Non-Prescribed Use of Opioid Agonist Medications and Associations with Non-Fatal Overdoses: A Repeated Cross-Sectional Study across a Decade of Reduced Monitoring
Year: 2025
Type: article
Study design: Observational Study
Abstract: Introduction: Non-prescribed use of opioid agonist treatment (OAT) medications is a public health concern. This study analyzes the prevalence of non-prescribed use and non-fatal overdoses in Norway in 2013 and 2023, a period marked by an increasingly flexible OAT regimen, and examines associations between non-prescribed use and non-fatal overdoses. METHODS: = 523 in 2023) of street-recruited individuals, who reported recent use of opioids and/or stimulants but were not currently enrolled in OAT, were employed. The primary outcomes were self-reported non-prescribed use of methadone and buprenorphine and non-fatal overdoses in the past month and past year. Covariates included demographics and substance use characteristics. RESULTS: Non-prescribed use of OAT medications significantly declined from 39.4% in 2013 to 28.1% in 2023 (p < 0.001), as did frequency of use (p < 0.01). There was no change in non-fatal overdoses in the past month (8.2% in both years), though past-year non-fatal overdoses decreased (23.6% in 2013 vs. 15.9% in 2023, p = 0.001). Multinomial regression analyses showed no significant association between non-prescribed OAT use and increased risk of non-fatal overdoses. Instead, factors such as injecting drug use, frequent heroin use, stimulant use, younger age, and female sex were associated with non-fatal overdose risk. CONCLUSION: Even with an increasingly flexible OAT regimen, non-prescribed use declined among street-recruited participants, and no corresponding increase in non-fatal overdoses was observed. These findings challenge the assumption that reduced monitoring in OAT is linked with higher rates of non-prescribed use and adverse outcomes, such as non-fatal overdoses, among individuals not in OAT. .
Source: European Addiction Research
DOI: 10.1159/000547909
Authors: Anne Line Bretteville-Jensen, Linda Nesse
Institutions: Norwegian Institute of Public Health, University of Oslo
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4413101742