–1.45) in men. Conclusions Use of PPIs was not associated with an increased risk of fractures.

• Lund, Ingunn Olea; Skurtveit, Svetlana; Handal, Marte; Bukten, Anne; Torvik, Fartein Ask & Ystrøm, Eivind [Vis alle 7 forfattere av denne artikkelen] (2019). Association of constellations of parental risk with children's subsequent anxiety and depression: Findings from a HUNT survey and health registry study. JAMA pediatrics. ISSN 2168-6203. 173(3), s. 251–259. doi: 10.1001/jamapediatrics.2018.4360. Fulltekst i vitenarkiv
• Handal, Marte; Nechanská, Blanka; Skurtveit, Svetlana; Lund, Ingunn Olea; Gabrhelík, Roman & Engeland, Anders [Vis alle 7 forfattere av denne artikkelen] (2019). Prenatal exposure to opioid maintenance treatment and neonatal outcomes: Nationwide registry studies from the Czech Republic and Norway. Pharmacology Research & Perspectives. 7(5), s. 1–10. doi: 10.1002/prp2.501. Fulltekst i vitenarkiv Vis sammendrag

  There is lack of knowledge about the safety of treatment with methadone and buprenorphine as part of opioid maintenance treatment (OMT) during pregnancy. The purpose of this study was to examine neonatal outcomes concerning the use of OMT during pregnancy. We used nationwide registry linkages from the Czech Republic (2000‐2014) and Norway (2004‐2013). We compared prenatally OMT–exposed newborns with (a) newborns of women hospitalized with opioid use disorder during pregnancy in the Czech sample and (b) newborns with neonatal abstinence syndrome (NAS) in Norway. We performed multivariate linear and binary logistic regression exploring the associations between OMT and neonatal outcomes (growth parameters, gestational age, fetal death, small for gestational age, Apgar score, and NAS). Regression coefficients (b) and odds ratios (ORs) were estimated. The cohorts consisted of 333 Czech, and 235 Norwegian OMT–exposed newborns, and 106 and 294 newborns in the comparison groups, respectively. In both countries, the neonatal growth parameters were similar in the OMT and the comparison groups. In Norway, OMT exposure prolonged gestational age (adjusted b = 0.96 weeks, 95% confidence interval [CI] =0.39‐1.53) while the odds of preterm birth and Apgar score at 5 minutes were lower than in the comparison group (adjusted OR = 0.35, 0.16‐0.75 and aOR = 0.21, 0.06‐0.78, respectively). Newborns of women in OMT had similar growth parameters as newborns of women with opioid use disorders who were not in OMT during pregnancy. Overall, our findings do not suggest that OMT results in worse neonatal outcomes.

• Muller, Ashley Elizabeth; Skurtveit, Svetlana & Clausen, Thomas (2019). Confirming the factor structure of a generic quality of life instrument among pre-treatment substance use disorder patients. Health and Quality of Life Outcomes. 17. doi: 10.1186/s12955-019-1152-7. Fulltekst i vitenarkiv Vis sammendrag

  Background Quality of life (QoL) is a patient-reported outcome of increasing importance in the substance use disorder (SUD) treatment field, and impaired QoL may be an important impetus for treatment uptake. Instruments and methodologies abound, precluding comparison, as does a dearth of population norms. The QOL10 is a generic, overall QoL tool containing ten items and with simple scoring procedures. It is therefore a potential alternative to the gold standard WHOQOL-BREF. This study aimed to assess the two-factor structure of the QOL10 that has been suggested by a previous exploratory factor analysis. Methods Adults entering 21 participating inpatient or outpatient SUD treatment were recruited to join a national longitudinal cohort study. 531 completed the QOL10 at treatment entry and were included in the analysis. Structural equation modelling (SEM) was used to confirm the model fit of a two-factor structure, and the scaling qualities of the QOL10 were reported. Results According to the SEM analysis, the QOL10 was comprised of one latent variable measuring social QoL, and one measuring global QoL, and all ten items were retained. Goodness of fit tests included: root mean square of approximation = 0.063, 90% CI 0.050–0.076; normed-fit index = 0.919; and comparative fit index = 0.943. Conclusions The QOL10 should be considered when clinicians in the SUD treatment field need a short, valid instrument that measures both global QoL and social QoL, with minimum respondent and administrator burden. The social domain is of particular utility and may be used as a stand-alone instrument. Test-retest reliability should be established in future studies.

• Fadnes, Lars T.; Aas, Christer Frode; Vold, Jørn Henrik; Ohldieck, Christian; Leiva, Rafael Alexander Mo & Chalabianloo, Fatemeh [Vis alle 13 forfattere av denne artikkelen] (2019). Integrated treatment of hepatitis C virus infection among people who inject drugs: study protocol for a randomised controlled trial (INTRO-HCV). BMC Infectious Diseases. 19:943, s. 1–9. doi: 10.1186/s12879-019-4598-7. Fulltekst i vitenarkiv Vis sammendrag

  Background: A large proportion of people who inject drugs (PWID) living with hepatitis C virus (HCV) infection have not been treated. It is unknown whether inclusion of HCV diagnostics and treatment into integrated substance use disorder treatment and care clinics will improve uptake and outcome of HCV treatment in PWID. The aim is to assess the efficacy of integrating HCV treatment to PWID and this paper will present the protocol for an ongoing trial. Methods: INTRO-HCV is a multicentre, randomised controlled clinical trial that will compare the efficacy of integrated treatment of HCV in PWID with the current standard treatment. Integrated treatment includes testing for HCV, assessing liver fibrosis with transient elastography, counselling, treatment delivery, follow-up and evaluation provided by integrated substance use disorder treatment and care clinics. Most of these clinics for PWID provide opioid agonist therapy while some clinics provide low-threshold care without opioid agonist therapy. Standard care involves referral to further diagnostics, treatment and treatment follow-up given in a hospital outpatient clinic with equivalent medications. The differences between the delivery platforms in the two trial arms involve use of a drop-in approach rather than specific appointment times, no need for additional travelling, less blood samples taken during treatment, and treatment given from already known clinicians. The trial will recruit approximately 200 HCV infected individuals in Bergen and Stavanger, Norway. The primary outcomes are time to treatment initiation and sustained virologic response, defined as undetectable HCV RNA 12 weeks after end of treatment. Secondary outcomes are cost-effectiveness, treatment adherence, changes in quality of life, fatigue and psychological well-being, changes in drug use, infection related risk behaviour, and risk of reinfection. The target group is PWID with HCV diagnosed receiving treatment and care within clinics for PWID. Discussion: This study will inform on the effects of an integrated treatment program for HCV in clinics for PWID compared to standard care aiming to increase access to treatment and improving treatment adherence. If the integrated treatment model is found to be safe and efficacious, it can be considered for further scale-up.

• Tverdal, Aage; Skurtveit, Svetlana; Selmer, Randi Marie; Myhre, Ronny & Thelle, Dag Steinar (2018). Coffee and wine consumption is associated with reduced mortality from alcoholic liver disease: follow-up of 219,279 Norwegian men and women aged 30-67 years. Annals of Epidemiology. ISSN 1047-2797. 28(11), s. 753–758. doi: 10.1016/j.annepidem.2018.08.010. Fulltekst i vitenarkiv
• Lupattelli, Angela; Wood, Mollie; Ystrøm, Eivind; Skurtveit, Svetlana; Handal, Marte & Nordeng, Hedvig Marie Egeland (2018). Effect of Time-Dependent Selective Serotonin Reuptake Inhibitor Antidepressants During Pregnancy on Behavioral, Emotional, and Social Development in Preschool-Aged Children. Journal of the American Academy of Child and Adolescent Psychiatry. ISSN 0890-8567. 57(3), s. 200–208. doi: 10.1016/j.jaac.2017.12.010. Fulltekst i vitenarkiv
• Engeland, Anders; Bjørge, Tone; Klungsøyr, Kari; Hjellvik, Vidar; Skurtveit, Svetlana & Furu, Kari (2018). Trends in prescription drug use during pregnancy and postpartum in Norway, 2005 to 2015. Pharmacoepidemiology and Drug Safety. ISSN 1053-8569. 27(9), s. 995–1004. doi: 10.1002/pds.4577. Fulltekst i vitenarkiv
• Nesvåg, Ragnar; Bramness, Jørgen Gustav; Handal, Marte; Hartz, Ingeborg; Hjellvik, Vidar & Skurtveit, Svetlana (2018). The incidence, psychiatric co-morbidity and pharmacological treatment of severe mental disorders in children and adolescents. European psychiatry. ISSN 0924-9338. 49, s. 16–22. doi: 10.1016/j.eurpsy.2017.12.009. Fulltekst i vitenarkiv
• Mauseth, Siri Ann; Skurtveit, Svetlana; Skovlund, Eva; Langhammer, Arnulf & Spigset, Olav (2018). Medication use and association with urinary incontinence in women: Data from the Norwegian Prescription Database and the HUNT study. Neurourology and Urodynamics. ISSN 0733-2467. 37(4), s. 1448–1457. doi: 10.1002/nau.23473. Fulltekst i vitenarkiv
• Egeland, Grace M.; Skurtveit, Svetlana; Staff, Anne Cathrine; Eide, Geir Egil; Daltveit, Anne Kjersti & Klungsøyr, Kari [Vis alle 10 forfattere av denne artikkelen] (2018). Pregnancy-related risk factors are associated with a significant burden of treated hypertension within 10 years of delivery: Findings from a population-based Norwegian Cohort. Journal of the American Heart Association (JAHA). 7(10). doi: 10.1161/JAHA.117.008318. Fulltekst i vitenarkiv Vis sammendrag

  Background: The association between pregnancy complications and women's later cardiovascular disease has, primarily, been evaluated in studies lacking information on important covariates. This report evaluates the prospective associations between pregnancy‐related risk factors (preeclampsia/eclampsia, gestational hypertension, pregestational and gestational diabetes mellitus, preterm delivery, and fetal growth restriction) and pharmacologically treated hypertension within 10 years after pregnancy, while adjusting for a wide range of covariates. Methods and Results: Prepregnancy normotensive women participating in the MoBa (Norwegian Mother and Child Cohort Study) from January 2004 through July 2009 were linked to the Norwegian Prescription Database to identify women with pharmacologically treated hypertension beyond the postpartum period of 3 months. The burden of hypertension associated with pregnancy‐related risk factors was evaluated using an attributable fraction method. A total of 1480 women developed pharmacologically treated hypertension within the follow‐up among 60 027 women (rate of hypertension, 3.6/1000 person‐years). The proportion of hypertension associated with a history of preeclampsia/eclampsia, gestational hypertension, preterm delivery, and pregestational or gestational diabetes mellitus was 28.6% (95% confidence interval, 25.5%–31.6%) on the basis of multivariable analyses adjusting for numerous covariates. The proportion was similar for women with a healthy prepregnancy body mass index (18.5‐24.9 kg/m2; attributable fraction (AF)% 25.9%; 95% confidence interval, 21.3%‐30.3%), but considerably higher for nulliparous women at baseline within the first 5 years of follow‐up. Small‐for‐gestational age, however, did not increase subsequent hypertension risk in multivariable analyses. Conclusions: A structured postpartum follow‐up of high‐risk women identified through pregnancy‐related risk factors would facilitate personalized preventive strategies to postpone or avoid onset of premature cardiovascular events.

• Hoff, Mari; Skurtveit, Svetlana; Meyer, Haakon E; Langhammer, Arnulf; Søgaard, Anne-Johanne & Syversen, Unni [Vis alle 10 forfattere av denne artikkelen] (2018). Anti-osteoporosis drug use: too little, too much, or just right? The HUNT study, Norway. Osteoporosis International. ISSN 0937-941X. 29(8), s. 1875–1885. doi: 10.1007/s00198-018-4560-3. Fulltekst i vitenarkiv Vis sammendrag

  Summary Use of anti-osteoporotic drugs (AODs) was examined in a Norwegian population 50–85 years. Among them with Fracture Risk Assessment Tool (FRAX) score for major osteoporotic fracture ≥ 20, 25% of the women and 17% of the men received AODs. The strongest predictors for AODs were high age in women and use of glucocorticoids among men. Introduction To examine the use of anti-osteoporotic drugs (AODs) and to identify predictors for prescriptions. Methods Data were obtained from the Nord-Trøndelag Health Study (HUNT3) performed in 2006–2008 and the Norwegian Prescription Database, including 15,075 women and 13,386 men aged 50–85 years. Bone mineral density (BMD) in the femoral neck was measured in a subgroup of 4538 women and 2322 men. High fracture risk was defined as a FRAX score for major osteoporotic fracture (MOF) ≥ 20%; in the subgroup with BMD, high risk was in addition defined as FRAXMOF ≥ 20% or T-score ≤ − 2.5. Hazard ratios (HRs) for predictors of incident use of AODs within 2 years after HUNT3 were estimated by Cox’ proportional hazards model. Results Among individuals with FRAX MOF ≥ 20%, 25% of the women and 17% of the men were treated with AODs. Among those with FRAX MOF < 20%, 3% and 1% were treated, respectively. In the subgroup with BMD measurement, 24% of the women and 16% of the men at high risk of fractures were treated, compared to 3 and 1% in women and men not fulfilling the criteria. In women, high age was the strongest predictor for treatment (HR 3.84: 95% confidence interval 2.81–5.24), followed by use of glucocorticoids (GCs) (2.68:1.84–3.89). In men, predictors were use of GCs (5.28: 2.70–10.35) followed by multimorbidity (3.16:1.31–7.63). In the subgroup with BMD, T-score ≤ − 2.5 was the strongest predictor (women 3.98:2.67–5.89; men 13.31:6.17–28.74). Conclusions This study suggests an undertreatment of AODs in individuals at high risk of fracture.

• Reset, Askild; Skurtveit, Svetlana; Furu, Kari & Skovlund, Eva (2018). Effect of the market withdrawal of dextropropoxyphene on use of other prescribed analgesics. Scandinavian Journal of Pain. ISSN 1877-8860. 18(4), s. 667–674. doi: 10.1515/sjpain-2018-0103. Fulltekst i vitenarkiv Vis sammendrag

  Background and aims Dextropropoxyphene (DXP) is a synthetic opioid that was prescribed worldwide for mild to moderate pain. It was withdrawn from the European market in 2009. In this study we aim to investigate the effect of the market withdrawal of dextropropoxyphene in Norway on overall use of opioids and other analgesics at an individual level. Methods Data were collected from the nationwide Norwegian Prescription Database (NorPD). It covers all prescription of drugs from 01 January 2004 from Norwegian pharmacies dispensed to individuals outside institutions. The study period was divided in two 2-year periods from 01 September 2008 to 31 August 2010, and from the market withdrawal of DXP on 01 September 2010 to 31 August 2012. We included every individual that filled at least one prescription of dextropropoxyphene in the first 2-year period in our study population. In this study dextropropoxyphene, codeine and tramadol are defined as “weak opioids”, and all other opioids are termed “strong opioids”. Results Nine thousand one hundred and seventy-one individuals were included in our study population. Four thousand two hundred and ninety filled a prescription of DXP only once and were classified as “single users”, 2,990 were users with prescriptions of up to 200 defined daily doses (DDD) over the first 2-year period, or “sporadic users”, and 1,886 were classified high users with over 200 DDDs over a 2-year period. After the market withdrawal 8,392 continued to be prescribed analgesics or benzodiazepines. In the single user group, the proportion of users of weak opioids decreased from 69.5% to 57.6%, whereas the proportion of users of strong opioids was unchanged. Among the sporadic user group, the proportion of users of weak opioids went from 69.7% to 71.0%, the proportion using tramadol from 39.1% to 43.9%, and the users of strong opioids from 25.8% to 31.3%. In the high user group, there was an increase in the number of users of strong opioids from 37.8% to 51.4%. The amount of strong opioids prescribed in the high user group increased from a mean of 262.5 DDD to a mean of 398.3 DDD in the following 2 years. The amount of tramadol increased in all groups and was 3 times as high in the high user group after market withdrawal of DXP. Conclusions Our study showed that the withdrawal of DXP lead to an increase in prescription of other analgesics. The proportion of users increased in all three groups and so did the prescribed amount of other analgesics. Both the proportion of users of other opioids and the amount prescribed increased considerably. However, 1 in 10 earlier users of DXP stopped using prescribed analgesics altogether in the following 2 years. The increase in use among earlier high users of DXP was most striking. Implications This study documents markedly increased prescriptions of other opioids after withdrawal of dextropropoxyphene due to its high risk of serious complications. However, consequences of the increased use of opioids among earlier high users of DXP such as changes in risk of poisonings, accidental deaths and suicides remain to be investigated.

• Skurtveit, Svetlana; Bramness, Jørgen Gustav; Hjellvik, Vidar; Hartz, Ingeborg; Nesvåg, Ragnar & Hauge, Lars Johan [Vis alle 7 forfattere av denne artikkelen] (2018). Increase in diagnosis of depressive disorders contributes to the increase in antidepressant use in adolescents. Acta Psychiatrica Scandinavica. ISSN 0001-690X. 137(5), s. 413–421. doi: 10.1111/acps.12877. Fulltekst i vitenarkiv
• Skjærvø, Ingeborg; Clausen, Thomas; Skurtveit, Svetlana; Abel, Eli Kristine Fiksdal & Bukten, Anne (2018). Similarities and Differences in Victimization Risk Factors for Nonoffending and Offending Substance Users. Victims & Offenders. ISSN 1556-4886. 13(4), s. 526–541. doi: 10.1080/15564886.2017.1383332. Fulltekst i vitenarkiv Vis sammendrag

  In this cross-sectional study of substance users in Norway, the authors describe the patterns of victimization and investigate the factors associated with victimization, for nonoffenders and offenders separately. Recent victimization was reported by 59%, and the victimization rate was higher among offenders compared with nonoffenders (69% and 43%, p < .001). Women, regardless of offender status, experienced more victimization. Unstable housing was associated with victimization among nonoffenders, whereas markers for more severe substance use and indicators for poor mental health were associated with victimization in both groups. Addressing these factors may be important in reducing victimization and its negative outcomes among substance users. This research has been published in Victims and Offenders. © 2017 Taylor & Francis

• Nechanská, Blanka; Mravčík, Viktor; Skurtveit, Svetlana; Lund, Ingunn Olea; Gabrhelík, Roman & Engeland, Anders [Vis alle 7 forfattere av denne artikkelen] (2018). Neonatal outcomes after fetal exposure to methadone and buprenorphine: national registry studies from the Czech Republic and Norway. Addiction. ISSN 0965-2140. 113(7), s. 1286–1294. doi: 10.1111/add.14192. Fulltekst i vitenarkiv Vis sammendrag

  Background and Aims Opioid maintenance treatment (OMT) is recommended to opioid‐dependent females during pregnancy. However, it is not clear which medication should be preferred. We aimed to compare neonatal outcomes after prenatal exposure to methadone (M) and buprenorphine (B) in two European countries. Design Nation‐wide register‐based cohort study using personalized IDs assigned to all citizens for data linkage. Setting The Czech Republic (2000–14) and Norway (2004–13). [Correction added after online publication on 26 April 2018: The Czech Republic (2000–04) corrected to (2000–14).] Participants Opioid‐dependent pregnant Czech (n = 333) and Norwegian (n = 235) women in OMT who received either B or M during pregnancy and their newborns. Measurements We linked data from health registries to identify the neonatal outcomes: gestational age, preterm birth, birth weight, length and head circumference, small for gestational age, miscarriages and stillbirth, neonatal abstinence syndrome (NAS) and Apgar score. We performed multivariate linear regression and binary logistic regression to explore the associations between M and B exposure and outcomes. Regression coefficient (β) and odds ratio (OR) were computed. Findings Most neonatal outcomes were more favourable after exposure to B compared with M, but none of the differences was statistically significant. For instance, in the multivariate analysis, birth weight was β = 111.6 g [95% confidence interval (CI) = −10.5 to 233.6 and β = 83.1 g, 95% CI = −100.8 to 267.0] higher after B exposure in the Czech Republic and Norway, respectively. Adjusted OR of NAS for B compared with M was 0.94 (95% CI = 0.46–1.92) in the Norwegian cohort. Conclusions Two national cohorts of women receiving opioid maintenance treatment during pregnancy showed small but not statistically significant differences in neonatal outcomes in favour of buprenorphine compared with methadone.

• Johannsdottir, Inga Marie; Loge, Jon Håvard; Kiserud, Cecilie E.; Karlstad, Øystein & Skurtveit, Svetlana (2018). Increased prescription rates of anxiolytics and hypnotics to survivors of cancer in childhood, adolescence, and young adulthood — A population-based study. Pediatric Blood & Cancer. ISSN 1545-5009. 65(2). doi: 10.1002/pbc.26860. Fulltekst i vitenarkiv Vis sammendrag

  Background Survivors of cancer diagnosed in childhood, adolescence, or young adulthood (CAYACS) risk psychological morbidities later in life. The study compares prescription rates of anxiolytics and hypnotics among survivors to rates in age- and gender-matched controls. Procedures The population-based cohort included 5,341 cancer survivors, diagnosed ≤25 years of age during 1965–2000. For each survivor, three age- and gender-matched controls were randomly selected from the general population. Data were identified from the Norwegian Cancer and Population registries and linked to the Norwegian Prescription Database. A Cox proportional hazard model was applied to estimate hazard ratios (HRs) of prescriptions during 2004–2012 to the survivors with controls as referents. Results Survivors had an increased risk of being prescribed anxiolytics with crude rates of 16.9/1,000 person years compared to 11.8/1,000 person years in controls (HR 1.41; 95% confidence interval [CI] 1.29–1.54). The relative risk was highest for survivors of neuroblastomas (HR 2.62; 95% CI 1.11–6.16), bone tumors (HR 2.00; 95% CI 1.26–3.18), and central nervous system tumors (HR 1.90; 95% CI 1.40–2.51). The risk of being prescribed hypnotics was increased with crude rates of 20.8/1,000 person years compared to 14.3/1,000 person years in controls (HR 1.44; 95% CI 1.32–1.56). The relative risk was highest for survivors of gastrointestinal tumors (HR 1.80; 95% CI 1.04–3.10), leukemias (HR 1.78; 95% CI 1.32–2.38), and soft tissue cancers (HR 1.70; 95% CI 1.09–2.64). Conclusions Certain groups of CAYACS have an increased risk for being prescribed anxiolytics or hypnotics compared to controls. Diagnostic reasons for prescriptions are unknown, but the results indicate an increased emotional burden among these groups of survivors.

• Handal, Marte; Steingrímsdóttir, Ólöf Anna; Nielsen, Christopher Sivert & Skurtveit, Svetlana (2018). Langvarig smerte. I Grøholt, Else Karin; Bøhler, Linn & Hånes, Hanna (Red.), Folkehelserapporten - Helsetilstanden i Norge. Folkehelseinstituttet. Fulltekst i vitenarkiv
• Heldal, Anne Taraldsen; Skurtveit, Svetlana; Lobmaier, Philipp Paul K.; Vederhus, John-Kåre & Bramness, Jørgen Gustav (2018). Bruk av medikamenter for alkoholbrukslidelser i Norge 2004–16. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 138(18). doi: 10.4045/tidsskr.18.0383. Fulltekst i vitenarkiv Vis sammendrag

  <p><i>Background - </i>Alcohol use disorder can lead to serious illness and early death. The lifetime prevalence rate among the Norwegian population is estimated at 7–10 %. Many patients are never admitted to any kind of treatment programme, and it is assumed that few of those who are treated receive medicinal treatment. There are a variety of drugs on the market that can help reduce alcohol consumption and maintain abstinence. We wanted to gain an insight into the prescription prevalence rate and practice for these drugs. <p><i>Material and method - </i>We obtained encrypted data from the Norwegian Prescription Database of everyone who received drugs for alcohol use disorder in the period 2004–2016. The drugs included were disulfiram, acamprosate, naltrexone 50 mg and nalmefene. <p><i>Results - </i>The annual prescription prevalence rate increased from 0.85 to 1.13 per 1000 during the observation period. Half of all patients only received prescribed drugs once, and Disulfiram was the most commonly prescribed drug. There was a slight increase in the prevalence rate in age groups up to and including 55 years, and a significant increase for the over-55s. <p><i>Conclusion - </i>There was a slight increase in the prescription prevalence rate during the observation period. Disulfiram was the most commonly prescribed drug. The prescription increase was greatest among women and in the group of over-55s.

• Holdø, Ingvild; Bramness, Jørgen Gustav; Handal, Marte; Torgersen, Leila; Reichborn-Kjennerud, Ted & Ystrøm, Eivind [Vis alle 8 forfattere av denne artikkelen] (2017). Hypnotics use in children 0-18 months: moderate agreement between mother-reported survey data and prescription registry data. Journal of Pharmaceutical Policy and Practice. 10:28, s. 1–8. doi: 10.1186/s40545-017-0117-7. Fulltekst i vitenarkiv Vis sammendrag

  Background Different methods in pharmacoepidemiology can be used to study hypnotic use in children. But neither questionnaire-based data nor prescription records can be considered a “gold standard”. This study aimed to investigate the agreement between mother-reported questionnaire-based data and prescription record data for hypnotic drugs in children aged 0–18 months. The agreement was compared to the agreement for a group of antiepileptic drugs. Methods Prescription record data were collected from the Norwegian prescription database for 47,413 children also surveyed in the Norwegian mother and child cohort between 2005 and 2009. Agreement between in the two data sources was calculated using Cohens Kappa. Multinomial logistic regression was used to calculate the effect of sociodemographic variables on discrepancies in data sources. Results The agreement between mother-reported and dispensed hypnotics was less than 50% for all hypnotics. Sensitivity of reporting increased with number of filled prescriptions. The agreement of antiepileptic drugs was 92.9% in the same population. Of several sociodemographic factors only paternal educational level and maternal work situation was significantly related to agreement between prescription record and survey data. Conclusion There was a moderate agreement between reported use and dispensed hypnotic drugs for infants and toddlers. Results indicate that sociodemographic factors play only a minor role in explaining discrepancy.

• Johannsdottir, Inga Marie; Karlstad, Øystein; Loge, Jon Håvard; Fosså, Sophie Dorothea; Kiserud, Cecilie E. & Skurtveit, Svetlana (2017). Prescriptions of Antidepressants to Survivors of Cancer in Childhood, Adolescence, and Young Adulthood: A Population-Based Study. Journal of Adolescent and Young Adult Oncology. ISSN 2156-5333. 6(1), s. 120–126. doi: 10.1089/jayao.2016.0041. Fulltekst i vitenarkiv
• Halfdanarson, Oskar; Zoega, Helga; Aagaard, Lise; Bernardo, Miquel; Brandt, Lena & Fusté, Anna Coma [Vis alle 30 forfattere av denne artikkelen] (2017). International trends in antipsychotic use: A study in 16 countries, 2005–2014. European Neuropsychopharmacology. ISSN 0924-977X. 27(10), s. 1064–1076. doi: 10.1016/j.euroneuro.2017.07.001. Fulltekst i vitenarkiv
• Bachmann, Christian J; Aagaard, Lise; Bernardo, Miquel; Brandt, Lena; Cartabia, M & Clavenna, Antonio [Vis alle 34 forfattere av denne artikkelen] (2017). International trends in clozapine use: a study in 17 countries. Acta Psychiatrica Scandinavica. ISSN 0001-690X. 136(1), s. 37–51. doi: 10.1111/acps.12742. Fulltekst i vitenarkiv
• Brandlistuen, Ragnhild Eek; Ystrøm, Eivind; Hernandez-Diaz, Sonia; Skurtveit, Svetlana; Selmer, Randi & Handal, Marte [Vis alle 7 forfattere av denne artikkelen] (2017). Association of prenatal exposure to benzodiazepines and child internalizing problems: A sibling-controlled cohort study. PLOS ONE. 12(7). doi: 10.1371/journal.pone.0181042. Fulltekst i vitenarkiv Vis sammendrag

  Background: During pregnancy, many women experience sleep problems and anxiety that require treatment. The long-term safety for the child of maternal benzodiazepine (BZD) and z-hypnotic use during pregnancy remains controversial. Method: We conducted a cohort and a sibling control study using data from the Norwegian Mother and Child Cohort Study. Data on use of BZD and z-hypnotics, internalizing and externalizing outcomes, and covariates were collected from mothers at gestational weeks 17 and 30 and when children were 0.5, 1.5, and 3 years of age. The total sample consisted of 71,996 children (19,297 siblings) at 1.5 years and 55,081 children (13,779 siblings) at 3 years. Short-term use was defined as use in one pregnancy period only. Long-term use was defined as use in two or more pregnancy periods. Linear full cohort random-effect and sibling-matched fixed-effect regression models were used to compare internalizing and externalizing behavior in children prenatally exposed compared to those unexposed in the full cohort of pregnancies accounting for family clusters, as well as within sibling clusters comparing pregnancies with discordant exposures. Propensity score (PS) adjustment included variables on indication for use (sleep problems, symptoms of anxiety and depression) and other potential confounding factors. Results: Long-term prenatal exposure to BZD or z-hypnotics was associated with increased internalizing behavior in crude cohort analyses and at age 1.5 years after PS adjustment in sibling-matched fixed-effect models [β 0.60, 95% confidence interval 0.17–0.95]. Analyses on specific drug groups showed that prenatal exposure to BZD-anxiolytics was associated with increased internalizing problems at both 1.5 years [β 0.25, 0.01–0.49] and 3 years [β 0.26, 0.002–0.52] while exposure to z-hypnotics was not associated with any adverse outcomes after adjustment. Conclusion: The findings suggest a moderate association between BZD-anxiolytic exposure and child internalizing problems that is not likely due to stable familial confounding factors.

• Egeland, Grace M; Skurtveit, Svetlana; Sakshaug, Solveig; Daltveit, Anne Kjersti; Vikse, Bjørn Egil & Haugen, Margaretha (2017). Low calcium intake in midpregnancy is associated with hypertension development within 10 years after pregnancy: The Norwegian mother and Child cohort study. Journal of Nutrition. ISSN 0022-3166. 147(9), s. 1757–1763. doi: 10.3945/jn.117.251520. Fulltekst i vitenarkiv
• Muller, Ashley Elizabeth; Skurtveit, Svetlana & Clausen, Thomas (2017). Building abstinent networks is an important resource in improving quality of life. Drug and Alcohol Dependence. ISSN 0376-8716. 180, s. 431–438. doi: 10.1016/j.drugalcdep.2017.09.006. Fulltekst i vitenarkiv Vis sammendrag

  Aims: To investigate changes in social network and quality of life of a substance use disorder cohort as they progressed through treatment. Design: Multi-site, prospective, observational study of 338 adults entering substance use disorder treatment. Setting: Patients at 21 facilities across Norway contributed baseline data when they initiated treatment, and follow-up data was collected from them one year later. Methods: The cohort was divided into those who completed, dropped out, and remained in treatment one year after treatment initiation. For each treatment status group, general linear models with repeated measures analyzed global and social quality of life with the generic QOL10 instrument over time. The between-group factor was a change in social network variable from the EuropASI. Findings: Those who gained an abstinent network reported the largest quality of life improvements. Improvements were smallest or negligible for the socially isolated and those who were no longer in contact with the treatment system. Conclusions: Developing an abstinent network is particularly important to improve the quality of life of those in substance use disorder treatment. Social isolation is a risk factor for impaired quality of life throughout the treatment course.

• Skjærvø, Ingeborg; Skurtveit, Svetlana; Clausen, Thomas & Bukten, Anne (2017). Substance use pattern, self‐control and social network are associated with crime in a substance‐using population. Drug and Alcohol Review. ISSN 0959-5236. 36(2), s. 245–252. doi: 10.1111/dar.12406. Fulltekst i vitenarkiv Vis sammendrag

  Introduction and Aims: Crime rates are high in substance‐using populations; therefore, investigation of factors associated with crime in these populations is highly relevant. We describe crime prevalence and associations between crime, pattern of substance use and psychosocial factors, such as self‐control and social network. Design and Methods: This is a cross‐sectional study including substance users (n = 549; mean age 34 years; 27% women) entering treatment at 21 treatment centres across Norway (December 2012 to April 2015). Data on demographics, substance use, psychosocial variables and crime in the 6 months prior to treatment were obtained through interviews. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) were estimated through logistic regression. Results: Sixty‐four percent of participants had committed crime in the 6 months prior to treatment. Of these, 93% committed income‐generating crime. Several factors were associated with increased likelihood of having committed crime: use of stimulants (aOR = 1.82, 95% CI 1.04–3.17), use of a higher number of different substances (aOR = 1.16, 95% CI 1.04–1.31) and spending most of their time with family or friends using addictive substances (aOR = 2.38, 95% CI 1.10–5.16 and aOR = 2.22, 95% CI 1.32–3.73). Protective factors associated with decreased likelihood of committing crime were being older (aOR = 0.95, 95% CI 0.92–0.97) and having higher self‐control (aOR = 0.94, 95% CI 0.91–0.97). Discussion and Conclusions: Stimulant use, higher number of different substances used, lower self‐control, primarily a substance‐using social network and being younger were associated with crime in this substance‐using population. Treatment clinics should consider these risk factors for crime, and suitable interventions should be implemented and evaluated. This research has been published in Drug and Alcohol Review. © 2016 Wiley

• Rognli, Eline Borger; Bramness, Jørgen Gustav; Skurtveit, Svetlana & Bukten, Anne (2017). Substance use and sociodemographic background as risk factors for lifetime psychotic experiences in a non-clinical sample. Journal of Substance Abuse Treatment. ISSN 0740-5472. 74, s. 42–47. doi: 10.1016/j.jsat.2016.12.007. Fulltekst i vitenarkiv
• Mauseth, Siri Ann; Skurtveit, Svetlana; Langhammer, Arnulf & Spigset, Olav (2017). Incidence of and factors associated with anticholinergic drug use among Norwegian women with urinary incontinence. International Urogynecology Journal. ISSN 0937-3462. doi: 10.1007/s00192-017-3499-9. Fulltekst i vitenarkiv
• Bukten, Anne; Stavseth, Marianne Riksheim; Skurtveit, Svetlana; Tverdal, Aage; Strang, John & Clausen, Thomas (2017). High risk of overdose death following release from prison: variations in mortality during a 15-year observation period. Addiction. ISSN 0965-2140. 112(8), s. 1432–1439. doi: 10.1111/add.13803. Fulltekst i vitenarkiv Vis sammendrag

  Background and Aims: The time post-release from prison involves elevated mortality, especially overdose deaths. Variations in overdose mortality both by time since release from prison and time of release has not been sufficiently investigated. Our aims were to estimate and compare overdose death rates at time intervals after prison release and to estimate the effect on overdose death rates over calendar time. Design, Setting, Participants, Measurements: This 15-year cohort study includes all persons (n= 91,090) released from prison (01.01.2000 to 31.12.2014) obtained from the Norwegian prison registry, linked to the Norwegian Cause of Death Registry (2000-2014). All-cause and cause-specific mortality were examined during different time-periods following release: first week, second week, 3- 4 weeks and 2-6 months, and by three different time intervals of release. We calculated crude mortality rates (CMRs) per 1000 PY and estimated incidence rate ratios (IRR) by Poisson regression analysis adjusting for time intervals after prison release, release periods and time spent in prison. Findings: Overdose deaths accounted for 85% (n=123) of all deaths during the first week following release (n=145), with a peak during the two days immediately following release. Compared with week 1, the risk of overdose death was more than halved during week 2 (IRR 0.43; 95% CI, 0.31-0.59) and reduced to one-fifth in weeks 3-4 (IRR 0.22; 95% CI, 0.16-0.31). The risk of overdose mortality during the first 6 months post-release was almost twofold higher in 2000-2004 compared with 2005- 2009 (IRR 0.53; 95% CI, 0.43-0.65) and 2010-2014 (IRR 0.47; 95% CI, 0.37-0.59). The risk of overdose death was highest for those incarcerated for 3-12 months compared with those who were incarcerated for shorter or longer periods, and recidivism was associated with risk of overdose death. Conclusions: There is an elevated risk of death from drug overdose among people released from Norwegian prisons, peaking in the first week. The risk has reduced since 2000-2004 but is greatest for those serving 3-12 months compared with shorter or longer periods. This research has been published in Addiction. © 2017 Wiley

• Hoff, Mari; Meyer, Haakon E; Skurtveit, Svetlana; Langhammer, Arnulf; Søgaard, Anne-Johanne & Syversen, Unni [Vis alle 10 forfattere av denne artikkelen] (2017). Validation of FRAX and the impact of self-reported falls among elderly in a general population: the HUNT study, Norway. Osteoporosis International. ISSN 0937-941X. 28(10), s. 2935–2944. doi: 10.1007/s00198-017-4134-9. Fulltekst i vitenarkiv Vis sammendrag

  Summary Fracture Risk Assessment Tool (FRAX) without bone mineral density (BMD) for hip fracture prediction was validated in a Norwegian population 50–90 years. Fracture risk increased with higher FRAX score, and the observed number of hip fractures agreed well with the predicted number, except for the youngest and oldest men. Self-reported fall was an independent risk factor for fracture in women. Introduction The primary aim was to validate FRAX without BMD for hip fracture prediction in a Norwegian population of men and women 50–90 years. Secondary, to study whether information of falls could improve prediction of fractures in the subgroup aged 70–90 years. Methods Data were obtained from the third survey of the Nord-Trøndelag Health Study (HUNT3), the fracture registry in Nord-Trøndelag, and the Norwegian Prescription Database (NorPD), including 15,432 women and 13,585 men. FRAX hip without BMD was calculated, and hip fractures were registered for a median follow-up of 5.2 years. The number of estimated and observed fractures was assessed, ROC curves with area under the curve (AUC), and Cox regression analyses. For the group aged 70–90 years, self-reported falls the last year before HUNT3 were included in the Cox regression model. Results The risk of fracture increased with higher FRAX score. When FRAX groups were categorized in a 10-year percentage risk for hip fracture as follows, <4, 4–7.9, 8–11.9, and ≥12%, the hazard ratio (HR) for hip fracture between the lowest and the highest group was 17.80 (95% CI: 12.86–24.65) among women and 23.40 (13.93–39.30) in men. Observed number of hip fractures agreed quite well with the predicted number, except for the youngest and oldest men. AUC was 0.81 (0.78–0.83) for women and 0.79 (0.76–0.83) for men. Self-reported fall was an independent risk factor for fracture in women (HR 1.64, 1.20–2.24), and among men, this was not significant (1.09, 0.65–1.83). Conclusions FRAX without BMD predicted hip fracture reasonably well. In the age group 70–90 years, falls seemed to imply an additional risk among women.

• Evandt, Jorunn; Oftedal, Bente Margaret; Krog, Norun Hjertager; Skurtveit, Svetlana; Nafstad, Per & Schwarze, Per E [Vis alle 9 forfattere av denne artikkelen] (2017). Road traffic noise and registry based use of sleep medication. Environmental health. 16. doi: 10.1186/s12940-017-0330-5. Fulltekst i vitenarkiv Vis sammendrag

  Background Road traffic noise has been associated with adverse health effects including sleep disturbances. Use of sleep medication as an indicator of sleeping problems has rarely been explored in studies of the effects of traffic noise. Furthermore, using registry data on sleep medications provides an opportunity to study the effects of noise on sleep where attribution of sleep problems to noise is not possible. Methods We used questionnaire data from the population-based study Health and Environment in Oslo (HELMILO) (2009–10) (n = 13,019). Individual data on sleep medications was obtained from the Norwegian Prescription Database (NorPD). Noise levels (L night) were modeled for the most exposed façade of the building at each participant’s home address. Logistic regression models adjusted for potential confounders were used to analyze the association between traffic noise and sleep medication use both for one whole year and for the summer season. The results were reported as changes in the effect estimate per 5 decibel (dB) increase in noise level. Results We observed no association between traffic noise and sleep medication use during one year [odds ratio (OR) = 1.00; 95% confidence interval (CI): 0.96, 1.04]. For sleep medication use in the summer season, there was a positive, however non-significant association (OR = 1.04; 95% CI: 0.99, 1.10). Among individuals sleeping with the bedroom window open, the association increased slightly and was borderline statistically significant (OR = 1.06; 95% CI: 1.00, 1.12). Conclusions We found no evidence of an association between traffic noise and sleep medication use during one year. However, for the summer season, there was some suggestive evidence of an association. These findings indicate that season may play a role in the association between traffic noise and sleep, possibly because indoor traffic noise levels are likely to be higher during summer due to more frequent window opening. More studies are, however, necessary in order to confirm this.

• Sakshaug, Solveig; Handal, Marte; Hjellvik, Vidar; Berg, Christian Lie; Ripel, Åse & Gustavsen, Ingebjørg G. [Vis alle 8 forfattere av denne artikkelen] (2017). Long-term Use of Z-Hypnotics and Co-Medication with Benzodiazepines and Opioids. Basic & Clinical Pharmacology & Toxicology. ISSN 1742-7835. 120, s. 292–298. doi: 10.1111/bcpt.12684. Fulltekst i vitenarkiv
• Skovlund, Eva; Handal, Marte; Selmer, Randi; Brandlistuen, Ragnhild Eek & Skurtveit, Svetlana (2017). Language competence and communication skills in 3-year-old children after prenatal exposure to analgesic opioids. Pharmacoepidemiology and Drug Safety. ISSN 1053-8569. 26(6), s. 625–634. doi: 10.1002/pds.4170. Fulltekst i vitenarkiv Vis sammendrag

  Purpose An increasing consumption of opioids in the general population has been reported in several countries also among pregnant women. Limited information is available regarding the effect of prenatal exposure to analgesic opioids on long-term neurocognitive function in children. The primary aim of the study was to determine the association between prenatal exposure to analgesic opioids and language competence and communication skills at 3 years of age. Methods The Norwegian Mother and Child Cohort Study (MoBa) prospectively included pregnant women during the period from 1999 to 2008. Participants reported medication use at pregnancy weeks 17–18 and 30, and 6 months after birth. Children's language competence and communication skills were reported by mothers on validated scales. Results A total of 45 211 women with 51 679 singleton pregnancies were included. The use of analgesic opioids was reported in 892 pregnancies (1.7%). In adjusted analyses, no association between opioid use and reduced language competence or communication skills was found, OR = 1.04 (95%CI: 0.89–1.22) and OR = 1.10 (95%CI: 0.95–1.27), respectively. Both pain and use of paracetamol were associated with a small reduction in communication skills. No such association was found for language competence. Conclusion The use of analgesic opioids in pregnant women does not seem to affect language development or communication skills in children at 3 years of age. Copyright © 2017 John Wiley & Sons, Ltd.

• Fredheim, Olav Magnus Søndenå; Brelin, Siri; Hjermstad, Marianne Jensen; Loge, Jon Håvard; Aass, Nina Kathrine & Johannessen, Tom Børge [Vis alle 7 forfattere av denne artikkelen] (2017). Prescriptions of analgesics during complete disease trajectories in patients who are diagnosed with and die from cancer within the five-year period 2005-2009. European Journal of Pain. ISSN 1090-3801. 21(3), s. 530–540. doi: 10.1002/ejp.956. Fulltekst i vitenarkiv
• Gjersing, Linn Renathe; Vinge-Holmquist, Kristine; Skurtveit, Svetlana; Bramness, Jørgen Gustav & Clausen, Thomas (2017). Emergency service use is common in the year before death among drug users who die from an overdose. Journal of Substance Use. ISSN 1465-9891. 22(3), s. 331–336. doi: 10.1080/14659891.2016.1208778. Fulltekst i vitenarkiv
• Fredheim, Olav Magnus; Skurtveit, Svetlana & Borchgrevink, Petter Chr. (2017). Utlevering av analgetika til barn f?r og etter nye anbefalinger om kodein. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 137(12). doi: 10.4045/tidsskr.16.0717. Fulltekst i vitenarkiv
• Engeland, Anders; Bjørge, Tone; Klungsøyr, Kari; Skurtveit, Svetlana & Furu, Kari (2017). Preterm births and use of medication in early adulthood: a population-based registry study. Pharmacoepidemiology and Drug Safety. ISSN 1053-8569. 26(7), s. 742–751. doi: 10.1002/pds.4174. Fulltekst i vitenarkiv
• Hartz, Ingeborg; Skurtveit, Svetlana; Steffenak, Anne Kjersti Myhrene; Karlstad, Øystein & Handal, Marte (2016). Psychotropic drug use among 0-17 year olds during 2004-2014: a nationwide prescription database study. BMC Psychiatry. 16(1). doi: 10.1186/s12888-016-0716-x. Fulltekst i vitenarkiv Vis sammendrag

  Background Time-trend studies on psychotropic drugs among children and adolescents are scarce, and most of them are outdated. The purpose of this study was to study prevalences of psychotropic drug use during 2004–2014 among Norwegians aged <18 years, overall and in psychotropic sub-groups. Methods Data were obtained from the Norwegian Prescription Database, which covers all dispensed prescription drugs in Norway from 2004 and onwards. Psychotropic drugs included: antipsychotics (ATC-group N05A), anxiolytics (N05B), hypnotic/sedatives (N05C), antidepressants (N06A), stimulants (N06BA), and alimemazine (R06AD01). Period (1-year) prevalence of use, overall and in subgroups of psychotropic drugs, was estimated by identifying individuals <18 years who had at least one psychotropic drug dispensed during each year. Results Psychotropic drug use increased in 0–17 year olds over an 11-year period, in which the main contributing drugs were stimulants (boys overall; 15.0 to 20.8/1000, girls overall; 3.8 to 8.5/1000), hypnotic/sedative drugs in adolescents (boys overall; 4.2 to 10.8/1000, girls overall; 2.6 to 8.8/1000) and to some extent antidepressants among adolescent girls (girls overall from 3.1 to 4.0/1000). Psychotropic drug use was, however, reduced by half in the youngest children, attributed to reduction of alimemazine only (1-year olds: boys; from 36.6 to 10.2/1000, girls; 26.9 to 7.2/1000). A higher level of psychotropic drug use was observed among younger boys, but there is a shift towards girls using more psychotropic drugs than boys during adolescence for all psychotropic drugs except for stimulants. Conclusion Different trends in psychotropic drug use exist in age and gender subgroups. Psychotropic drug use has decreased among the youngest children, attributed to alimemazine, and increased in older children and adolescents, attributed mainly to stimulants and hypnotics/sedatives.

• Gabrhelik, Roman; Nechanska, Blanka; Mravcik, Viktor; Skurtveit, Svetlana; Lund, Ingunn Olea & Handal, Marte (2016). A unique opportunity to study shortand long-term consequences in children prenatally exposed to illicit drugs and opioid maintenance treatment using czech and scandinavian registers. Central European Journal of Public Health. ISSN 1210-7778. 24(3), s. 248–251. doi: 10.21101/cejph.a4474. Fulltekst i vitenarkiv
• Nesvåg, Ragnar; Hartz, Ingeborg; Bramness, Jørgen Gustav; Hjellvik, Vidar; Handal, Marte & Skurtveit, Svetlana (2016). Mental disorder diagnoses among children and adolescents who use antipsychotic drugs. European Neuropsychopharmacology. ISSN 0924-977X. 26(9), s. 1412–1418. doi: 10.1016/j.euroneuro.2016.07.001. Fulltekst i vitenarkiv Vis sammendrag

  Antipsychotic drugs are used increasingly by children and adolescents and there is concern about offlabel use. We aimed to study which substances, and for which mental disorder diagnoses, antipsychotic drugs were prescribed to 0–18-year-old boys and girls in Norway. Linked data from the national health registry for prescription drugs in 2010 and mental disorder diagnoses in 2008–2012 were used to study the prevalence of antipsychotic drug use, the type of antipsychotic drug substances used, mental disorder diagnoses in users and distribution of drugs per diagnostic category across gender. In total, 0.18% of Norwegian children and adolescents were prescribed antipsychotic drugs during 2010, of which there were more boys (0.23%) than girls (0.13%). Risperidone was the most frequently used substance among boys (57.4%) and girls (32.3%), followed by aripiprazole (19.4%) in boys and quetiapine (27.4%) in girls. The most common mental disorder diagnoses among male users were hyperkinetic (49.9%) and autism spectrum disorder (27.1%), while anxiety disorders (41.5%) and depressive illness (33.6%) were most common among female users. A schizophrenia-like psychosis diagnosis was given to 11.1% of the male and 18.2% of the female users. A hyperkinetic disorder was diagnosed among 56.9% and 52.4% of the male risperidone and aripiprazole users, respectively. Among female quetiapine users, 57.1% were diagnosed with anxiety disorders and 52.4% with depressive illness. These results demonstrate that children and adolescents who use antipsychotic drugs are predominantly diagnosed with non-psychotic mental disorders such as hyperkinetic disorder among boys and anxiety disorder or depressive illness among girls.

• Muller, Ashley; Skurtveit, Svetlana & Clausen, Thomas (2016). Many correlates of poor quality of life among substance users entering treatment are not addiction-specific. Health and Quality of Life Outcomes. 14. doi: 10.1186/s12955-016-0439-1. Fulltekst i vitenarkiv Vis sammendrag

  Background Quality of life (QoL) is an important measure and outcome within chronic disease management and treatment, including substance use disorders (SUD). The aim of this paper was to investigate correlates of poorer QoL of individuals entering SUD treatment in Norway, in order to identify subgroups that may most benefit from different interventions. Methods Twenty-one treatment facilities invited all incoming patients to participate. Five hundred forty-nine patients who enrolled between December 2012 and April 2015 are analyzed. QoL, substance use, mental and physical comorbidities, and exercise behaviors were measured. Multinomial regression analysis was used to determine variables significantly associated with poorer QoL. Results The majority of both genders (75 %) reported “poor” or “very poor” QoL at intake. Depression showed a strong association with poor QoL (relative risk ratio [RRR] 3.3, 95 % confidence interval [CI] 1.0–10.3) and very poor QoL (RRR 3.8, 1.2–11.8) among women. Physical inactivity among men was associated with very poor QoL (RRR 2.0, 1.1–3.7), as was reporting eating most meals alone (RRR 2.6, 1.4–4.8). Evaluating one’s weight as too low was also associated with poor QoL (RRR 2.0, 1.0-3.9) and very poor QoL (RRR 2.0, 1.1–3.7) among men. Consuming methadone/buprenorphine was a protective factor for men reporting poor QoL (RRR 0.5, 0.3–0.9) and very poor QoL (RRR 0.4, 0.2–0.9), as well as for women reporting very poor QoL (RRR 0.2, 0.0–0.6). Conclusions Factors associated with poorer QoL among other healthy and clinical populations, such as impaired social and physical well-being and psychological distress, were also seen associated in this sample. Treatment should be targeted towards patients with these particular vulnerabilities in addition to focusing on substance-related factors, and interventions proven to improve the QoL of other populations with these vulnerabilities should be explored in a SUD context.

• Handal, Marte; Skurtveit, Svetlana; Furu, Kari; Hernandez-Diaz, S; Skovlund, Eva & Nystad, Wenche [Vis alle 7 forfattere av denne artikkelen] (2016). Motor development in children prenatally exposed to selective serotonin reuptake inhibitors: a large population-based pregnancy cohort study. BJOG: An International Journal of Obstetrics and Gynaecology. ISSN 1470-0328. 123(12), s. 1908–1917. doi: 10.1111/1471-0528.13582. Fulltekst i vitenarkiv
• Hartz, Ingeborg; Skurtveit, Svetlana; Hjellvik, Vidar; Furu, Kari; Nesvåg, Ragnar & Handal, Marte (2016). Antidepressant drug use among adolescents during 2004–2013: a population-based register linkage study. Acta Psychiatrica Scandinavica. ISSN 0001-690X. 134(5), s. 420–429. doi: 10.1111/acps.12633. Fulltekst i vitenarkiv Vis sammendrag

  Objective: To study trends in use of antidepressants (ADs) by adolescents, and psychiatric morbidity and use of other psychotropic drugs as a measure of psychiatric comorbidity. Methods: One-year prevalence of AD drug use was analyzed for 13- to 17-year-old Norwegians during 2004–2013. Use of other psychotropic drugs and specialist healthcare services was analyzed for incident AD users in 2012, using linked data from the Norwegian Prescription Database and the Norwegian Patient Register. Results: The 1-year prevalence of AD drug use increased from 6.4/1000 to 9.1/1000 during 2004–2013, with the steepest increase from 2010, particularly among girls. The highest prevalence was found in 17-yearold girls (17.8/1000 in 2010, 27.5/1000 in 2013). Of incident AD drug users in 2012, 84.4% had been in contact with specialist health care. As the first drug, 78.4% were prescribed a selective serotonin reuptake inhibitor. The most common types of other psychotropic drugs were melatonin (24.6%), antipsychotic drugs (13.2%), stimulants (8.8%), and anxiolytics (6.0%). Conclusions: Use of ADs among adolescents has increased over the last 3–4 years, particularly among 16- to 17-year-old girls. A total of 85% of incident users had been in contact with specialist health care, which may indicate that drug-therapy is used by adolescents with more severe symptoms.

• Tjagvad, Christian; Clausen, Thomas; Handal, Marte & Skurtveit, Svetlana (2016). Benzodiazepine prescription for patients in treatment for drug use disorders: A nationwide cohort study in Denmark, 2000-2010. BMC Psychiatry. 16(1). doi: 10.1186/s12888-016-0881-y. Fulltekst i vitenarkiv Vis sammendrag

  Background Benzodiazepines are frequently prescribed to patients with drug use disorders. However, it has previously been difficult to distinguish whether this frequent prescribing was due to underlying psychiatric disorders or inappropriate prescribing. In a nationwide cohort study, we investigated the prescribing of benzodiazepines to patients with drug use disorders in connection with treatment admission. Methods Benzodiazepine prescriptions to patients (N = 33203) aged 18 to 67 years admitting for outpatient treatment for drug use disorders in Denmark, 2000 to 2010, were studied by using linked data from nationwide health registries. Factors associated with increasing amounts of benzodiazepine use within the first year after admission were assessed by multinomial logistic regression. Proportions of very long-term benzodiazepine prescription were calculated. Results During the first year after admission to treatment, 26.2 % of patients were prescribed benzodiazepines. Of these, 35.5 % were prescribed benzodiazepines at dose levels that might indicate inappropriate use (>365 Defined Daily Dose per year), and 34.6 % were prescribed more than one type of benzodiazepines. Diazepam was the most commonly prescribed type. Among patients with opioid use, 43.2 % were prescribed benzodiazepines which were three times higher than for patients with cannabis (12.2 %) or central stimulating drugs (13.8 %) as their primary drug use. Admitting to treatment for a drug use disorder did not increase the specialized psychiatric treatment coverage of this patient group, disregarding use of prescribed benzodiazepines. 29.5 % were new users of prescribed benzodiazepines, and of these, 27.5 % continued into very long-term use (≥4 years after admission) during the study period. Conclusions Benzodiazepines were commonly prescribed to patients admitting to treatment for drug use disorders, and included prescription of multiple and non-optimal types, high doses, and very long-term prescriptions. These findings point towards inappropriate prescribing of benzodiazepines in many cases more than treatment for psychiatric disorders.

• Tjagvad, Christian; Skurtveit, Svetlana; Linnet, Kristian; Andersen, Ljubica Vukelic; Christoffersen, Dorte J. & Clausen, Thomas (2016). Methadone-related overdose deaths in a liberal opioid maintenance treatment program. European Addiction Research. ISSN 1022-6877. 22(5), s. 249–258. doi: 10.1159/000446429. Fulltekst i vitenarkiv
• Tjagvad, Christian; Skurtveit, Svetlana; Bramness, Jørgen Gustav; Gjersing, Linn Renathe; Gossop, Michael & Clausen, Thomas (2016). Misuse of prescription drugs and overdose deaths. Journal of Substance Use. ISSN 1465-9891. 21(5), s. 515–520. doi: 10.3109/14659891.2015.1077280. Fulltekst i vitenarkiv
• Midgard, Håvard; Bramness, Jørgen Gustav; Skurtveit, Svetlana; Haukeland, John Willy & Dalgard, Olav (2016). Hepatitis C Treatment Uptake among Patients Who Have Received Opioid Substitution Treatment: A Population-Based Study. PLOS ONE. 11(11). doi: 10.1371/journal.pone.0166451. Fulltekst i vitenarkiv Vis sammendrag

  Background and Aims There is limited data on hepatitis C (HCV) treatment uptake among people who inject drugs including individuals receiving opioid substitution treatment (OST). We aimed to calculate cumulative HCV treatment uptake, estimate annual treatment rates, and identify factors associated with HCV treatment among individuals who have received OST in Norway. Methods This observational study was based on linked data from The Norwegian Prescription Database and The Norwegian Surveillance System for Communicable Diseases between 2004 and 2013. Both registries have national coverage. From a total of 9919 individuals who had been dispensed OST (methadone, buprenorphine or buprenorphine-naloxone), we included 3755 individuals who had been notified with HCV infection. In this population, dispensions of HCV treatment (pegylated interferon and ribavirin), benzodiazepines, selective serotonin reuptake inhibitors and antipsychotics were studied. Results Among 3755 OST patients notified with HCV infection, 539 (14%) had received HCV treatment during the study period. Annual HCV treatment rates during OST ranged between 1.3% (95% confidence interval [CI] 0.7-2.2) in 2005 and 2.6% (95% CI 1.9-3.5) in 2008 with no significant changes over time. HCV treatment uptake was not associated with age or gender, but associated with duration of active OST (adjusted odds ratio [aOR] 1.11 per year; 95% CI 1.07-1.15), high (> 80%) OST continuity (aOR 1.62; 95% CI 1.17-2.25), and heavy benzodiazepine use (aOR 0.65; 95% CI 0.49-0.87). Conclusions Cumulative HCV treatment uptake among OST patients notified with HCV infection in Norway between 2004 and 2013 was 14%. Annual treatment rates during OST remained unchanged below 3% per year. High continuity of OST over time and absence of heavy benzodiazepine use predicted HCV treatment uptake. Increased awareness for HCV among OST patients is needed as tolerable and efficient directly acting antiviral treatment is being introduced.

• Mellbye, Andreas; Borchgrevink, Petter Chr.; Skurtveit, Svetlana & Fredheim, Olav Magnus (2016). Hva vet vi om bruken av opioider ved ikke-malign smerte? : resultater fra studier basert på Reseptregisteret 2004-2014. Norsk Farmaceutisk Tidsskrift (NFT). ISSN 0029-1935. 124(3), s. 25–30. Fulltekst i vitenarkiv
• Muller, Ashley; Skurtveit, Svetlana & Clausen, Thomas (2016). Validating the generic quality of life tool "QOL10" in a substance use disorder treatment cohort exposes a unique social construct. BMC Medical Research Methodology. 16. doi: 10.1186/s12874-016-0163-x. Fulltekst i vitenarkiv Vis sammendrag

  Background Generic quality of life (QoL) instruments provide important measures of self-reported wellbeing that can be compared across healthy and clinical populations. The aim of this analysis is to validate the ten-item QoL instrument “QOL10”, as well as to confirm the validity of the embedded “QOL5” questionnaire and single-item “QOL1” in measuring overall QoL among adults in a substance use disorder treatment study. Methods We used exploratory factor analysis and measured internal and convergent validity of the QOL10 against the gold standard measure of the WHOQOL-BREF, in a subsample of 107 participants in a substance use disorder treatment study. Results The QOL10 displayed internal and convergent validity to the gold standard measure. Factor analysis revealed a two-factor structure that can be interpreted as “social QoL”, containing items about relationships and social functioning, and “global QoL”, comprised of items about health, working ability, self-evaluation, and an overall QoL estimation. Conclusions The QOL10 provides clinically useful and valid measures of social-related QoL and global QoL via two subscales. Interestingly, the QOL10’s social QoL measure, from the current sample, had little relationship to the analyzed groups previously reported to have differential global QoL: social QoL appears to be not only conceptually distinct from global QoL, but also to be less influenced by typical substance- and treatment-specific factors.

• Mellbye, Andreas; Karlstad, Øystein; Skurtveit, Svetlana; Borchgrevink, Petter Chr. & Fredheim, Olav Magnus (2016). The duration and course of opioid therapy in patients with chronic non-malignant pain. Acta Anaesthesiologica Scandinavica. ISSN 0001-5172. 60(1), s. 128–137. doi: 10.1111/aas.12594. Fulltekst i vitenarkiv
• Brelin, Siri; Fredheim, Olav Magnus; Loge, Jon Håvard; Skurtveit, Svetlana; Johannesen, Tom Børge & Aass, Nina Kathrine [Vis alle 8 forfattere av denne artikkelen] (2016). Opioids for outpatients with cancer in their last year of life: A nationwide pharmacoepidemiological study. Journal of Opioid Management. ISSN 1551-7489. 12(1), s. 25–36. doi: 10.5055/jom.2016.0309. Fulltekst i vitenarkiv
• Handal, Marte; Skurtveit, Svetlana; Roth, Christine; Hernandez-Diaz, Sonia & Selmer, Randi (2016). Prenatal Exposure to Folic Acid and Antidepressants and Language Development: A Population-Based Cohort Study. Journal of Clinical Psychopharmacology. ISSN 0271-0749. 36(4). doi: 10.1097/JCP.0000000000000519. Fulltekst i vitenarkiv
• Engeland, Anders; Bjørge, Tone; Klungsøyr, Kari; Skjaerven, Rolv; Skurtveit, Svetlana & Furu, Kari (2015). Preeclampsia in pregnancy and later use of antihypertensive drugs. European Journal of Epidemiology (EJE). ISSN 0393-2990. 30(6), s. 501–508. doi: 10.1007/s10654-015-0018-5. Fulltekst i vitenarkiv Vis sammendrag

  We explored the association between preeclampsia and later use of antihypertensive drugs in a population-based study with data from the Medical Birth Registry of Norway and the Norwegian Prescription Database. The study cohort consisted of 980,000 women having 2.1 million pregnancies during 1967–2012. Hazard ratios (HRs) with 95 % confidence intervals (95 % CI) were estimated in multivariate time-dependent Cox proportional hazards regression models. Overall, the HR of later use of antihypertensive drugs was 2.0 (95 % CI 2.0–2.0) in women with one preeclamptic pregnancy compared to women without preeclamptic pregnancies. The HR increased by increasing number of preeclamptic pregnancies, both term and preterm pregnancies. In women with two or more preeclamptic pregnancies, the HR was 2.8 (2.7–3.0). The overall HR after 40 years of follow-up for women with one preeclamptic pregnancy was 1.3 (1.2–1.4) and for two or more preeclamptic pregnancies the HR was 1.6 (1.1–2.1). The first 5 years after the first birth, the HR of being dispensed antihypertensive drugs was higher in preterm [8.4 (7.7–9.1)] than term preeclamptic pregnancies [4.3(4.0–4.6)]. However, after 10 years, this difference was no longer present. The HR of later use of antihypertensive drugs increased with the number of preeclamptic pregnancies, and in the first 10 years the HR was higher after a preterm than a term preeclamptic pregnancy. Although the HR decreased with time since first birth, the risk was still elevated after 40 years.

• Fredheim, Olav Magnus; Mahic, Milada; Skurtveit, Svetlana & Borchgrevink, Petter Chr. (2015). Use of nasal fentanyl for cancer pain: A pharmacoepidemiological study. Palliative Medicine. ISSN 0269-2163. 29(7), s. 661–666. doi: 10.1177/0269216315575252. Fulltekst i vitenarkiv
• Dale, Ola; Borchgrevink, Petter Chr.; Fredheim, Olav Magnus; Mahic, Milada; Romundstad, Pål Richard & Skurtveit, Svetlana (2015). Prevalence of use of non-prescription analgesics in the Norwegian HUNT3 population: Impact of gender, age, exercise and prescription of opioids. BMC Public Health. 15(461). doi: 10.1186/s12889-015-1774-6. Fulltekst i vitenarkiv Vis sammendrag

  Background: There are concerns about potential increasing use of over-the-counter (OTC) analgesics. The aims of this study were to examine 1) the prevalence of self-reported use of OTC analgesics; 2) the prevalence of combining prescription analgesics drugs with OTC analgesics and 3) whether lifestyle factors such as physical activity were associated with prevalence of daily OTC analgesic use. Methods: Questionnaire data from the Nord–Trøndelag health study (HUNT3, 2006–08), which includes data from 40,000 adult respondents. The questionnaire included questions on use of OTC analgesics, socioeconomic conditions, health related behaviour, symptoms and diseases. Data were linked to individual data from the Norwegian Prescription Database. A logistic regression was used to investigate the association between different factors and daily use of paracetamol and/or non-steroid anti-inflammatory drugs (NSAIDs) in patients with and without chronic pain. Results: The prevalence of using OTC analgesics at least once per week in the last month was 47%. Prevalence of paracetamol use was almost 40%, compared to 19% and 8% for NSAIDs and acetylsalicylic acid (ASA), respectively. While the use of NSAIDs decreased and the use of ASA increased with age, paracetamol consumption was unaffected by age. Overall more women used OTC analgesics. About 3-5% of subjects using OTC analgesics appeared to combine these with the same analgesic on prescription. Among subjects reporting chronic pain the prevalence of OTC analgesic use was almost twice as high as among subjects without chronic pain. Subjects with little physical activity had 1.5-4 times greater risk of daily use of OTC compared to physically active subjects. Conclusions: Use of OTC analgesics is prevalent, related to chronic pain, female gender and physical inactivity.

• Lund, Ingunn Olea; Skurtveit, Svetlana & Handal, Marte (2015). Commentary on Raitasalo et al. (2015): The great potential in nation-wide registers to study prescription drug use and abuse. Addiction. ISSN 0965-2140. 110(4), s. 644–645. doi: 10.1111/add.12856. Fulltekst i vitenarkiv
• Lund, Ingunn Olea; Bukten, Anne; Storvoll, Elisabet; Moan, Inger Synnøve; Skurtveit, Svetlana & Handal, Marte [Vis alle 9 forfattere av denne artikkelen] (2015). A cohort study on long-term adverse effects of parental drinking: Background and study design. Substance Abuse: Research and Treatment. 9, s. 77–83. doi: 10.4137/SART.S23329. Fulltekst i vitenarkiv Vis sammendrag

  Although many studies have addressed adverse outcomes in children of parents with alcohol abuse/dependence, less is known about the possible long-term effects of more normative patterns of parental alcohol consumption, including drinking at lower risk levels and heavy episodic or binge drinking. The extent of harm from parental drinking may therefore be underestimated. With this research proposal, we describe a project that aims to assess possible long-term adverse effects of parental drinking by combining survey and nationwide registry data. Advantages of a longitudinal general population cohort design include that it allows for detailed information on parental drinking through survey data and identification of possible negative long-term health and social outcomes from exposure to parental drinking 1–19 years after exposure through continuously updated nationwide registers. The rich information available from combining survey and registry data allows us to take into account important confounders, mediators, and moderators.

• Bukten, Anne; Lund, Ingunn Olea; Rognli, Eline Borger; Riksheim, Marianne; Lobmaier, Philipp Paul & Skurtveit, Svetlana [Vis alle 8 forfattere av denne artikkelen] (2015). The Norwegian offender mental health and addiction study – Design and implementation of a national survey and prospective cohort study. Substance Abuse: Research and Treatment. 9, s. 59–66. doi: 10.4137/SART.S23546. Fulltekst i vitenarkiv Vis sammendrag

  The Norwegian prison inmates are burdened by problems before they enter prison. Few studies have managed to assess this burden and relate it to what occurs for the inmates once they leave the prison. The Norwegian Offender Mental Health and Addiction (NorMA) study is a large-scale longitudinal cohort study that combines national survey and registry data in order to understand mental health, substance use, and criminal activity before, during, and after custody among prisoners in Norway. The main goal of the study is to describe the criminal and health-related trajectories based on both survey and registry linkage information. Data were collected from 1,499 inmates in Norwegian prison facilities during 2013–2014. Of these, 741 inmates provided a valid personal identification number and constitute a cohort that will be examined retrospectively and prospectively, along with data from nationwide Norwegian registries. This study describes the design, procedures, and implementation of the ongoing NorMA study and provides an outline of the initial data.

• Handal, Marte; Sakshaug, Solveig; Hjellvik, Vidar; Berg, Christian Lie & Skurtveit, Svetlana (2015). Kjønnsforskjeller i bruk av vanedannende legemidler i Norge. Norsk Farmaceutisk Tidsskrift (NFT). ISSN 0029-1935. 123(4), s. 27–31. Fulltekst i vitenarkiv
• Hartz, Ingeborg; Handal, Marte; Tverdal, Aage & Skurtveit, Svetlana (2015). Paediatric Off-Label Use of Melatonin – A Register Linkage Study between the Norwegian Prescription Database and Patient Register. Basic & Clinical Pharmacology & Toxicology. ISSN 1742-7835. 117(4), s. 267–273. doi: 10.1111/bcpt.12411. Fulltekst i vitenarkiv Vis sammendrag

  The aims were, for the entire Norwegian population aged 4–17 years, to study the prevalence of melatonin use during 2004–2012, recurrent use in incident users and psychiatric and neurological morbidity in recurrent users. Data on dispensed melatonin were retrieved from the Norwegian Prescription Database and linked to diagnostic data from the Norwegian Patient Register. Outcome measures were the following: 1-year prevalence of use, proportion of recurrent use (use over three consecutive 365-day periods among incident users in 2009) and annual number of milligrams and number of prescriptions dispensed in recurrent users. The prevalence of registered ICD-10 diagnoses during the period of 2008–2012 was given for the recurrent users. The prevalence of melatonin use increased annually in both genders during 2004–2012 (boys: 3.4–11.0 per 1000; girls: 1.5–7.7 per 1000). Twenty-nine per cent of boys and 23% of girls were recurrent melatonin users, with highest level of recurrent use among the youngest (aged 4–8 years; boys: 47%, girls: 42%). In the third year, the median annual amount of melatonin dispensed was 1080 (IQR 586–1800) milligrams in boys and 900 (IQR 402–1620) milligrams in girls. Among recurrent users, 91% had a diagnosis of either psychiatric (84%) or neurological (32%) disorder. Off-label recurrent use of melatonin seems to have acquired a role mainly in treating secondary sleep problems in children and adolescents with psychiatric and neurological disorders. Once melatonin has been started, a large proportion of patients continue for at least 3 years, in doses corresponding to daily use in the majority.

• Odsbu, Ingvild; Skurtveit, Svetlana; Selmer, Randi; Roth, Christine; Hernandez-Diaz, Sonia & Handal, Marte (2015). Prenatal exposure to anxiolytics and hypnotics and language competence at 3 years of age. European Journal of Clinical Pharmacology. ISSN 0031-6970. 71(3), s. 283–291. doi: 10.1007/s00228-014-1797-4. Fulltekst i vitenarkiv
• Hoff, Mari; Skurtveit, Svetlana; Meyer, Haakon E; Langhammer, Arnulf; Søgaard, Anne-Johanne & Syversen, Unni [Vis alle 8 forfattere av denne artikkelen] (2015). Use of anti-osteoporotic drugs in central Norway after a forearm fracture. Archives of Osteoporosis. ISSN 1862-3522. 10. doi: 10.1007/s11657-015-0235-2. Fulltekst i vitenarkiv
• Welle-Strand, Gabrielle; Skurtveit, Svetlana; Tanum, Lars; Waal, Helge; Bakstad, Brittelise & BJARKØ, LISA [Vis alle 7 forfattere av denne artikkelen] (2015). Tapering from methadone or buprenorphine during pregnancy: maternal and neonatal outcomes in Norway 1996-2009. European Addiction Research. ISSN 1022-6877. 21(5), s. 253–261. doi: 10.1159/000381670. Fulltekst i vitenarkiv Vis sammendrag

  Background: The tapering of methadone or buprenorphine during pregnancy is an understudied and controversial issue. The aim of this study was to determine to what extent women tapered their opioid medication dose during pregnancy and what the neonatal outcomes were for those who tapered compared to the women who did not. Methods: The study was a mixed prospective/retrospective national cohort study of 123 Norwegian women in opioid maintenance treatment (OMT) during pregnancy and their neonates. A standardized questionnaire was administered to the women and medical information that could be used for verification was collected from hospitals and municipalities. Results: Two of the women came off the OMT-medication during pregnancy and another 15% tapered their OMT-medication dose more than 50%. The birth weights of methadone-exposed neonates of the women who tapered more than 50% were significantly higher than for the methadone-exposed neonates of the women tapering between 11 and 50%. No other significant differences were found. Conclusion: Pregnant women in OMT who taper their OMT-medication dose should be monitored closely. We need studies that document the maternal well-being and fetal safety of maternal tapering of the OMT-medication during pregnancy. This is the peer-reviewed but unedited manuscript version of the following article: Tapering from Methadone or Buprenorphine during Pregnancy: Maternal and Neonatal Outcomes in Norway 1996-2009. Welle-Strand GK, Skurtveit S, Tanum L, Waal H, Bakstad B, Bjarkø L, Ravndal E. Eur Addict Res. 2015;21(5):253-61. The final, published version is available at http://www.karger.com/?doi=10.1159/000381670

• Hansen, Anneli Borge; Skurtveit, Svetlana; Borchgrevink, Petter Chr.; Dale, Ola; Romundstad, Pål Richard & Mahic, Milada [Vis alle 7 forfattere av denne artikkelen] (2015). Consumption of and satisfaction with health care among opioid users with chronic non-malignant pain. Acta Anaesthesiologica Scandinavica. ISSN 0001-5172. 59(10), s. 1355–1366. doi: 10.1111/aas.12568. Fulltekst i vitenarkiv
• Riska, Solvor; Skurtveit, Svetlana; Furu, Kari; Engeland, Anders & Handal, Marte (2014). Dispensing of benzodiazepines and benzodiazepine-related drugs to pregnant women: a population-based cohort study. European Journal of Clinical Pharmacology. ISSN 0031-6970. 70(11), s. 1367–1374. doi: 10.1007/s00228-014-1744-4. Fulltekst i vitenarkiv
• Mellbye, Andreas; Karlstad, Øystein; Skurtveit, Svetlana; Borchgrevink, Petter Chr. & Fredheim, Olav Magnus (2014). Co-morbidity in persistent opioid users with chronic non-malignant pain in Norway. European Journal of Pain. ISSN 1090-3801. 18(8), s. 1083–1093. doi: 10.1002/j.1532-2149.2014.00449.x. Fulltekst i vitenarkiv
• Skurtveit, Svetlana; Selmer, Randi; Odsbu, Ingvild & Handal, Marte (2014). Self-reported data on medicine use in the Norwegian mother and child cohort study compared to data from the Norwegian prescription database. Norsk Epidemiologi. ISSN 0803-2491. 24(1-2), s. 209–216. doi: 10.5324/nje.v24i1-2.1824. Fulltekst i vitenarkiv
• Mahic, Milada; Fredheim, Olav Magnus; Borchgrevink, Petter Chr. & Skurtveit, Svetlana (2014). Use of prescribed opioids by children and adolescents: Differences between Denmark, Norway and Sweden. European Journal of Pain. ISSN 1090-3801. 19(8), s. 1095–1100. doi: 10.1002/ejp.632. Fulltekst i vitenarkiv
• Fredheim, Olav Magnus; Mahic, Milada; Skurtveit, Svetlana; Dale, Ola; Romundstad, Pål Richard & Borchgrevink, Petter Chr. (2014). Chronic pain and use of opioids: A population-based pharmacoepidemiological study from the Norwegian Prescription Database and the Nord-Trøndelag Health Study. Pain. ISSN 0304-3959. 155(7), s. 1213–1221. doi: 10.1016/j.pain.2014.03.009. Fulltekst i vitenarkiv
• Svendsen, Kristian; Fredheim, Olav Magnus; Romundstad, Pål Richard; Borchgrevink, Petter Chr. & Skurtveit, Svetlana (2014). Persistent opioid use and socio-economic factors: A population-based study in Norway. Acta Anaesthesiologica Scandinavica. ISSN 0001-5172. 58(4), s. 437–445. doi: 10.1111/aas.12281. Fulltekst i vitenarkiv
• Karlstad, Øystein; Furu, Kari; Skurtveit, Svetlana & Selmer, Randi (2014). Prescribing of drugs for attention-deficit hyperactivity disorder in opioid maintenance treatment patients in Norway. European Addiction Research. ISSN 1022-6877. 20(2), s. 59–65. doi: 10.1159/000353969. Fulltekst i vitenarkiv Vis sammendrag

  Background: Attention-deficit hyperactivity disorder (ADHD) is a risk factor for development of substance use disorders. Treatment of ADHD with psychostimulants in patients on opioid maintenance treatment (OMT) has been restricted in Norway. We examined use of prescribed drugs for ADHD in OMT patients, and assessed co-medication with other psychotropics. Methods: Data were drawn from the nationwide Norwegian Prescription Database (NorPD), which includes all prescriptions filled at pharmacies. The study population was people ≥18 years on OMT during 2008-2010. Results: In 2010, 6,116 patients received OMT and 2.8% of these patients also received ADHD drugs. This is seven times greater than in the gender-and age-specific general population of Norway. Prevalence was higher in the youngest patients, while there was no gender difference. Methylphenidate was the most commonly used drug for ADHD in OMT patients, followed by atomoxetine. 60% of OMT patients filled at least one prescription for antidepressants, anxiolytics or hypnotics and percentages were similar for users and non-users of ADHD drugs. Conclusion: Treatment with ADHD drugs was higher in OMT patients than expected from the general population, but was relatively low compared to the prevalence of ADHD in patients with substance use disorders reported in the literature.

• Neutel, C. Ineke; Skurtveit, Svetlana; Berg, Christian Lie & Sakshaug, Solveig (2014). Trends in prescription of strong opioids for 41-80 year old Norwegians, 2005-2010. European Journal of Pain. ISSN 1090-3801. 18(3), s. 438–446. doi: 10.1002/j.1532-2149.2013.00374.x. Fulltekst i vitenarkiv
• Skurtveit, Svetlana; Selmer, Randi; Roth, Christine; Hernandez-Diaz, S & Handal, Marte (2014). Prenatal exposure to antidepressants and language competence at age three: results from a large population-based pregnancy cohort in Norway. BJOG: An International Journal of Obstetrics and Gynaecology. ISSN 1470-0328. 121(13), s. 1621–1631. doi: 10.1111/1471-0528.12821. Fulltekst i vitenarkiv
• Bukten, Anne; Skurtveit, Svetlana; Waal, Helge & Clausen, Thomas (2014). Factors associated with dropout among patients in opioid maintenance treatment (OMT) and predictors of re-entry. A national registry-based study. Addictive Behaviours. ISSN 0306-4603. 39(10), s. 1504–1509. doi: 10.1016/j.addbeh.2014.05.007. Fulltekst i vitenarkiv
• Neutel, Ineke; Skurtveit, Svetlana; Berg, Christian Lie & Sakshaug, Solveig (2013). Multiple prescribers in older frequent opioid users--does it mean abuse? Journal for Population Therapeutics and Clinical Pharmacology. ISSN 1710-6222. 20(3), s. 393–405. Fulltekst i vitenarkiv
• Lund, Ingunn Olea; Skurtveit, Svetlana; Sarfi, Annamaria Monika; Bakstad, Brittelise; Welle-Strand, Gabrielle & Ravndal, Edle (2013). A 2-year prospective study of psychological distress among a national cohort of pregnant women in opioid maintenance treatment and their partners. Journal of Substance Use. ISSN 1465-9891. 18(2), s. 148–160. doi: 10.3109/14659891.2011.642928. Fulltekst i vitenarkiv
• Brelin, Siri; Loge, Jon Håvard; Skurtveit, Svetlana; Johannesen, Tom Børge; Aass, Nina Kathrine & Ottesen, Stig [Vis alle 7 forfattere av denne artikkelen] (2013). Antidepressants to cancer patients during the last year of life - a population-based study. Psycho-Oncology. ISSN 1057-9249. 22(3), s. 506–514. doi: 10.1002/pon.3059. Fulltekst i vitenarkiv
• Bukten, Anne; Herskedal, Aina; Skurtveit, Svetlana; Bramness, Jørgen Gustav & Clausen, Thomas (2013). Driving under the influence (DUI) among patients in opioid maintenance treatment (OMT): a registry-based national cohort study. Addiction. ISSN 0965-2140. 108(11), s. 1954–1961. doi: 10.1111/add.12275. Fulltekst i vitenarkiv
• Lund, Ingunn Olea; Skurtveit, Svetlana; Engeland, Anders; Furu, Kari; Ravndal, Edle & Handal, Marte (2013). Prescription drug use among pregnant women in opioid Maintenance Treatment. Addiction. ISSN 0965-2140. 108(2), s. 367–376. doi: 10.1111/j.1360-0443.2012.04049.x. Fulltekst i vitenarkiv
• Skollerud, Lars Morten; Fredheim, Olav Magnus; Svendsen, Kristian; Skurtveit, Svetlana & Borchgrevink, Petter Chr. (2013). Laxative prescriptions to cancer outpatients receiving opioids: a study from the Norwegian prescription database. Supportive Care in Cancer. ISSN 0941-4355. 21(1), s. 67–73. doi: 10.1007/s00520-012-1494-8. Fulltekst i vitenarkiv
• Welle-Strand, Gabrielle; Skurtveit, Svetlana; Jones, Hendree E.; Waal, Helge; Bakstad, Brittelise & Bjarkø, Lisa [Vis alle 7 forfattere av denne artikkelen] (2013). Neonatal outcomes following in utero exposure to methadone or buprenorphine: A National Cohort Study of opioid-agonist treatment of Pregnant Women in Norway from 1996 to 2009. Drug and Alcohol Dependence. ISSN 0376-8716. 127(1-3), s. 200–206. doi: 10.1016/j.drugalcdep.2012.07.001. Fulltekst i vitenarkiv
• Skurtveit, Svetlana; Selmer, Randi; Tverdal, Aage; Furu, Kari; Nystad, Wenche & Handal, Marte (2013). Drug exposure: inclusion of dispensed drugs before pregnancy may lead to underestimation of risk associations. Journal of Clinical Epidemiology. ISSN 0895-4356. 66(9), s. 964–972. doi: 10.1016/j.jclinepi.2013.02.011. Fulltekst i vitenarkiv
• Log, Tomas; Skurtveit, Svetlana; Selmer, Randi Marie; Tverdal, Aage; Furu, Kari & Hartz, Ingeborg (2013). The association between prescribed opioid use for mothers and children: a record-linkage study. European Journal of Clinical Pharmacology. ISSN 0031-6970. 69(1), s. 111–118. doi: 10.1007/s00228-012-1312-8. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Purpose The repeated use of prescription opioids may lead to serious side effects. It is therefore important to examine factors associated with such repeated use. The aim of this study was to investigate the association between the maternal use of prescription opioids and their use by offspring of these mothers. Methods Data were extracted from two nationwide registers linked by unique personal identity numbers: the 2001 Norwegian Population and Housing Census and the Norwegian Prescription Database 2004–2009. The study population consisted of 97,574 adolescents aged 15–16 years in 2001 and their mothers. The repeated use of opioids was defined as the issuing of >4 and >15 prescriptions to an adolescent and his/her mother, respectively, during the period 2004–2009. Non-steroidal anti-inflammatory drugs (NSAIDs) are not potentially addictive, and individuals issued prescriptions for NSAIDs were used as the reference analgesic drug group. Results The proportion of repeated prescription opioid users was higher among adolescents whose mother was registered as a repeated user of prescription opioids (8.4 %) than among those whose mother did not repeatedly use prescription opioids (2.4 %). The odds ratio (OR) was 3.1 [95 % confidence interval (CI) 2.7–3.6] when adjusted for the mother’s socioeconomic characteristics and the gender of the offspring. A lower socioeconomic position of the mother increased the risk of repeated opioid use by her offspring. Maternal repeated use of NSAIDs was associated with repeated use of NSAIDs among offspring (OR 1.8, 95 % CI 1.7–2.0). Conclusions Among our study population, the maternal use of opioids was associated with the repeated use of prescription opioids among the respective offspring. The same association was seen with NSAIDs, but to a lesser extent.

• Holdø, Ingvild; Handal, Marte; Skurtveit, Svetlana & Bramness, Jørgen Gustav (2013). Association between prescribing hypnotics for parents and children in Norway. Archives of Disease in Childhood. ISSN 0003-9888. 98(9), s. 732–736. doi: 10.1136/archdischild-2013-303646. Fulltekst i vitenarkiv
• Welle-Strand, Gabrielle; Skurtveit, Svetlana; Jansson, Lauren M; Bakstad, Brittelise; BJARKØ, LISA & Ravndal, Edle (2013). Breastfeeding reduces the need for withdrawal treatment in opioid-exposed infants. Acta Paediatrica. ISSN 0803-5253. 102(11), s. 1060–1066. doi: 10.1111/apa.12378. Fulltekst i vitenarkiv
• Engeland, Anders; Bjørge, Tone; Daltveit, Anne Kjersti; Skurtveit, Svetlana; Vangen, Siri & Vollset, Stein Emil [Vis alle 7 forfattere av denne artikkelen] (2013). Effects of preconceptional paternal drug exposure on birth outcomes: cohort study of 340,000 pregnancies using Norwegian population-based databases. British Journal of Clinical Pharmacology. ISSN 0306-5251. 75(4), s. 1134–1141. doi: 10.1111/j.1365-2125.2012.04426.x. Fulltekst i vitenarkiv
• Mauseth, Siri Ann; Skurtveit, Svetlana & Spigset, Olav (2013). Adherence, persistence and switch rates for anticholinergic drugs used for overactive bladder in women: data from the Norwegian Prescription Database. Acta Obstetricia et Gynecologica Scandinavica. ISSN 0001-6349. 92(10), s. 1208–1215. doi: 10.1111/aogs.12196. Fulltekst i vitenarkiv
• Bukten, Anne; Røislien, Jo; Skurtveit, Svetlana; Waal, Helge; Gossop, Michael & Clausen, Thomas (2013). A day-by-day investigation of changes in criminal convictions before and after entering and leaving opioid maintenance treatment: a national cohort study. BMC Psychiatry. 13. doi: 10.1186/1471-244X-13-262. Fulltekst i vitenarkiv
• Fredheim, Olav; Borchgrevink, Petter; Mahic, Milada & Skurtveit, Svetlana (2013). A pharmacoepidemiological cohort study of subjects starting strong opioids for nonmalignant pain: A study from the Norwegian Prescription Database. Pain. ISSN 0304-3959. 154(11), s. 2487–2493. doi: 10.1016/j.pain.2013.07.033. Fulltekst i vitenarkiv

Se alle arbeider i NVA

• Skurtveit, Svetlana Ondrasova (2026). Preventing an Opioid epidemic In Norway: Focusing on Treatment of chronic pain foredrag. Fulltekst i vitenarkiv
• Bukten, Anne; Mehlum, Lars; Fazel, Seena; Lokdam, Nicoline Toresen; Skurtveit, Svetlana Ondrasova & Ericson, Øystein Bruun [Vis alle 11 forfattere av denne artikkelen] (2026). Risikofaktorer for selvmord under fengsling og etter løslatelse. Fulltekst i vitenarkiv
• Bukten, Anne; Mehlum, Lars; Fazel, Seena; Lokdam, Nicoline Toresen; Tverborgvik, Torill & Skurtveit, Svetlana Ondrasova [Vis alle 12 forfattere av denne artikkelen] (2026). Psykisk helse i fengsel. Risikofaktorer for selvmord under fengsling og etter løslatelse. doi: https:/www.fagligforum.no/event/rus-og-psykisk-helse-2026/. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2026). Vanedannende legemidler – trender og bruk. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2026). Vanedannende legemidler – trender og bruk. doi: https:/www.akan.no/kursoversikt. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova & Odsbu, Ingvild (2026). Rekvirenttilbakemeldinger (tiltak 10.2) og kunnskap (tiltak 10.5). Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2026). Har vi en opioid-epidemi? doi: https:/relis.no/kurs_og_seminar/44920/. Fulltekst i vitenarkiv
• Bukten, Anne; Mehlum, Lars; Lokdam, Nicoline Toresen; Fazel, Seena; Tverborgvik, Torill & Skurtveit, Svetlana Ondrasova [Vis alle 12 forfattere av denne artikkelen] (2025). Suicides among people in prison. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2025). Har vi en opioid-epidemi? doi: https:/relis.no/kurs_og_seminar/44756/. Fulltekst i vitenarkiv
• Rolová, Gabriela; Engeland, Anders; Pedersen, Line; Odsbu, Ingvild; Hamina, Aleksi & Skurtveit, Svetlana Ondrasova (2025). Reply to the Chen and Chen. Pain. ISSN 0304-3959. 166(10), s. e493–e494. doi: 10.1097/j.pain.0000000000003741. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2025). Opioider og bruksmønstre. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2025). Results of the Project on Preventing the Opioid Epidemic in Norway. doi: https:/dialogy2025.cz/program/. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2025). Vedvarende bruk av reseptbelagte sterkesmertestillende legemidler og konsekvenser. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2025). Har vi en opioid-epidemi? Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2025). Vedvarende bruk av reseptbelagte sterke smertestillende legemidler og konsekvenser. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova & Borchgrevink, Petter Christian (2025). Denne gruppen har fire ganger høyere risiko for å dø. [Internet]. TV2. Fulltekst i vitenarkiv
• Hamina, Aleksi; McDonald, Rebecca Silvia & Skurtveit, Svetlana Ondrasova (2025). Pregabalin is associated with a higher overdose risk but the risk with gabapentin is not negligible. Pain. ISSN 0304-3959. 166(2), s. 463–464. doi: 10.1097/j.pain.0000000000003453. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova & Odsbu, Ingvild (2025). Handlingsplanen mot overdoser, del B. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2025). Suget etter pillene ble for stort. Daniel «måtte» rane apoteket. [Journal]. Dagsavisen. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2025). Opioider til smertepasienter: Forsker på hvem som blir avhengige. [Journal]. Dagens Medisin. Fulltekst i vitenarkiv
• Engel, Sophia; Rosseland, Leiv Arne; Smits, Martijn Johannes Bernardus; Skurtveit, Svetlana Ondrasova; Gran, Jon Michael & Nordseth, Trond [Vis alle 8 forfattere av denne artikkelen] (2024). Kartlegging av peritraumatisk opioidbruk ved bruk av multistate-modellering: En populasjonsbasert kohortstudie. Fulltekst i vitenarkiv
• Engel, Sophia; Rosseland, Leiv Arne; Smits, Martijn Johannes Bernardus; Skurtveit, Svetlana Ondrasova; Gran, Jon Michael & Nordseth, Trond [Vis alle 8 forfattere av denne artikkelen] (2024). Kartlegging av peritraumatisk opioidbruk ved bruk av multistate-modellering: En populasjonsbasert kohortstudie . Fulltekst i vitenarkiv
• Engel, Sophia; Rosseland, Leiv Arne; Smits, Martijn Johannes Bernardus; Skurtveit, Svetlana Ondrasova; Gran, Jon Michael & Nordseth, Trond [Vis alle 8 forfattere av denne artikkelen] (2024). Peritraumatic patterns of opioid use among trauma patients: A population-based retrospective cohort study. Fulltekst i vitenarkiv
• Lid, Torgeir Gilje; Skurtveit, Svetlana Ondrasova; Handal, Marte & Haarr, Eirik (2024). Oxycodone and Morphine use in hospitals and primary healthcare in Norway 2010-2021. Fulltekst i vitenarkiv
• Engel, Sophia; Rosseland, Leiv Arne; Smits, Martijn; Skurtveit, Svetlana Ondrasova; Gran, Jon Michael & Nordseth, Trond [Vis alle 8 forfattere av denne artikkelen] (2024). Peritraumatic patterns of opioid use among trauma patients: A national retrospective cohort study. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2024). Differences in use of prescribed opioid analgesics between Norway, Denmark, and Sweden. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2024). Point studien (forskrivning av reseptbelagte opioider). Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2024). Smertestillende medikamenter og eldre kvinner. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova; Hamina, Aleksi & Hoffmann, Mikael (2024). Drugs utilization research in specific therapeutic areas – opioids. I Elseviers, Monique; Wettermark, Björn; Mueller, Tanja; Benko, Ria; Bennie, Marion; Gvozdanovic, Katarina; Hoffmann, Mikael; Iaru, Irina; Ivanovska, Verica; Macbride-Stewart, Sean; Poluzzi, Elisabetta; Pont, Lisa; Blix, Hege Salvesen; Sanfelix-Gimeno, Gabriel; Selke, Gisbert; Taxis, Katja; Petrovic, Ana Tomas; Treciokiene, Indre & Vogler, Sabine (Red.), Drug Utilization Research: Methods and Applications, 2nd Edition. Wiley-Blackwell. ISSN 9781119911661. s. 352–362. Fulltekst i vitenarkiv
• Engel, Sophia; Rosseland, Leiv Arne; Smits, Martijn; Skurtveit, Svetlana Ondrasova; Gran, Jon Michael & Nordseth, Trond [Vis alle 8 forfattere av denne artikkelen] (2024). Peritraumatic patterns of opioid use among trauma patients: A national retrospective cohort study. Fulltekst i vitenarkiv
• Engel, Sophia; Rosseland, Leiv Arne; Smits, Martijn; Skurtveit, Svetlana Ondrasova; Gran, Jon Michael & Nordseth, Trond [Vis alle 8 forfattere av denne artikkelen] (2024). Peritraumatic patterns of opioid use among trauma patients: A national retrospective cohort study. Fulltekst i vitenarkiv
• Engel, Sophia; Rosseland, Leiv Arne; Smits, Martijn; Skurtveit, Svetlana Ondrasova; Gran, Jon Michael & Nordseth, Trond [Vis alle 8 forfattere av denne artikkelen] (2024). Peritraumatic patterns of opioid use among Norwegian trauma patients: A national retrospective cohort study. Fulltekst i vitenarkiv
• Nestvold, Håkon Høydal; Skurtveit, Svetlana Ondrasova & Odsbu, Ingvild (2024). Sosioøkonomiske vansker øker sjansen for utvikle langvarig opioidbruk uavhengig av smertetilstander. Glimt. ISSN 1890-8489. 1-2024, s. 14–15. Fulltekst i vitenarkiv
• Rolová, Gabriela; Engeland, Anders; Odsbu, Ingvild; Hjellvik, Vidar & Skurtveit, Svetlana Ondrasova (2024). Mortality among patients with long-term prescription opioid use in Norway. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2024). Mortality among patients with long-term prescription opioid use in Norway: A nationwide registry-based cohort study. Fulltekst i vitenarkiv
• Odsbu, Ingvild & Skurtveit, Svetlana Ondrasova (2024). Opioidepidemi i Norge? Fulltekst i vitenarkiv
• Haarr, Eirik; Høibø, Trond; Gjesdal, Kine; Lid, Torgeir Gilje & Skurtveit, Svetlana Ondrasova (2024). Smertepasienter må bli tatt på alvor. Fulltekst i vitenarkiv
• Borchgrevink, Petter Christian; Bjernæs, Jacob; Woodhouse, Astrid; Trydal, Heidi; Jost, Peter Dietrich & Landmark, Tormod [Vis alle 11 forfattere av denne artikkelen] (2024). Fastlegers respons på et mestringsorientert behandlingskonsept (NOMED). Utposten. ISSN 0800-5680. Fulltekst i vitenarkiv
• Hartz, Ingeborg; Cohen, Jacqueline Mallory; Skurtveit, Svetlana Ondrasova; Andersen, Per Normann; Handal, Marte & Odsbu, Ingvild (2024). Psychotropic Drug Use Among 0–17 Year Old Norwegians During 2014–2021: A Nationwide Register Study. Fulltekst i vitenarkiv
• Hartz, Ingeborg; Cohen, Jacqueline Mallory; Skurtveit, Svetlana Ondrasova; Andersen, Per Normann; Handal, Marte & Odsbu, Ingvild (2024). Psychotropic Drug Use Among 0–17 Year Old Norwegians During 2014–2021: A Nationwide Register Study. Pharmacoepidemiology and Drug Safety. ISSN 1053-8569. 33. doi: 10.1002/pds.5891. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2024). Da medisinene sluttet å virke. [Internet]. TV2. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2024). Exploring dual diagnosis in opioid agonist treatment: A comparative study between the Czech Republic and Norway. Fulltekst i vitenarkiv
• Clausen, Thomas & Skurtveit, Svetlana Ondrasova (2024). Bruken øker kraftig blant unge. Ingen vet hvorfor. [Internet]. TV2. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2023). POINT project: Hvordan unngå en opioidepidemi i Norge: Fokus på behandling av kroniske smerter. Fulltekst i vitenarkiv
• vambheim, Sara Magelssen; Hjellvik, Vidar; Odsbu, Ingvild; Skurtveit, Svetlana Ondrasova; Ekholdt, Christopher & Granan, Lars-Petter Ness [Vis alle 8 forfattere av denne artikkelen] (2023). Postoperative Opioid Use in Norway - Patterns of Prolonged Use. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova; Hamina, Aleksi & Odsbu, Ingvild (2023). Overdose risk-increasing medication is more often dispensed to individuals dying of overdoses related to pharmaceutical available opioids compared to individuals dying of overdoses related to other substances: a population-based register study. Fulltekst i vitenarkiv
• Odsbu, Ingvild; Hjellvik, Vidar; Hamina, Aleksi & Skurtveit, Svetlana Ondrasova (2023). Prevalence of pain-related and mental health diagnoses among persistent opioid users: a population-based registry-linkage study. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2023). Overdoser av reseptbelagte opioider. Fulltekst i vitenarkiv
• Nestvold, Håkon Høydal; Skurtveit, Svetlana Ondrasova; Hamina, Aleksi; Hjellvik, Vidar & Odsbu, Ingvild (2023). Socioeconomic risk factors for long-term opioid use: a national registry-linkage study. Fulltekst i vitenarkiv
• Steingrímsdóttir, Ólöf Anna; Skurtveit, Svetlana Ondrasova & Eriksen, Kjersti Flugstad (2023). Kvinner er overrepresentert blant dem som lever med langvarig smerte. [Journal]. Dagens Medisin. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2023). Langvarig bruk av forskrevne opioider til smertebehandling. Fulltekst i vitenarkiv
• Husberg-Bru, Vendela; Bergland, Anne Katrine; Skurtveit, Svetlana Ondrasova & Lid, Torgeir Gilje (2023). Pasientforløp etter en Alkohol-intervensjon på Somatisk Sykehus: TRAITS Hospital. Fulltekst i vitenarkiv
• Borchgrevink, Petter Chr.; Glette, Mari; Jost, Peter Dietrich; Woodhouse, Astrid; Landmark, Tormod & Bjertnæs, J [Vis alle 9 forfattere av denne artikkelen] (2023). General practitioners`response to a coping-oriented treatment concept as an alternative to opioid prescriptions for chronic pain (NOMED). Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2023). Opoidbruk i Norge – utviklingstrekk. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2023). Farlig pilletrend blant tenåringer. [Journal]. Dagbladet. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2023). Medikamentrelaterte overdoser – hva viser tallene? Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2023). Flere kvinner dør av smertestillende piller. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova & Clausen, Thomas (2023). Hun kjemper mot abstinensene smertene og skammen har norge en opioid krise. [Journal]. A-magasinet : uketillegg til Aftenposten. Fulltekst i vitenarkiv
• Høibø, Trond; Skurtveit, Svetlana Ondrasova & Lid, Torgeir Gilje (2023). RGP Involvement in Initiation of Opioids for Chronic Non-Cancer Pain associated with Opioid Dose and Concurrent Drug Use? A Web-Based Survey. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2023). POINT prosjektet. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova; Nestvold, Håkon Høydal & Odsbu, Ingvild (2023). Flere bruker opioider over lang tid. Glimt. ISSN 1890-8489. s. 10–11. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2023). Dobbeltdiagnose hos LAR pasienter: En populasjonsbasert registerbasert studie fra Tsjekkia og Norge. Fulltekst i vitenarkiv
• Gjesdal, Kine; Høibø, Trond & Skurtveit, Svetlana Ondrasova (2023). Hvordan unngå en opioidepidemi i Norge: Fokus på behandling av kroniske smerter. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2023). Medikamentrelaterte overdoser – hva viser tallene?  Mennesker med langvarige smertetilstander. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova & Clausen, Thomas (2022). Flere kvinner dør av smertestillende piller. [Journal]. Aftenposten (morgenutg. : trykt utg.). Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2022). Avslører detaljer om dødelig legepraksis. [Internet]. TV2. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2022). KoRus. [Internet]. https://korusoslo.no/2022/08/29/hvordan-unnga-en-opioide-epi. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2022). Smertemedisin ulovlig markedsført: – Jeg mistet sju år av mitt liv. [Internet]. NRK. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2022). Bruk av forskrevne opioider og dødelige overdoser: Velkommen til Norsk Sykepleierforbund of NSFs faggruppe for sykepleiere innen psykisk helse og rus sin markering av Overdosedagen 2022. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2022). OxyContin: Ser vi amerikanske trender i Norge? Fulltekst i vitenarkiv
• Stangeland, Helle; Handal, Marte; Skurtveit, Svetlana Ondrasova; Aakvaag, Helene Flood; Dyb, Grete Anita & Wentzel-Larsen, Tore [Vis alle 10 forfattere av denne artikkelen] (2022). Killing pain? A 15-year population-based registry study of the use of prescription analgesics, anxiolytics and hypnotics among young people in Norway, oral presentation. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2022). Bruk av forskrevne opioider og dødelige overdoser. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2022). LAR pasienter med smerte og smertebehandling i LAR. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova & Frimand, Marte (2022). Ser vi starten på en opioidepidemi i Norge? [Internet]. Nasjonal kompetansetjeneste for samtidig rusmisbruk og psyki. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2022). Overdoser og forskrevne opioider. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2022). Forskrevne opioider og overdoser. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2022). Ny norsk pasientgruppe rammes av opioid-overdoser. [Internet]. NRK. Fulltekst i vitenarkiv
• Gjerde, Line Cecilie; Handal, Marte; Nesvåg, Ragnar; Clausen, Thomas; Lid, Torgeir Gilje & Hamina, Aleksi [Vis alle 8 forfattere av denne artikkelen] (2022). A nationwide registry-linkage study of mental disorders in chronic pain patients: Characteristics of users of opioid versus non-opioid analgesics. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2022). Flere eldre kvinner dør av overdose. [Internet]. vi.no. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2022). Medikamentbruk og overdoser. Fulltekst i vitenarkiv
• Hamina, Aleksi; Odsbu, Ingvild; Hjellvik, Vidar; Gjersing, Linn; Lid, Torgeir Gilje & Clausen, Thomas [Vis alle 7 forfattere av denne artikkelen] (2022). Fatal overdoses in a cohort of chronic pain patients. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2022). Opioid-overdoser rammer ny norsk pasientgruppe. [Internet]. Psykologisk.no. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2022). Individuals dying of overdoses related to pharmaceutical opioids differ from individuals dying of overdoses related to other substances. Fulltekst i vitenarkiv
• Odsbu, Ingvild; Handal, Marte; Borchgrevink, Petter Chr.; Clausen, Thomas & Skurtveit, Svetlana Ondrasova (2022). Endringer i opioidbruken i Norge må tas på dypeste alvor. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. doi: 10.4045/tidsskr.21.0909. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2022). Bruk av forskrevne opioider. To dagers Nasjonalt overdosenettverk-nettverksamling. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2022). Hvordan unngå en opioid epidemi i Norge: Fokus på behandling av kroniske smerter. Fulltekst i vitenarkiv
• Bukten, Anne; Lokdam, Nicoline; Skjærvø, Ingeborg; Ugelvik, Thomas; Skurtveit, Svetlana Ondrasova & Gabrhelík, Roman [Vis alle 20 forfattere av denne artikkelen] (2022). PriSUD-Nordic—Diagnosing and Treating Substance Use Disorders in the Prison Population: Protocol for a Mixed Methods Study. JMIR Research Protocols. 11(3). doi: 10.2196/35182. Fulltekst i vitenarkiv Vis sammendrag

  Background: A large proportion of the prison population experiences substance use disorders (SUDs), which are associated with poor physical and mental health, social marginalization, and economic disadvantage. Despite the global situation characterized by the incarceration of large numbers of people with SUD and the health problems associated with SUD, people in prison are underrepresented in public health research. Objective: The overall objective of the PriSUD (Diagnosing and Treating Substance Use Disorders in Prison)-Nordic project is to develop new knowledge that will contribute to better mental and physical health, improved quality of life, and better life expectancies among people with SUD in prison. Methods: PriSUD-Nordic is based on a multidisciplinary mixed method approach, including the methodological perspectives of both quantitative and qualitative methods. The qualitative part includes ethnographic fieldwork and semistructured interviews. The quantitative part is a registry-based cohort study including national registry data from Norway, Denmark, and Sweden. The national prison cohorts will comprise approximately 500,000 individuals and include all people imprisoned in Norway, Sweden, and Demark during the period from 2000 to 2019. The project will investigate the prison population during three different time periods: before imprisonment, during imprisonment, and after release. Results: PriSUD-Nordic was funded by The Research Council of Norway in December 2019, and funding started in 2020. Data collection is ongoing and will be completed in the first quarter of 2022. Data will be analyzed in spring 2022 and the results will be disseminated in 2022-2023. The PriSUD-Nordic project has formal ethical approval related to all work packages. Conclusions: PriSUD-Nordic will be the first research project to investigate the epidemiology and the lived experiences of people with SUD in the Nordic prison population. Successful research in this field will have the potential to identify significant areas of benefit and will have important implications for ongoing policy related to interventions for SUD in the prison population.

• Skurtveit, Svetlana Ondrasova (2022). Medikamentbruk og overdoser. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova & Odsbu, Ingvild (2022). Resultater fra tildelingsbrev og utvalgte resultater fra pågående forskningsprosjekt (POINT). Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2022). Opioide dødsfall og forskrivning av opioider. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2022). Hvordan unngå en opioid epidemi i Norge: Fokus på behandling av kroniske smerter. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova & Odsbu, Ingvild (2022). Resultater fra oppdrag i tildelingsbrevet for 2020 – fokus på blåreseptordningen. Fulltekst i vitenarkiv
• Strand, Tormod & Skurtveit, Svetlana Ondrasova (2022). Reagerer på merkingen av «Dopesick»-medisinen i Norge. [Internet]. NRK. Fulltekst i vitenarkiv
• Hamina, Aleksi; Odsbu, Ingvild; Clausen, Thomas & Skurtveit, Svetlana Ondrasova (2022). Intentional overdoses and associated mental health challenges, an overlooked sub-population of overdoses. Fulltekst i vitenarkiv
• Uleberg, Oddvar; Stenehjem, Jo S.; Nordseth, Trond; Clausen, Thomas; Natvig, Bård & Skurtveit, Svetlana Ondrasova [Vis alle 12 forfattere av denne artikkelen] (2022). The injury prevention and outcomes following trauma (IPOT) project: is a nationwide registry-based study in Norway feasible? Fulltekst i vitenarkiv
• Stenehjem, Jo S.; Røise, Olav; Nordseth, Trond; Clausen, Thomas; Natvig, Bård & Skurtveit, Svetlana Ondrasova [Vis alle 12 forfattere av denne artikkelen] (2021). Injury Prevention and long-term Outcomes following Trauma - the IPOT project: a protocol for prospective nationwide registry-based studies in Norway. Fulltekst i vitenarkiv
• Rosseland, Leiv Arne; Stenehjem, Jo S.; Nordseth, Trond; Clausen, Thomas; Natvig, Bård & Skurtveit, Svetlana Ondrasova [Vis alle 12 forfattere av denne artikkelen] (2021). The Injury Prevention and Outcomes following Trauma project: a prospective nationwide registry-based study in Norway. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2021). Hvordan unngå en opioidepidemi i Norge: Fokus på behandlin av langvarige smerter. Glimt. ISSN 1890-8489. Fulltekst i vitenarkiv
• Skurtveit, Svetlana Ondrasova (2021). Hvordan unngå en opioid epidemi i Norge: Fokus på behandling av langvarige smerter. Glimt. ISSN 1890-8489. 2(1), s. 26–27. Fulltekst i vitenarkiv
• Odsbu, Ingvild; Handal, Marte; Hjellvik, Vidar & Skurtveit, Svetlana Ondrasova (2021). Trends in long-term use of prescribed opioids in Norway 2010-2019. Pharmacoepidemiology and Drug Safety. ISSN 1053-8569. 30, s. 53–53. doi: 10.1002/pds.5305. Fulltekst i vitenarkiv Vis sammendrag

  Background Since 2008, patients with chronic, non-malignant pain conditions can get reimbursement for analgesic opioids. There is limited evidence of analgesic effect of opioids when used over a long time period while the risk of adverse effects is increasing. Thus, closely monitoring of opioid consumption at the population level to detect signs of escalation is needed. Objectives To investigate whether there has been a change in the number of long-term users of prescribed opioids over time and according to reimbursement scheme (reimbursed opioids for palliative care, reimbursed opioids for chronic, non-malignant pain, or non-reimbursable opioids). Methods Data were retrieved from the Norwegian Prescription Database. The study population consisted of all individuals filling at least one prescription of an opioid (ATC N02A) during 2010-2019. Long-term use was defined as being dispensed more than 180 defined daily doses or more than 4500 mg oral morphine equivalents of opioids a given year and filling prescriptions in at least 3 quarters of the year. Individuals were divided into mutually exclusive groups according to reimbursement scheme in a hierarchical manner; reimbursed opioids for palliative care > reimbursed opioids for chronic, non-malignant pain > non-reimbursable opioids. The proportion of long-term opioid users according to reimbursement scheme was calculated. Results The number of long-term opioid users increased from 49,993 in 2010 to 59,996 in 2019. The increase over time was almost solely attributed to an increase among chronic, non-malignant pain patients. The number of long-term users receiving non-reimbursable opioids and opioids for palliative care remained stable over time. In 2019, the majority of the 59,996 long-term users received non-reimbursable opioids only (n=38,006), followed by long-term users receiving opioids for chronic, non-malignant pain (n=14,812), and long-term users receiving palliative care (n=7,178). Conclusions The number of long-term opioid users have increased by 20% (10,000 individuals) over an 11 years period in Norway due to an increase in number of long-term users receiving reimbursed opioids to treat chronic, non-malignant pain. More studies are needed to understand whether the introduction of the reimbursement scheme for chronic pain patients has been a contributing factor to the observed increase in number of long-term opioid users and why the majority of the long-term opioid users do not receive opioids according to the reimbursement scheme for chronic, non-malignant pain.

• Heger, Katrine; Skipsfjord, Julia; Kiselev, Yury; Burns, Margrete Larsen; Aaberg, Kari Modalsli & Johannessen, Svein Ivar [Vis alle 8 forfattere av denne artikkelen] (2021). Changes in the use of antiseizure medications with focus on children and adolescents in Norway 2009-18. Fulltekst i vitenarkiv
• Stangeland, Helle; Handal, Marte; Skurtveit, Svetlana Ondrasova; Aakvaag, Helene Flood; Dyb, Grete Anita & Wentzel-Larsen, Tore [Vis alle 10 forfattere av denne artikkelen] (2021). Killing pain? A population-based registry study of the use of prescription analgesics, anxiolytics, and hypnotics among children, adolescents and young adults in Norway from 2004-2019, poster på den 10. Nasjonale forskningskonferansen innen muskelskjeletthelse 2021 (MUSS). Fulltekst i vitenarkiv
• Odsbu, Ingvild; Handal, Marte; Hjellvik, Vidar & Skurtveit, Svetlana Ondrasova (2021). Trends in long-term use of prescribed opioids in Norway 2010-2019. Fulltekst i vitenarkiv
• Odsbu, Ingvild; Handal, Marte; Hjellvik, Vidar & Skurtveit, Svetlana Ondrasova (2021). Trends in long-term use of prescribed opioids in Norway 2010-2019. Fulltekst i vitenarkiv
• Skipsfjord, Julia; Heger, Katrine; Skurtveit, Svetlana; Aaberg, Kari Modalsli; Kiselev, Yury & Burns, Margrete Larsen [Vis alle 8 forfattere av denne artikkelen] (2021). Forbruk av antiepileptika hos barn og unge i Skandinavia-er det likt? Fulltekst i vitenarkiv
• Stangeland, Helle; Handal, Marte; Skurtveit, Svetlana Ondrasova; Aakvaag, Helene Flood; Dyb, Grete Anita & Wentzel-Larsen, Tore [Vis alle 10 forfattere av denne artikkelen] (2020). Bruk av smertestillende og vanedannende medikamenter til barn og unge i Norge: En populasjonsbasert studie over 15 år (2004-2019), foredrag på den 9. Nasjonale forskningskonferansen innen muskelskjeletthelse 2020 (MUSS). Fulltekst i vitenarkiv
• Waal, Helge; Vold, Jørn Henrik & Skurtveit, Svetlana (2020). Kvetiapinmisbruk-myte eller realitet? 140(12), s. 1–5. doi: 10.4045/tidsskr.20.0059. Fulltekst i vitenarkiv
• Burdzovic, Jasmina; Torvik, Fartein Ask; Ystrøm, Eivind; Skurtveit, Svetlana; Handal, Marte & Lund, Ingunn Olea (2019). Alcohol use disorder (AUD) in offspring following exposure to parental risk constellations during adolescence: A combined HUNT survey and health registries study. Fulltekst i vitenarkiv
• Skurtveit, Svetlana; Kiselev, Yury; Handal, Marte; Stoltenberg, Camilla; Reichborn-Kjennerud, Ted & Suren, Pål [Vis alle 8 forfattere av denne artikkelen] (2019). Co-Occurring Neuropsychiatric Diagnoses and Use of Psychotropic Drugs in Children with Autism Spectrum Disorder. Pharmacoepidemiology and Drug Safety. ISSN 1053-8569. doi: 10.10002/pds.4864. Fulltekst i vitenarkiv
• Lund, Ingunn Olea; Skurtveit, Svetlana; Handal, Marte; Bukten, Anne; Torvik, Fartein Ask & Ystrøm, Eivind [Vis alle 7 forfattere av denne artikkelen] (2019). Association of Constellations of Parental Risk With Children's Subsequent Anxiety and Depression: Findings From a HUNT Survey and Health Registry Study. Fulltekst i vitenarkiv
• Wood, Mollie; Mahic, Milada; Handal, Marte; Skurtveit, Svetlana; Lund, Ingunn Olea & Hernandez-Diaz, Sonia (2019). Risk of Neonatal Abstinence Syndrome Following Prenatal Exposure to Methadone vs Buprenorphine. Pharmacoepidemiology and Drug Safety. ISSN 1053-8569. doi: 10.1002/pds.4864. Fulltekst i vitenarkiv
• Handal, Marte; Skurtveit, Svetlana; Odsbu, Ingvild; Kieler, Helle; Nørgaard, Mette & Öztürk, Buket [Vis alle 12 forfattere av denne artikkelen] (2019). In utero opioid exposure and risk of ADHD in childhood: A Scandinavian registry study. Pharmacoepidemiology and Drug Safety. ISSN 1053-8569. 28(S2). doi: 10.1002/pds.4864. Fulltekst i vitenarkiv
• Steingrímsdóttir, Ólöf Anna; Nielsen, Christopher Sivert; Odsbu, Ingvild; Skurtveit, Svetlana Ondrasova & Handal, Marte (2018). Langvarig smerte i Norge. I Grøholt, Else Karin; Bøhler, Linn & Hånes, Hanna (Red.), Folkehelserapporten - Helsetilstanden i Norge. Folkehelseinstituttet. Fulltekst i vitenarkiv
• Handal, Marte; Nechanská, Blanka; Skurtveit, Svetlana; Mahic, Milada; Mravčík, Viktor & Gabrhelík, Roman (2018). Hospitalization of Children after Prenatal Exposure to Methadone and Buprenorphine: National Registry Studies from the Czech Republic. Fulltekst i vitenarkiv
• Muller, Ashley Elizabeth; Odsbu, Ingvild; Sjøgren, Per; Clausen, Thomas & Skurtveit, Svetlana (2018). Prescribed opioid analgesic use developments in the Scandinavian countries, 2006-2017. Fulltekst i vitenarkiv
• Handal, Marte; Nechanska, Blanka; Skurtveit, Svetlana; Mahic, Milada; Mravcik, Viktor & Gabrhelik, Roman (2018). Hospitalization of children after prenatal exposure to methadone and buprenorphine: National registry studies from Czech Republic. Pharmacoepidemiology and Drug Safety. ISSN 1053-8569. Fulltekst i vitenarkiv
• Lupattelli, Angela; Chambers, Christina; Bandoli, Gretchen; Handal, Marte; Skurtveit, Svetlana & Nordeng, Hedvig Marie Egeland (2018). Maternal use of benzodiazepines and z‐hypnotics during pregnancy and developmental outcomes in offspring at 5 years of age. Pharmacoepidemiology and Drug Safety. ISSN 1053-8569. 27(S2), s. 173–173. doi: 10.1002/pds.4629. Fulltekst i vitenarkiv
• Skurtveit, Svetlana; Bramness, Jørgen Gustav; Hjellvik, Vidar; Hartz, Ingeborg; Nesvåg, Ragnar & Hauge, Lars Johan [Vis alle 7 forfattere av denne artikkelen] (2018). Increase in diagnosis of depressive disorders contributes to the increase in antidepressant use in adolescents. Pharmacoepidemiology and Drug Safety. ISSN 1053-8569. Fulltekst i vitenarkiv
• Lund, Ingunn Olea; Skurtveit, Svetlana; Handal, Marte; Bukten, Anne; Torvik, Fartein Ask & Ystrøm, Eivind [Vis alle 7 forfattere av denne artikkelen] (2018). Parental drinking and child long-term depression and anxiety: A longitudinal combined survey and registry study. Fulltekst i vitenarkiv
• Mahic, Milada; Hernandez-Diaz, Sonia; Wood, Mollie; Odsbu, Ingvild; Nørgaard, Mette & Kieler, Helle [Vis alle 8 forfattere av denne artikkelen] (2018). Infections in children after prenatal exposure to methadone and buprenorphine: Nordic registry study. Pharmacoepidemiology and Drug Safety. ISSN 1053-8569. Fulltekst i vitenarkiv
• Nechanská, Blanka; Mahic, Milada; Mravčík, Viktor; Gabrhelík, Roman; Skurtveit, Svetlana & Handal, Marte (2018). Sykelighet hos barn som har vært eksponert for LAR legemidler i fosterlivet. En registerstudie fra Tsjekkia. Fulltekst i vitenarkiv
• Handal, Marte; Skurtveit, Svetlana; Nechanská, Blanka; Mahic, Milada; Mravčík, Viktor & Gabrhelík, Roman (2018). Hospitalization of children after prenatal exposure to methadone and buprenorphine: National registry study from the Czech Republic. Fulltekst i vitenarkiv
• Hoff, Mari; Schei, Berit; Skovlund, Eva; Skurtveit, Svetlana; Langhammer, Arnulf & Syversen, Unni [Vis alle 10 forfattere av denne artikkelen] (2018). Gir bruk av protonpumpehemmere økt risiko for brudd? Data fra HUNT 3. Fulltekst i vitenarkiv
• Handal, Marte; Nechanská, Blanka; Mravčík, Viktor; Skurtveit, Svetlana; Lund, Ingunn Olea & Gabrhelík, Roman [Vis alle 7 forfattere av denne artikkelen] (2017). Neonatal Outcomes after fetal exposure to methadone and buprenorphine: national registry studies from the Czech Republic and Norway. Fulltekst i vitenarkiv
• Muller, Ashley; Clausen, Thomas & Skurtveit, Svetlana (2017). Building an abstinent network to support quality of life gains through treatment. Fulltekst i vitenarkiv Vis sammendrag

  Research questions - How does QoL change as patients progress through treatment? - Can certain social network developments support QoL improvements?

• Holdø, Ingvild; Bramness, Jørgen Gustav; Handal, Marte; Hansen, Berit Marina Hjelde; Hjellvik, Vidar & Skurtveit, Svetlana (2017). Infants With dispensed hypnotics have a greater risk of developing hyperkinetic disorder in School age. Fulltekst i vitenarkiv
• Nechanska, Blanka; Mravcik, Viktor; Skurtveit, Svetlana; Lund, Ingunn Olea; Gabrhelik, Roman & Engeland, Anders [Vis alle 7 forfattere av denne artikkelen] (2017). Condition of newborns of women received OMT and opiates during pregnancy: comparison of Czech and Norwegian cohorts. Fulltekst i vitenarkiv
• Handal, Marte; Nechanska, Blanka; Lund, Ingunn Olea; Gabrhelik, Roman; Mahic, Milada & Engeland, Anders [Vis alle 8 forfattere av denne artikkelen] (2017). OMT or drug abuse during pregnancy - does it affect the offspring? Results from Nationwide registry studies in the Czech Republic and Norway. Fulltekst i vitenarkiv
• Holdø, Ingvild; Bramness, Jørgen Gustav; Skurtveit, Svetlana; Handal, Marte; Hansen, Berit Hjelde & Hjellvik, Vidar (2017). Infants with Sleep Problems have a Greater Risk of Developing ADHD in school age. Fulltekst i vitenarkiv
• Hartz, Ingeborg; Skurtveit, Svetlana; Hjellvik, Vidar; Furu, Kari; Nesvåg, Ragnar & Handal, Marte (2016). Antidepressant Drug use Among Adolescents in Norway from 2004 to 2013‐ A Population‐Based Register Study. Pharmacoepidemiology and Drug Safety. ISSN 1053-8569. Fulltekst i vitenarkiv
• Handal, Marte; Mahic, Milada; Hjellvik, Vidar; Lund, Ingunn Olea; Øhman, Inger & Wikner, Birgitta Norstedt [Vis alle 13 forfattere av denne artikkelen] (2016). Background and design: A Scandinavian cohort of pregnant women in opioid maintenance treatment during pregnancy: long term consequences for the child (ScopeOMT). Fulltekst i vitenarkiv
• Skovlund, Eva; Handal, Marte; Selmer, Randi Marie; Brandlistuen, Ragnhild Eek & Skurtveit, Svetlana (2016). Language Development in 3 Year Old Children After Prenatal Exposure to Opioids. Pharmacoepidemiology and Drug Safety. ISSN 1053-8569. Fulltekst i vitenarkiv
• Nesvåg, Ragnar; Hartz, Ingeborg; Bramness, Jørgen Gustav; Hjellvik, Vidar; Handal, Marte & Skurtveit, Svetlana (2016). Differences Between Genders in Antipsychotic Medication Among Children and Adolescents – Patterns in Use and Underlying Mental Disorders. Pharmacoepidemiology and Drug Safety. ISSN 1053-8569. Fulltekst i vitenarkiv
• Handal, Marte; Mahic, Milada; Hjellvik, Vidar; Lund, Ingunn Olea; Øhman, Inger & Wikner, Birgitta Nordstedt [Vis alle 13 forfattere av denne artikkelen] (2016). Background and design: A Scandinavian cohort of pregnant women in opioid maintenance treatment during pregnancy: long term consequences for the child (ScopeOMT). Fulltekst i vitenarkiv
• Hartz, Ingeborg; Skurtveit, Svetlana; Steffenak, Anne Kjersti Myhrene; Karlstad, Øystein & Handal, Marte (2015). Psychotropic drug use among 0-17 year olds during 2004-2013: a nationwide prescription database study. Fulltekst i vitenarkiv
• Hartz, Ingeborg; Skurtveit, Svetlana; Hjellvik, Vidar; Furu, Kari; Nesvåg, Ragnar & Handal, Marte (2015). Antidepressant drug use among adolescents during 2004-2013 – a population-based linkage study between the Nationwide prescription database and patient register. Norsk Epidemiologi, Supplement. ISSN 0803-4206. 25, s. 95–95. Fulltekst i vitenarkiv
• Berg, Christian Lie; Skurtveit, Svetlana; Sakshaug, Solveig; Hjellvik, Vidar & Handal, Marte (2015). Reduced Prescribing of Benzodiazepines in Denmark and Norway. Basic & Clinical Pharmacology & Toxicology. ISSN 1742-7835. 116(6), s. 457–458. doi: 10.1111/bcpt.12377. Fulltekst i vitenarkiv
• Hoff, Mari; Skurtveit, Svetlana; Meyer, Haakon E; Langhammer, Arnulf; Søgaard, Anne-Johanne & Syversen, Unni [Vis alle 8 forfattere av denne artikkelen] (2015). Use of anti-osteoporotic drugs among women in central Norway after a forearm fracture. Norsk Epidemiologi, Supplement. ISSN 0803-4206. 25, s. 96–96. Fulltekst i vitenarkiv
• Hartz, Ingeborg; Skurtveit, Svetlana; Steffenak, Anne Kjersti Myhrene; Karlstad, Øystein & Handal, Marte (2014). Psychotropic drug use among 0-17 year olds during 2004-2013: a Nationwide prescription database study. Norsk Epidemiologi, Supplement. ISSN 0803-4206. 24, s. 57–57. Fulltekst i vitenarkiv
• Hartz, Ingeborg; Skurtveit, Svetlana; Steffenak, Anne Kjersti Myhrene; Karlstad, Øystein & Handal, Marte (2014). Psychotropic drug use among 0-17 year olds during 2004-2013: a Nationwide prescription database study. Fulltekst i vitenarkiv
• Hartz, Ingeborg; Handal, Marte; Tverdal, Aage & Skurtveit, Svetlana (2014). Pediatric off-label use of melatonin - a register-linkage study between the Norwegian Prescription Database and Patient Registry. Fulltekst i vitenarkiv
• Hartz, Ingeborg; Skurtveit, Svetlana & Handal, Marte (2014). Trends in melatonin use during 2004 to 2011 among children and adolecents. A Nationwide prescription database study. Fulltekst i vitenarkiv
• Nielsen, Christopher Sivert; Handal, Marte; Skurtveit, Svetlana & Steingrímsdóttir, Ólöf Anna (2014). Langvarige smertetilstander. I Stoltenberg, Camilla; Grøholt, Else Karin; Hånes, Hanna & Reneflot, Anne (Red.), Folkehelserapporten 2014. Helsetilstanden i Norge. Folkehelseinstituttet. ISSN 9788280826367. s. 141–147. Fulltekst i vitenarkiv
• Hartz, Ingeborg; Skurtveit, Svetlana; Karlstad, Øystein; Steffenak, Anne Kjersti Myhrene & Handal, Marte (2014). Psychotropic drug use among 0-17 year olds during 2004-2013: a nationwide prescription database study. Fulltekst i vitenarkiv
• Neutel, CI; Skurtveit, Svetlana & Berg, Christian Lie (2012). Dramatic Increases in the Use of Strong Opioids in the Elderly. Pharmacoepidemiology and Drug Safety. ISSN 1053-8569. 21, s. 172–173. Fulltekst i vitenarkiv
• Hansen, Thomas; Reneflot, Anne; Kirkøen, Benedicte; Strand, Bjørn Heine; Vedaa, Øystein & Bye, Elin Kristin [Vis alle 10 forfattere av denne artikkelen] (2025). En kartlegging av psykisk helse og livskvalitet blant eldre i Norge. Folkehelseinstituttet. Fulltekst i vitenarkiv Vis sammendrag

• Furu, Kari; Hjellvik, Vidar; Hartz, Ingeborg; Karlstad, Øystein; Skurtveit, Svetlana & Blix, Hege Salvesen [Vis alle 8 forfattere av denne artikkelen] (2018). Legemiddelbruk hos barn og unge i Norge 2008–2017. Folkehelseinstituttet. ISSN 9788280829542. Fulltekst i vitenarkiv
• Skjærvø, Ingeborg; Bukten, Anne; Skurtveit, Svetlana & Clausen, Thomas (2018). Substance use and crime: Characteristics of victim and offender roles in a longitudinal study of patients entering substance use treatment. Universitetet i Oslo. Fulltekst i vitenarkiv Vis sammendrag

  Sammendrag Det tas ofte ikke høyde for at rusbrukere som utfører kriminalitet samtidig kan være utsatt for kriminalitet selv. For å bedre utfall av rus- og kriminalomsorg er det viktig at tiltakene og ikke minst politikere er oppmerksomme på at en stor andel personer i rusbehandling og under kriminalomsorgen kan ha behov for offeromsorg. For å redusere utført kriminalitet blant rusbrukere kan fokus på risikogrupper være viktig, spesifikt brukere av amfetaminer, personer med lavere selvkontroll og personer som hovedsakelig tilbrakte fritiden med andre rusbrukere. For de som har vært utsatt for kriminalitet ser vi at boligpolitikk og fokus på psykisk helse i behandling er viktig. Funnene er fra NorComt-studien (www.norcomt.no), en stor norsk studie av over 500 personer som startet omfattende rusbehandling (i form av døgnbehandling eller legemiddelassistert rehabilitering). Deltagerne ble intervjuet ved behandlingsoppstart og ett år senere. Vi så at 64% av pasientene hadde utført kriminalitet i månedene før behandlingsstart. Samtidig hadde 59% vært utsatt for kriminalitet i den samme perioden. Det viste seg at det var en stor overlapp mellom de to gruppene. Vi så at amfetaminer var spesielt assosiert med utført kriminalitet, og fikk bekreftet og understreket viktigheten av tiltak rettet mot selvkontroll og sosiale nettverk for å redusere kriminalitet. Mer spesifikt så vi at bruk av amfetaminer, nivå av selvkontroll og om man hovedsakelig tilbringer fritiden med andre rusbrukere, hang sammen med både risiko for kriminalitet før behandling, og sannsynligheten for at man hadde sluttet med kriminalitet ett år etter behandlingsstart. Pasienter som hadde vært utsatt for kriminalitet i perioden før behandling hadde alvorligere rusbruk, hadde oftere en ustabil bosituasjon og de hadde flere symptomer på dårligere psykisk helse, i form av angst, depresjon og tidligere selvmordsforsøk. Disse funnene viser viktigheten av en trygg boligpolitikk og oppfølging av psykiske symptomer i rusbehandling.

• Muller, Ashley Elizabeth; Skurtveit, Svetlana & Clausen, Thomas (2017). Quality of life, substance use disorders, and social lives: Exploring one-year outcomes and intrinsic links. Universitetet i Oslo. Fulltekst i vitenarkiv Vis sammendrag

  Substance use disorders are increasingly being recognized as chronic diseases, with important treatment implications: not only should a finite course of treatment not be expected to be curative, but outcomes of interest must be relevant to the patient and not limited to reduced substance use. While quality of life is a standard outcome measure among other chronic disease treatment, the substance use disorder treatment field has lagged behind in systematically evaluating it. Sustained contact with the treatment system lasting beyond intensive inpatient treatment appears best to maintain treatment’s benefits long-term, therefore the social environments of patients – the larger contexts of their lives, including but not limited to treatment – must also be addressed. The overall objective of this thesis was to examine changes in quality of life along with natural treatment progression and explore the relationship of these changes to underresearched social factors in order to inform the clinical approach to patients’ social lives. The specific aims were to identify patterns in poor quality of life at entry to SUD treatment; to examine how quality of life changes along with social network developments through the treatment course; and to validate and confirm the utility of a new quality of life instrument. This thesis used data from The Norwegian Cohort of Patients in Opioid Maintenance Treatment and Other Drug Treatment study, an observational, prospective study of adults entering substance use disorder treatment in 21 facilities throughout Norway. 548 patients entering treatment enrolled at were administered a battery of questionnaires, such as the EuropASI, HSCL-25, and QOL10, through structured interviewed by trained facility staff. One year later, regardless of treatment progression or drop out, participants answered the same questionnaires through interviews with research staff. 338 were included in the longitudinal analysis. The majority of the sample entered treatment with extremely impaired quality of life as measured through a single item, along with substance-using social networks, poor mental health, and polysubstance use. Depression was associated with the poorest quality of life among women, while physical inactivity, weight dissatisfaction, and eating alone were the most important factors for men. Opioid maintenance treatment medication was a protective factor for both genders. After one year, 75% of participants were still receiving treatment, 9% had completed, and 15% amount as at study inclusion reported no network (17.5%). Global and social quality of life measured by the QOL10 improved for the entire sample, although global quality of life remained below population norms. The trend in each of the three treatment status groups, and statistically significant for those still in treatment, was for participants who gained or maintained an abstinent network to report the largest gains in quality of life, and for participants who gained a substance-using network or were socially isolated to report the smallest, or clinically negligible, improvements. In a validation study of the QOL10, factor analysis revealed the QOL10 to measure two domains described as “global quality of life” and “social quality of life”. The global domain correlated negatively with symptoms of clinical anxiety, depression, and physical inactivity; the social domain was only weakly correlated to anxiety. Both domains had satisfactory internal validity, scores were easily calculated, and the QOL10 as a whole presented minimal administrative and participant burden. At both treatment initiation and one year later, we found quality of life to correlate with lesser explored factors such as physical inactivity and social isolation. These vulnerabilities, along with mental health, should be evaluated immediately in the clinical setting and addressed through exercise and network interventions. Entering treatment without a social network may be a particular risk factor for both dropping out and failing to experience improved quality of life, and network interventions need to be further developed to explicit help isolated patients. Any contact with the treatment system appears to be beneficial to quality of life, but the combination of remaining in treatment after one year and building or maintaining an abstinent network resulted in the highest quality of life. Quality of life is not a simple proxy for health or for disease or treatment progression, although undoubtedly influenced by these factors. To fully understand how best to support patients’ quality of life, network building, and treatment retention, and to understand the causal mechanisms in these relationships, repeated measurements and sustained contact with patients are needed.

• Bukten, Anne; Stavseth, Marianne Riksheim; Skurtveit, Svetlana; Kunøe, Nikolaj; Lobmaier, Philipp Paul & Lund, Ingunn Olea [Vis alle 7 forfattere av denne artikkelen] (2016). Rusmiddelbruk og helsesituasjon blant innsatte i norske fengsel. Resultater fra The Norwegian offender mental health and addiction study (NorMA). Universitetet i Oslo. Fulltekst i vitenarkiv
• Tjagvad, Christian; Clausen, Thomas & Skurtveit, Svetlana (2016). Addictive medication in relation to drug treatment and overdose death. Universitetet i Oslo. Fulltekst i vitenarkiv Vis sammendrag

  Background The involvement of the addictive medications, benzodiazepines (BZDs) and prescription opioids, including opioid maintenance treatment (OMT) medications, have increasingly contributed to the high overdose death rates in Denmark and Norway during the past decades. Investigating prescription patterns and patient behavior in relation to drug treatment and overdose deaths is important to increase our knowledge on how these addictive medications are used, misused, and how they may contribute to overdose deaths. Study aims The overall aim of the thesis was to acquire new knowledge of the involvement of addictive medications in the treatment of populations with drug use disorders (DUDs) and also in overdose deaths to improve treatment approaches and reduce detrimental outcomes in a vulnerable group of individuals. More specifically the aim was to investigate prescription patterns and use of addictive medication in relation to drug treatment and overdose deaths among populations in Denmark and Norway. Furthermore, to compare overdose cases with and without detection of legally prescribed addictive medications and investigate factors associated with having detection of non-prescribed addictive medication. Materials and methods This thesis was based on three different cohorts/samples from two countries: A Danish nationwide cohort including individuals admitted for treatment for DUDs in 2000-2010 (n=33,203); a Norwegian sample including overdose deaths in the capital city, Oslo, in 2006-2008 (n=167), and; a Danish sample including overdose deaths in Copenhagen, Aarhus, and Odense Municipality in 2008-2011 (n=130). The cohorts/samples were linked with data from population registries, local based registries, and journal reviews by using a unique identification number assigned to all Danish and Norwegian citizens. Results Overall, in the period after entering treatment and in the period prior to overdose death, addictive medication was often prescribed to individuals with DUD. In both periods, inappropriate prescription patterns were identified. During the first year after admission to DUD treatment, about one-quarter of the individuals (26.2%) were prescribed BZDs. Of these, about one-third (35.5%) were prescribed BZDs at dose levels that might indicate inappropriate use, and about one-third (34.6%) were prescribed more than one type of BZDs. Particularly individuals with opioid use (43.2%) were commonly prescribed BZDs. Admitting to treatment for a DUD did not increase the specialized psychiatric treatment coverage of this patient group, disregarding use of prescribed BZDs. Among overdose deaths in Denmark and Norway, the prescribed doses of the addictive medications among the deceased were in general higher than recommended. Further, the control/monitoring measures were insufficient and allowing use of multiple prescribing physicians (Norway), low levels of supervised intake of OMT medication (Denmark), and use of multiple prescribed addictive medications (Denmark). We investigated the deceased with detection of prescribed vs. non-prescribed addictive medication. In the Norwegian sample, we found that a lower proportion of the deceased (with detection of the target medications) had been prescribed BZDs (28.1%), strong analgesics (33.3%), or BZDs plus strong analgesics (50.0%) four weeks prior to death. However, in Denmark the majority of deceased with methadone-related overdose deaths (63.1%) were prescribed methadone as part of OMT at the time of death. In the Norwegian sample, detection of non-prescribed BZDs and/or strong analgesics was associated with younger age (a-OR=4.9; 95% CI, 1.4-18.0) and to have a permanent place of residence outside Oslo (a- OR=2.9; 1.1-8.1). In the Danish sample, detection of non-prescribed methadone was associated with younger age of 30 years or below (a-OR=9.5; 1.8-50.5), concomitant detection of 6-MAM/heroin (a-OR=3.1; 1.2-7.8), and non-prescribe

• Skurtveit, Svetlana Ondrasova; Sakshaug, Solveig; Hjellvik, Vidar; Berg, Christian Lie & Handal, Marte (2014). Bruk av vanedannende legemidler i Norge 2005 - 2013. Basert på data fra Reseptregisteret. Folkehelseinstituttet. ISSN 9788280826305. Fulltekst i vitenarkiv

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