Substance abuse, anxiety and depression after 10 years: A prospective study of drug users in and outside OMT treatment AIMS - The national Opiate Maintenance Treatment (OMT) program in Norway started officially in 1998. The same year a treatment study was initiated, including the most used treatment measures for drug users in Norway. The main aim in the present study was to investigate the prevalence of live OMT patients in the total sample after 10 years, and to compare the outcome of primarily substance abuse, anxiety and depression among OMT patients versus non-OMT patients. DESIGN & METHODS - Four hundred and seven patients, in Oslo and the nearby regions, who started in 16 different in- and outpatients programs, were followed from intake to treatment and during ten years (1998-2009). Patients in the sample were interviewed after one, two, seven and ten years, and they were divided into three different treatment groups: inpatient residency for grown-ups, outpatient psychiatric youth teams and youths living in collectives. Data was collected through use of EuropASI and HSCL-25 at all follow-ups. RESULTS - After ten years 15 % were deceased. Of the 333 persons left, 73 % (n=248) were interviewed after ten years. Forty percent (n=99) were then in OMT. After ten years there were no gender differences regarding attendance to OMT, but the OMT-group was older (30 vs .28 yrs, p<0.05), and they used more benzodiazepines (p<0.000) and cannabis (p<0.01) than the others. The OMT-group reported to a larger extent more anxiety and depression throughout the total observation period than the non OMT participants. Use of heroin and criminality were significantly reduced in both groups. CONCLUSIONS - In spite of reduced use of heroin, the OMT patients seemed to have more difficulties in reducing the use of benzodiazepines and cannabis, whereas the anxiety and depression scores were high and stable through the total observation time.
Siv Merete Myra, Edle Ravndal, Vigdis Wie Torsteinsson and Eli Marie Wiig
BACKGROUND – Use of coercion against pregnant women who misuse substances was legalised in Norway in 1996. The background for the law was that substance abuse during pregnancy represents a significant health problem for the child.
AIM – The main aim of this study was to explore if an attachment between the mother and her unborn child was possible in a context of coercion as experienced from the woman’s perspective. The women had many challenges, such as lack of social support and poor living conditions.
MATERIAL – Data were collected in eight qualitative indepth interviews.
FINDINGS – The main findings show how involuntary detention enabled safety for and connection with the unborn child. Within this context, the pregnant substance-abusing women’s own relational experiences and developmental histories represent the most significant barrier for their ability to bond with the expected child.
CONCLUSIONS – The study underlines the importance of helping women with their own attachment experiences in order to break the generational transference of risk and pathology, and in this way, start the attachment process to the unborn child during the coerced treatment stay. Implications of the findings are discussed.