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Skurtveit, Svetlana Ondrasova & Clausen, Thomas
(2023).
Hun kjemper mot abstinensene smertene og skammen har norge en opioid krise.
A-magasinet : uketillegg til Aftenposten.
ISSN 0807-5654.
s. 16–28.
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Clausen, Thomas
(2023).
Når det går galt.
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Clausen, Thomas
(2022).
What lessons from Norway’s experience could be applied in the United States in response to the addiction and overdose crisis?
Addiction.
ISSN 0965-2140.
117(7),
s. 2126–2126.
doi:
10.1111/add.15845.
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Bech, Anne Berit; Clausen, Thomas & Mcdonald, Rebecca Silvia
(2022).
Revised service delivery of opioid agonist treatment in Norway in 2021, the second year of the pandemic: a national cross-sectional study of treatment provider experiences.
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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.
ISSN 1179-1349.
14,
s. 1477–1486.
doi:
10.2147/CLEP.S382136.
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Bjørnestad, Endre Dahlen; Vederhus, John-Kåre & Clausen, Thomas
(2022).
High smoking and low cessation rates among patients in treatment for opioid and other substance use disorders.
-
Mcdonald, Rebecca Silvia & Clausen, Thomas
(2022).
Revised service delivery of opioid agonist treatment in Norway in 2021, the second year of the pandemic: a national cross-sectional study of treatment provider experiences.
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Hamina, Aleksi; Odsbu, Ingvild; Clausen, Thomas & Skurtveit, Svetlana Ondrasova
(2022).
Intentional overdoses and associated mental health challenges, an overlooked sub-population of overdoses.
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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.
ISSN 1929-0748.
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.
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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.
ISSN 0029-2001.
doi:
10.4045/tidsskr.21.0909.
Fulltekst i vitenarkiv
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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.
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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.
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Opsal, Anne; Kristensen, Øistein & Clausen, Thomas
(2019).
Perceived coercion to enter treatment among involuntarily and voluntarily admitted patients with substance use disorders
.
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Muller, Ashley Elizabeth; Medved, David & Clausen, Thomas
(2018).
Long-term opioid maintenance treatment patients and the role of benzodiazepines.
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Muller, Ashley Elizabeth; Odsbu, Ingvild; Sjøgren, Per; Clausen, Thomas & Skurtveit, Svetlana
(2018).
Prescribed opioid analgesic use developments in the Scandinavian countries, 2006-2017.
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Medved, David; Clausen, Thomas & Muller, Ashley Elizabeth
(2018).
Disease burden in ageing long-term opioid maintenance
treatment patients; the triple burden.
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Muller, Ashley Elizabeth & Clausen, Thomas
(2018).
Somatiske helseutfordringer i LAR: NorComt-studien.
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Kristensen, Øistein; Opsal, Anne & Clausen, Thomas
(2018).
Tvangsinnleggelse for rusbehandling?
Tidsskrift for Den norske legeforening.
ISSN 0029-2001.
138(8).
doi:
10.4045/tidsskr.17.1114.
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Muller, Ashley Elizabeth & Clausen, Thomas
(2017).
Social network changes predict adherence to opioid maintenance treatment
.
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Muller, Ashley; Clausen, Thomas & Skurtveit, Svetlana
(2017).
Building an abstinent network to support quality of life gains through treatment.
Vis sammendrag
Research questions - How does QoL change as patients progress through treatment? - Can certain social network developments support QoL improvements?
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Madah-Amiri, Desiree & Clausen, Thomas
(2016).
The use of public health infrastructure probably the best strategy for national and large-scale naloxone distribution programmes.
Addiction.
ISSN 0965-2140.
111(7),
s. 1309–1310.
doi:
10.1111/add.13400.
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Lobmaier, Philipp Paul & Clausen, Thomas
(2016).
Radical red tape reduction by government supported nasal naloxone: the Norwegian pilot project is innovative, safe and an important contribution to further development and dissemination of take-home naloxone.
Addiction.
ISSN 0965-2140.
11(4),
s. 586–587.
doi:
10.1111/add.13261.
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Havnes, Ingrid Amalia; Clausen, Thomas & Bukten, Anne
(2016).
Anabolic androgenic steroid use prior to and during imprisonment - findings from a Norwegian national prison survey.
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Berntson, Eirik; Bernhard-Oettel, Claudia; Christensen, Marit; Clausen, Thomas & Mauno, Saija
(2016).
The Launch of a New Scandinavian Journal of Work and Organizational Psychology.
Scandinavian Journal of Work and Organizational Psychology.
ISSN 2002-2867.
1(1),
s. 1–2.
doi:
10.16993/sjwop.12.
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Clausen, Thomas
(2015).
Coherent long-term treatment approaches–superior in the treatment of opioid dependence.
Addiction.
ISSN 0965-2140.
110(6),
s. 1006–1007.
doi:
10.1111/add.12922.
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Clausen, Thomas; Kristensen, Øistein & Åsland, Reidun
(2014).
Re: Pasienter som avbryter LAR-behandling - hvordan går det med dem?
Tidsskrift for Den norske legeforening.
ISSN 0029-2001.
134(16),
s. 1548–1549.
doi:
10.4045/tidsskr.14.0927.
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Skeie, Ivar; Clausen, Thomas & Bukten, Anne
(2014).
I. Skeie og medarbeidere svarer: :.
Tidsskrift for Den norske legeforening.
ISSN 0029-2001.
134(16).
doi:
10.4045/tidsskr.14.0922.
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Skeie, Ivar; Clausen, Thomas & Bukten, Anne
(2014).
Legemiddelassistert rehabilitering – viktig behandling med dilemmaer :.
Tidsskrift for Den norske legeforening.
ISSN 0029-2001.
134(11),
s. 1156–1158.
doi:
10.4045/tidsskr.13.1429.
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Wüsthoff, Linda Elise; Rognli, Eline Borger; Waal, Helge & Clausen, Thomas
(2013).
Lost in Downtown Oslo - How did they get there and how do they get out? - A Project presentation.
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Bukten, Anne & Clausen, Thomas
(2012).
Økt bruk av legemiddelassistert rehabilitering kan føre til færre heroinmisbrukere i norske fengsel.
Aktuelt for kriminalomsorgen.
ISSN 0803-6438.
1,
s. 16–16.
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Bukten, Anne & Clausen, Thomas
(2012).
Kriminalitetsreduserende rusbehandling.
Rus & samfunn.
ISSN 1500-8614.
s. 12–14.
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Waal, Helge & Clausen, Thomas
(2011).
The Importance of a Life Long Perpective in Opioid Maintenance Therapy (OMT). Theoretical Analyses and Empirical Evidence.
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Hjemdahl, Bente; John-Kåre, Vederhus & Clausen, Thomas
(2011).
Quality of Life (QoL) - Perceived QoL among Patients Admitted to Detox.
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Clausen, Thomas
(2011).
Mortality is reduced while on opiate maintenance treatment, but there is a temporary increase in mortality immediately after starting and stopping treatment, a finding that may vary by setting.
Evidence-Based Medicine.
ISSN 1356-5524.
16(3),
s. 94–95.
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Gjersing, Linn Renathe & Clausen, Thomas
(2011).
Holdninger og behandlinger.
Rus & samfunn.
ISSN 1500-8614.
5(3),
s. 28–29.
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Gjersing, Linn Renathe; Jonassen, Kristine Vinge; Skurtveit, Svetlana; Bramness, Jørgen Gustav & Clausen, Thomas
(2011).
A descriptive registry study of those who died from drug-induced deaths between 2006-2008 in Oslo.
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Bukten, Anne; Røislien, Jo; Skurtveit, Svetlana & Clausen, Thomas
(2011).
GENDER DIFFERENCES IN CRIME DURING PERIODS OF TRANSITION IN OPIOID MAINTENANCE TREATMENT: A NATIONAL COHORT STUDY.
Drug and Alcohol Review.
ISSN 0959-5236.
30,
s. 16–16.
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Fredheim, Olav Magnus; Borchgrevink, Petter Chr.; Nordstrand, Berit; Clausen, Thomas & Skurtveit, Svetlana
(2010).
Prescription of analgesics to patients in opioid maintenance therapy - a pharmacoepidemiological study.
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Bukten, Anne; Havnes, Ingrid Amalia; Skurtveit, Svetlana; Gossop, Michael; Waal, Helge & Stangeland, Per
[Vis alle 7 forfattere av denne artikkelen]
(2010).
Kriminalitet - før, under og etter LAR (1997-2003)Fokus på regionale forskjeller.
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Bukten, Anne; Skurtveit, Svetlana; Gossop, Michael; Havnes, Ingrid Amalia; Waal, Helge & Clausen, Thomas
(2010).
The effect of Opioid Maintenance Treatment on rates of criminal charges during a 7 year study period: A longitudinal national cohort study.
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Havnes, Ingrid Amalia; Bernard, Jean-Paul Anthony; Waal, Helge; Clausen, Thomas & Mørland, Jørg
(2010).
Methadone treatment and methadone-related deaths in Norway.
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Havnes, Ingrid Amalia; Bukten, Anne; Waal, Helge & Clausen, Thomas
(2010).
Violent crime before, during and after opioid maintenance treatment; a national cohort study.
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Havnes, Ingrid Amalia; Bukten, Anne; Waal, Helge & Clausen, Thomas
(2010).
Voldskriminalitet før, under og etter LAR.
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Gjersing, Linn Renathe; Waal, Helge & Clausen, Thomas
(2009).
BENZODIAZEPINE USE AMONG PATIENTS IN OPIOID MAINTENANCE TREATMENT (OMT) CENTRES WITH DIFFERENT TREATMENT APPROACHES.
Drug and Alcohol Review.
ISSN 0959-5236.
28,
s. A24–A24.
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Anchersen, Katinka; Hansteen, Viggo; Gossop, Michael; Clausen, Thomas & Waal, Helge
(2009).
QTc Prolongation during opioid maintenance treatment: congenital long QT syndrome and cardiac management.
-
Clausen, Thomas
(2009).
Age and its relationship with cause of death among opiate users.
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Clausen, Thomas
(2009).
Opioid Maintenance Therapy (OMT) and cardiac arrhythmia; Mortality assessment in a Norwegian national registry study.
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Clausen, Thomas
(2009).
Mortalitet før, under og etter LAR.
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Vederhus, John-Kåre; Kristensen, Øistein; Laudet, Alexandre & Clausen, Thomas
(2009).
Attitudes toward 12-step groups and referral practices in a culture naive to 12-step ideology.
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Clausen, Thomas
(2009).
Samfunnets reaksjoner og sanksjoner; bruk av tvang.
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Clausen, Thomas; Langva, H. A. & Gudmestad, Ove Tobias
(2007).
Heated Arctic Bundles.
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Clausen, Thomas; Langva, H. A. & Gudmestad, Ove Tobias
(2007).
Heated Arctic Bundles,
Proceedings of Russian Arctic Offshore Conference, RAO 2007.
Russian Arctic Offshore Conference, RAO 2007.
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Clausen, Thomas & Waal, Helge
(2007).
Patterns of mortality after Opioid Maintenance Treatment.
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Clausen, Thomas & Rossow, Ingeborg
(2007).
Diverse alcohol drinking patterns in 20 African countries.
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Clausen, Thomas
(2006).
Mental disorder and limited social support predict of short survival in older persons in Botswana.
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Clausen, Thomas & Holmboe-Ottesen, Gerd
(2004).
Health inequalities in older persons in Botswana, a sub-Saharan African country in health transition.
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Johannessen, Hans-Olaf; Clausen, Thomas; Mjåland, Odd & Johnson, Egil
(2003).
Smerter og rehablitering etter dagkirurgi for lyskebrokk.
Vis sammendrag
Regionsmøte for Gastrointeresserte leger, Helseregion Øst.
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Clausen, Thomas; Romøren, Tor Inge & Holmboe-Ottesen, Gerd
(2003).
Self reported health status among the elderly in Botswana.
Vis sammendrag
Den ellevte norske epidemiologikonferansen.
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Clausen, Thomas; Gobotswang, Kesitegile & Holmboe-Ottesen, Gerd
(2003).
Nutritional status among the older adults in Botswana.
Vis sammendrag
Geriatrix Africa'03, Geriatric care in Africa-now and the future.
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Clausen, Thomas; Romøren, Tor Inge; Molebatsi, Robert & Holmboe-Ottesen, Gerd
(2003).
Alcohol consumption among the elderly in Botswana: Drinking patterns and some relevant health measures.
Vis sammendrag
Geriatrix Africa'03, Geriatric care in Africa -Now and the future.
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Clausen, Thomas; Romøren, Tor Inge & Holmboe-Ottesen, Gerd
(2003).
Health status among the elderly in Botswana.
Vis sammendrag
Abstract #63947, Session 5042.0, 2003 November 15-19,
San Francisco, CA (APHA; 131st Meeting)
Behavior, Lifestyle, and Social Determinants of Health.
http://apha.confex.com/apha/131am/techprogram/meeting_131am.htm
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Clausen, Thomas; Romøren, Tor Inge; Gobotswang, Kesitegile & Holmboe-Ottesen, Gerd
(2002).
Alcohol consumption among the elderly in Botswana; Is it a health problem?
Vis sammendrag
A study of drinking patterns in relation to health problems among the elderly in Botswana.
The data were collected in 1998-99 as part of a national medical survey among inhabitants above 60 years of age in Botswana. A national representative sample of 372 respondents (response rate 72%.) were visited at home; interviewed with questionnaires and subjected to a medical examination. Of the total study population 34% were current drinkers, 24% previous drinkers and 42% were life-time abstainers. A sorghum based homemade beer was the most commonly consumed beverage. About three times as many men were current drinkers compared to women (O/R; 3,3 [1,8-6,3]). Multinomic logit regression analyses show that higher socioeconomic status and being a Christian reduces the likelihood of being a current drinker. When the group of current drinkers as a whole is compared with the previous drinkers and life time abstainers the following differences were found: 10% of the current drinkers reported to have severe health problems, 33% of previous drinkers and 8% of life-time abstainers reported the same. 9% of the current drinkers have BMI above 30, compared with 20% of previous drinkers and 23% of lifetime abstainers. For BMI below 18, the corresponding figures are; 16%, 13% and 10% respectively. Among the current drinkers 30% also smoked tobacco, whereas only 6% of previous drinkers and 7% of life time abstainers did so.
In addition to being female, higher SES and being a Christian contribute to reducing the likelihood of drinking alcohol in this population. Previous drinkers report more health problems than current drinkers and life time abstainers. But even though current drinkers report "good health", risk factors like drinking, smoking and poor nutrition cluster in this group.
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Mjåland, Odd; Clausen, Thomas & Tønnessen, Theis
(1997).
Brokkirurgi-1-årsmateriale fra dagkirurgisk avdeling.
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Nesse, Linda; Lobmaier, Philipp Paul; Skeie, Ivar; Lillevold, Pål Henrik & Clausen, Thomas
(2023).
Statusrapport 2022: Første år med nye LAR-retningslinjer.
Universitetet i Oslo.
Vis sammendrag
SERAF utarbeider en årlig nasjonal statusrapport for legemiddelassistert rehabilitering (LAR) på oppdrag fra Helsedirektoratet. Statusrapportenen er basert på en kartlegging som alle LAR-tiltakene gjennomfører en gang i året. Formålet er å kartlegge pasientenes situasjon, behandling, og behandlingsutfall i LAR. Denne spørreundersøkelsen har blitt gjennomført gjennom de siste 23 årene, og har vist at LAR over tid har utviklet seg til å være en godt etablert, standardisert behandling for de fleste med opioiddominert avhengighet.
I statusrapporten oppsummeres sentrale funn om situasjonen til pasienter i LAR, aktuell behandlingsstatus, medikamentell behandling (inkludert valg av medikament og dosering), psykososial oppfølging (som behandlingsmål, individuell plan, ansvarsgruppemøter og behandling for psykiske helseproblemer), psykiske helseproblemer og rusbruk siste fire uker, og rusbruk og helserelaterte forhold siste år, og tilfredshet med behandlingen. I tillegg presenteres funn om dødsfall blant pasienter i LAR siste år. Ivar Skeie har analysert mortalitetsdata og har fulgt LAR-tiltakene tett for å kunne inkludere komplette tall på overdoser, suicid og naturlige dødsfall.
Årets statusrapport bygger på svar fra 18 ulike LAR-tiltak fordelt på fem regioner. Innføringen av det elektroniske journalsystemet Helseplattformen ved St. Olavs hospital og i Nord-Trøndelag har medført utfordringer som har gjort at disse LAR-tiltakene ikke har hatt mulighet til å gjennomføre statusundersøkelsen. Dette innebærer at tallene som presenteres for region Midt ikke kan sammenlignes med fjorårets tall for samme region, og at nasjonale gjennomsnitt ikke inkluderer St. Olavs hospital og Nord-Trøndelag.
I 2022 ble det innført nye LAR-retningslinjer, og dette er den første statusrapporten som er gjennomført etter dette. I tillegg inneholder årets statusrapport flere nye elementer. LAR-tiltak som benytter det elektroniske journalsystemet DIPS Arena har besvart en noe videreutviklet versjon av statusundersøkelsen som inkluderer nye tilleggsopplysninger. Tiltakene det gjelder er Oslo, Bergen, Fonna og Førde. De nye spørsmålene omhandler blant annet opplevde bivirkninger av LAR-medikament, og ulike spørsmål om fysisk helse, sykdommer og behandling siste år. Spørsmålene er besvart av omtrent 1 av 4 pasienter i LAR, og bidrar til å videreutvikle kunnskap om behandlingen og om pasientenes situasjon. Samtidig er det første gang pasienter som er i heroinassistert behandling (HAB) deltar i statsundersøkelsen. I et av kapitlene oppsummeres hovedfunn for pasienter i HAB.
Vi ser at økningen av gjennomsnittsalderen i LAR fortsetter også i år. Vi minner om at en aldrende LAR-populasjon er å anse som en suksess i seg selv. LAR har medført at mange personer med opioidavhengighet kan eldes med sykdommen. Samtidig ønsker vi i fremtiden å styrke forutsetninger for gode levevaner, tilgjengelig utredning og behandling for psykiske lidelser, utredning og behandling for somatiske sykdommer som hepatitt C, og regelmessige legeundersøkelser. Det er viktig at LAR fortsetter å være en behandlingsmodell som oppleves tilgjengelig, til å leve godt med over tid, med høy faglig kvalitet og forsvarlighet. Samtidig er det viktig å støtte majoriteten av pasientene i å ha en rimelig god rusmestring. Denne balansegangen utgjør hverdagen til pasienter og behandlere i LAR.
Denne rapporten er resultatet av betydelig innsats i hvert LAR-tiltak. Vi takker for innsatsen fra pasienter i LAR som har besvart statusundersøkelsen, LAR-ansatte over hele landet for arbeidet med innsamling av svar, og for et godt samarbeid med LAR-tiltakene og med Helsedirektoratet.
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Bech, Anne Berit; Bukten, Anne; Lobmaier, Philipp Paul; Skeie, Ivar; Lillevold, Pål Henrik & Clausen, Thomas
(2022).
SERAF RAPPORT 2/2022
Statusrapport 2021-Siste år med gamle LAR-retningslinjer.
7Letras.
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Bech, Anne Berit; Clausen, Thomas & Lillevold, Pål Henrik
(2022).
SERAF rapport 1/2022 - Forebygging og håndtering av covid-19 i LAR-tiltakene i spesialisthelsetjenesten 2021 - Erfaringer og tiltak.
7Letras.
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Bukten, Anne; Lokdam, Nicoline; Clausen, Thomas & Skjærvø, Ingeborg
(2021).
Bruk, besittelse og ruspåvirket kjøring blant innsatte i Norske fengsel 2000-2019.
Senter for rus og avhengighetsforskning (SERAF).
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Lobmaier, Philipp Paul; Skeie, Ivar; Lillevold, Pål Henrik; Bussesund, Kari; Waal, Helge & Clausen, Thomas
(2020).
Statusrapport 2019
Nye medisiner - nye muligheter?
SERAF RAPPORT 1/2020.
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Stavseth, Marianne Riksheim; Clausen, Thomas & Røislien, Jo
(2019).
Annual assessment data from the Norwegian opioid maintenance programme: A methodological perspective.
Universitetet i Oslo.
ISSN 978-82-8377-460-3.
Vis sammendrag
Background and aims: Application of statistics to medicine has been named one of the greatest advances of the second millennium and there has been an expansive growth and development in statistical methods within this field of research. This study investigates clinical and methodological aspects regarding the annual assessment questionnaire from the Norwegian Opioid Maintenance Treatment (OMT) programme. In addition, it facilitates the description of complex statistical methods and illustrates the advantages and disadvantages of the methods to a wider audience.
Material and methods: The data utilized in this study was collected among patients in the Norwegian OMT programme. Aggregate data based on 34 001 questionnaires collected between 2002-2011 were used to study the development of the OMT programme. Person-level data consisting of 18 538 questionnaires collected from 5 654 unique patients in 2005-2010 were used to study clinical and methodological aspects of ongoing criminal activity in OMT.
Trends in the OMT programme were investigated using a Mann Kendall trend test and factors associated with engagement in criminal activity were examined using generalized estimation equations (GEE). Through an extensive simulation study including six different imputation methods, the handling of missing data was investigated. How to perform variable selection was explored with a range of methods in a case study.
Results: The Norwegian OMT programme expanded widely in the 10-year period between 2002-2011, while shifting the main substitution medicine from methadone to buprenorphine. Having a full or part-time job, being a student and living under stable conditions is negatively associated with ongoing criminal in OMT, while being male, younger, and using illicit drugs regularly was positively associated with ongoing criminal engagement while in OMT.
Handling missing data becomes especially important when the proportion of missing data is high (≥20%) and when the sample size is small. Complete Case analysis should be used with caution is this setting, while Multiple Imputation using Multiple Correspondence Analysis has shown promising results.
The choice of variables to be included in a logistic regression model will depend on the aim of the study. However, a variable selection strategy should always be carefully considered. Using a combination of expert-based selection and automated procedures is recommended.
Discussion and conclusion: Based on aggregate data recorded over a long time period, several marked changes in the Norwegian OMT programme were observed. Despite the varying quality of the data, the findings are important to monitor and evaluate many aspects of the treatment programme. Person-level data give more information and allow more detailed analysis. By using GEE to account for dependencies in clustered data, important association between engagement in criminal activities while in OMT treatment could be identified.
Ignoring the presence of missing data and failing to handle it may result in distorted clinical conclusions, both in regard to effect estimates and the associated confidence intervals. The choice of variables selection procedure may also influence clinical conclusions, as it affects both which covariates are selected and the effect sizes. Increased awareness concerning the importance of handling missing data and performing variable selection will be crucial in a world where science is being questioned while more and more data is collected.
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Edvardsen, Hilde Marie Erøy; Rogde, Sidsel; Clausen, Thomas & Vindenes, Vigdis
(2018).
GHB-, fentanyl- og oksykodonrelaterte dødsfall.
Universitetet i Oslo.
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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.
ISSN 978-82-8377-250-0.
-
Madah-Amiri, Desiree; Clausen, Thomas & Lobmaier, Philipp Paul
(2017).
Opioid overdoses and overdose prevention:
The establishment of take-home naloxone in Norway.
Universitetet i Oslo.
ISSN 978-82-8377-110-7.
-
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.
ISSN 978-82-8377-139-8.
Fulltekst i vitenarkiv
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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 in
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Tjagvad, Christian; Clausen, Thomas & Skurtveit, Svetlana
(2016).
Addictive medication in relation to drug treatment and overdose death.
Universitetet i Oslo.
ISSN 978-82-8333-308-4.
Fulltekst i vitenarkiv
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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
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Havnes, Ingrid Amalia; Clausen, Thomas; Middelthon, Anne-Lise Orvin & Waal, Helge
(2015).
Violence and diversion of prescribed opioids among individuals in opioid maintenance treatment.A complementary methods study of violent crime convictions in a national cohort and qualitative interviews among prisoners.
Universitetet i Oslo.
ISSN 978-82-8264-944-5.
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Opsal, Anne; Clausen, Thomas & Larsen, Tor Ketil
(2013).
Involuntarily admitted patients with substance use disorders.
Universitetet i Oslo.
ISSN 978-82-8264-574-4.
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Martinez, Priscilla; Lien, Lars; Clausen, Thomas & Landheim, Anne
(2013).
Alcohol use in special populations in Africa: Data from the World Health Survey and Study on Global AGEing and adult health.
Universitetet i Oslo.
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Bramness, Jørgen Gustav; Clausen, Thomas; Ravndal, Edle & Waal, Helge
(2012).
LAR- forskningen 2011.
7Letras.
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Waal, Helge; Clausen, Thomas; Håseth, Atle & Lillevold, Pål Henrik
(2012).
Statusrapport 2011 LAR i Helseforetakene.
Universitetet i Oslo.
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Bukten, Anne; Clausen, Thomas & Skurtveit, Svetlana
(2012).
Criminal convictions among patients in opioid maintenance treatment in Norway. A national cohort study.
Unipub forlag.
ISSN 978-82-8264-465-5.
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Waal, Helge; Clausen, Thomas; Håseth, Atle & Lillevold, Pål Henrik
(2011).
SERAF rapport 1/2012. Statusrapport 2011 LAR i helseforetakene.
7Letras.
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Gjersing, Linn Renathe; Biong, Stian Nissen; Ravndal, Edle; Waal, Helge; Bramness, Jørgen Gustav & Clausen, Thomas
(2011).
Dødelige overdoser i Oslo 2006 til 2008 : En helhetlig gjennomgang.
Senter for rus- og avhengighetsforskning (SERAF).
ISSN 978-82-93019-03-9.
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Waal, Helge; Gjersing, Linn Renathe & Clausen, Thomas
(2011).
Open Drug Scenes and Overdose Mortality - What to Do? Lessons from five European cities.
Universitetet i Oslo.
ISSN 978-82-93019-02-2.
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Gjersing, Linn Renathe; Waal, Helge & Clausen, Thomas
(2009).
Evaluering av Klinikk Motivasjon (SERAF rapport 3/2009).
Unipub forlag.
ISSN 978-82-93019-00-8.
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Christensen, Marit; Straume, Lisa Vivoll; Kopperud, Karoline Hofslett; Borg, Vilhelm; Clausen, Thomas & Hakanen, Jari
[Vis alle 9 forfattere av denne artikkelen]
(2007).
Positive Factors at Work.
Ekspressen Tryk & Kopicenter.