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Rossow I, Bramness JG. The total sale of prescription drugs with an abuse potential predicts the number of excessive users: a national prescription database study. BMC Public Health 2015; 15:288. [PMID: 25885781 PMCID: PMC4377902 DOI: 10.1186/s12889-015-1615-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 03/05/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prescription drug sales may vary considerably across regions and over time. This study aimed to assess whether there is an association between mean drug sales and prevalence of excessive use in a range of psychotropic prescription drugs with an abuse potential, and if so, whether the variation in mean drug sales mostly reflects variation in the prevalence of excessive use or mostly reflects variation in non-excessive use. METHODS Data on all filled prescriptions taken from the Norwegian prescription database for 10 drugs with an abuse potential (pain relievers, anxiolytics, and hypnotics) during one calendar year (2005) in Norway (n = 4,053,624) included number of defined daily doses (DDD). These were aggregated to individual level (n = 815,836) and county level (n = 19). RESULTS Analyses of individual level data showed that the distribution of drug use was skewed; those who used more than 365 DDD per year accounted for almost half of the sales of both anxiolytics and hypnotics. At the county level, the mean sales per inhabitant and the prevalence of excessive users were closely correlated, but both prevalence of non-excessive use and prevalence of excessive drug use were associated with the county-wise variation in mean drug sales. CONCLUSION Despite a strong individual control of access to psychotropic drugs through health personnel' prescribing, a small proportion of users account for a large fraction of the sales of these drugs. The sales vary significantly between regions and this variation is closely associated with the prevalence of excessive users. This suggests that sales figures as such may be used as an indicator to monitor variations in excessive use between regions and over time, and to evaluate interventions targeting over-prescription and excessive use.
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Neupane SP, Lien L, Martinez P, Hestad K, Bramness JG. The relationship of alcohol use disorders and depressive symptoms to tryptophan metabolism: cross-sectional data from a Nepalese alcohol treatment sample. Alcohol Clin Exp Res 2015; 39:514-21. [PMID: 25639711 DOI: 10.1111/acer.12651] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 12/03/2014] [Indexed: 01/22/2023]
Abstract
BACKGROUND Activation of the kynurenine pathway of tryptophan metabolism results in increased production of potentially depressogenic tryptophan catabolites and a reduction in tryptophan availability for serotonin synthesis. As alcohol consumption affects tryptophan metabolism and disposition, we determined serum levels of tryptophan, kynurenine, and an index of tryptophan degradation (kynurenine/tryptophan ratio) in patients with alcohol-use disorder (AUD) and compared their levels considering abstinence duration, AUD severity, and comorbid depression. METHODS The study sample included 169 AUD inpatients from 8 alcohol treatment facilities in Kathmandu, Nepal. The Composite International Diagnostic Interview was administered to generate the AUD diagnosis. The Alcohol Use Disorder Identification Test (AUDIT) captured AUD severity and patterns of alcohol use. The Hopkins Symptom Checklist-25 was used to reveal current depressive symptoms. Serum kynurenine and tryptophan levels were determined by high-performance liquid chromatography, and tryptophan degradation was measured by KT ratio (kynurenine/tryptophan × 10(3)). RESULTS Patients with above average AUDIT scores had higher mean serum levels of kynurenine (2.1 μM ± 0.7 vs. 1.8 μM ± 0.6, p = 0.006) and KT ratios (48.6 ± 17.6 vs. 40.4 ± 14.3, p = 0.002) than those with below average scores. Patients with current depressive symptoms had higher mean tryptophan concentrations (49.9 μM ± 13 vs. 45.7 μM ± 14.1, p = 0.047) and lower KT ratios (41.4 ± 14 vs. 47.5 ± 17.6, p = 0.028) compared to patients whose reported depressive symptoms were below the standard cutoff. Higher tryptophan levels and lower KT ratios in the depressed group were specific to patients with longer abstinence and higher AUD severity. CONCLUSIONS Depression-related deregulation in tryptophan metabolism was found to depend on length of abstinence and on AUD severity. Together, results suggest that in AUD populations, peripheral tryptophan metabolism is subject to interactions between AUD severity and depressive symptoms.
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Bramness JG, Henriksen B, Person O, Mann K. Reply: To PMID 23921359. Eur Addict Res 2015; 21:32. [PMID: 25621344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
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Rognli EB, Medhus SE, Bramness JG. Amfetaminutløst psykose eller schizofreni? TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2015; 135:249-51. [DOI: 10.4045/tidsskr.14.1365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Bramness JG. Omfattende og godt om cannabis. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2015. [DOI: 10.4045/tidsskr.14.1511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Skrede S, Tvete IF, Tanum L, Steen VM, Bramness JG. Incident users of antipsychotic agents and future use of cholesterol-lowering drugs: an observational, pharmacoepidemiologic study. J Clin Psychiatry 2015; 76:e111-6. [PMID: 25650676 DOI: 10.4088/jcp.14m08996] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 04/29/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Antipsychotic agents have serious metabolic adverse effects, among them dyslipidemia, which may necessitate secondary prophylaxis with cholesterol-lowering drugs. Second-generation antipsychotics (SGAs), particularly clozapine and olanzapine, are known to confer a higher risk of metabolic adverse effects than first-generation antipsychotics (FGAs). However, little is known regarding the real-life number of antipsychotic-treated patients receiving statins. METHOD By extracting data from the Norwegian prescription database, all patients 18-69 years old that started treatment with an antipsychotic during 2004-2012 formed the basis for analysis (n = 301,713). The primary outcome measure was the proportion of FGA and SGA users prescribed with cholesterol-lowering agent during the same period. We used Cox proportional hazards regression to evaluate the risk of redeeming a cholesterol-lowering drug for formerly antipsychotic drug-naive patients (n = 147,218). RESULTS Statin prescription rates in patients receiving antipsychotic agents were lower (5.3%) than comparable rates in studies covering the general population (34%) and lower than would be expected based on the recognized negative impact of antipsychotics on serum lipids. Statin prescription rates were affected by patient age, antipsychotic dose, and the number of antipsychotic agents prescribed, but rates were only 5% elevated in patients receiving SGAs compared to patients receiving FGAs (P = .048). CONCLUSIONS Our results may support the notion that patients treated with antipsychotic agents receive suboptimal care with regard to metabolic adverse effects.
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Eikemo M, Bramness JG. Klinisk anvendelig om nevrobiologi og avhengighet. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2015. [DOI: 10.4045/tidsskr.15.0221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Bramness JG. Skadelig bruk av legemidler. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2015. [DOI: 10.4045/tidsskr.15.1172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Bramness JG. Skadelig bruk av legemidler. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2015. [DOI: 10.4045/tidsskr.15.0787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Bramness JG. God norsk innføringsbok til forståelse av rus- og avhengighetsproblematikk. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2015. [DOI: 10.4045/tidsskr.14.1294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Neupane SP, Bramness JG. Who seeks treatment for alcohol problems? Demography and alcohol-use characteristics of patients in taboo and non-taboo drinking groups attending professional alcohol services in Nepal. Asian J Psychiatr 2014; 12:82-7. [PMID: 25440566 DOI: 10.1016/j.ajp.2014.06.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 06/11/2014] [Accepted: 06/15/2014] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Only few individuals with alcohol problems seek help; those who do have not been described adequately. Here, we summarize the demographic and alcohol-related features of inpatients attending professional alcohol services in Nepal and examine differences between patients with and without social taboos about drinking. METHODS Fully structured interviews including the Composite International Diagnostic Interview and the Alcohol Use Disorder Identification Test were administered to 177 men and 21 women consecutively admitted to eight alcohol treatment centres in Kathmandu. RESULTS Altogether, 164 patients (83%) had alcohol dependence and 24 patients (12%) had alcohol abuse. The sample had a mean age of 35.3 years (SD 10.1) with a time lag of 16.8 years (SD 9.8) from start of habitual drinking to first entry into treatment. Most (62%) were married, lived in urban areas (72%), had above-average income (57%), received adequate social support (71%), and belonged to social groups in which drinking is taboo (57%). Individuals in non-taboo group more often lived in urban areas, had lower socioeconomic status, more often reported parental problem drinking and started drinking at a younger age, whereas individuals in the taboo group more often had late onset, risky drinking, and waited longer before seeking treatment (P<0.05). CONCLUSION Traditionally alcohol non-using castes and people with higher socioeconomic status over-represent professional alcohol services in Kathmandu. This, and high levels of hazardous and harmful alcohol use, indicate changing trends concerning social tolerance towards alcohol in Nepalese society in recent times and a heavy burden associated with alcohol disorders.
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Neupane SP, Lien L, Martinez P, Aukrust P, Ueland T, Mollnes TE, Hestad K, Bramness JG. High frequency and intensity of drinking may attenuate increased inflammatory cytokine levels of major depression in alcohol-use disorders. CNS Neurosci Ther 2014; 20:898-904. [PMID: 24995667 PMCID: PMC4257130 DOI: 10.1111/cns.12303] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 06/02/2014] [Accepted: 06/03/2014] [Indexed: 01/09/2023] Open
Abstract
AIMS As major depression (MD) is often comorbid with alcohol-use disorders (AUD) and alcohol itself modulates the immune system, we examined serum levels of interleukin (IL)-6, IL-10, tumor necrosis factor (TNF), and interferon (IFN)-γ in AUD patients with and without MD. Putative interactions between alcohol variables and MD on cytokine levels were also assessed. METHODS A consecutive sample of inpatients with AUD (N = 176) from eight alcohol treatment centers in Kathmandu, Nepal, was assessed for alcohol use and depression by administering fully structured psychiatric interviews. Serum cytokine levels were determined using multiplex technology. RESULTS Alcohol-use disorders patients with a positive history of MD had higher levels of the inflammatory cytokines IL-6 (P = 0.019), TNF (P = 0.020), and IFN-γ (P = 0.001), but not of IL-10 (P = 0.853). AUD patients with MD had higher concentrations of cytokines compared with those without, regardless of the severity of the alcohol problem, but the difference was greater among those drinking in lower frequency and intensity. CONCLUSION These findings provide evidence for altered functioning of the immune system in AUD patients with comorbid MD. However, frequent and intense drinking may attenuate the difference in the cytokine profiles between AUD patients with and without MD.
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Rognli EB, Håkansson A, Berge J, Bramness JG. Does the pattern of amphetamine use prior to incarceration predict later psychosis?--a longitudinal study of amphetamine users in the Swedish criminal justice system. Drug Alcohol Depend 2014; 143:219-24. [PMID: 25146382 DOI: 10.1016/j.drugalcdep.2014.07.037] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 07/24/2014] [Accepted: 07/27/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The aim of this longitudinal study was to investigate the relationship between self-reported amphetamine use prior to inclusion in the criminal justice system and hospitalization due to psychosis in the years following release. METHOD All the information was extracted from existing databases. Amphetamine-using clients in the criminal justice system in Sweden were identified using the European version of the addiction severity index (Europ-ASI) interview. Between 2001 and 2006, a total of 1709 individuals were identified. A follow-up of the subjects, using national registry data, was conducted in 2010. The outcome measure was hospitalization for primary or substance-induced psychotic episodes during the follow-up period. Data was analyzed in a multivariate logistic regression model. RESULTS Age of onset of amphetamine use, number of years used, and use in the month prior to baseline interview were all unrelated to risk of future hospitalization due to psychosis. Prior psychiatric hospitalization and experience of hallucinations not related to drug use, as well as being born outside of a Nordic country and being homeless, were all positively linked to hospitalization due to psychosis. CONCLUSIONS This study demonstrates that, in a cohort of amphetamine users within the criminal justice system, prior psychiatric morbidity and demographic risk factors are more important than baseline patterns of amphetamine use in predicting future risk of hospitalization due to psychosis.
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Tveito M, Lorentzen B, Engedal K, Tanum L, Bramness JG, Refsum H, Høiseth G. Changes in cognitive function during psychogeriatric treatment in relation to benzodiazepine cessation. PHARMACOPSYCHIATRY 2014; 47:145-50. [PMID: 24936805 DOI: 10.1055/s-0034-1381982] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
INTRODUCTION The aim of this study was to investigate cognitive functions after admission to a geriatric psychiatric hospital, and to study the short-term effects of cessation of benzodiazepine use on cognitive functions. METHODS Details of benzodiazepine use and serum concentration measurements were recorded on admission. The Hopkins verbal learning test, the Stroop test, Digit Vigilance Test and the Mini Mental Status Examination were performed on admission, and after 4 weeks of hospitalization. Test results were compared for the total group of patients, as well as for benzodiazepine "continuers" and the "quitters". RESULTS For all patients (n=224), improved performances were observed in 10 out of 12 cognitive tests. Significant improvements were seen in 4 out of 12 tests. Benzodiazepine "quitters" improved significantly more than the "continuers" (p=0.027) only on the Hopkins verbal learning test, delayed recall performance. DISCUSSION Among elderly psychiatric patients, cognitive function improved slightly during the 4 weeks of hospital treatment, but only for one of the memory tests, the improvement was related to the cessation of benzodiazepine treatment.
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Bramness JG, Henriksen B, Person O, Mann K. A bibliometric analysis of European versus USA research in the field of addiction. Research on alcohol, narcotics, prescription drug abuse, tobacco and steroids 2001-2011. Eur Addict Res 2014; 20:16-22. [PMID: 23921359 DOI: 10.1159/000348260] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2012] [Accepted: 01/20/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND To compare the publication and citation rate within the areas of drug abuse and dependence research in Europe with that in the USA. METHODS This is a bibliometric study using the Thomson Reuters Web of Knowledge as data source, 40 key words were used as search terms, but certain scientific publications not concerning the issue were excluded. Scientific publications from Denmark, England, Finland, France, Germany, Italy, the Netherlands, Norway, Spain, Sweden, and the USA were studied. The number of publications in each country and in each year in addition to the citation indices for these publications was retrieved. RESULTS Approximately two thirds of the publications came from the USA. Both in absolute and relative figures, Europe lagged behind. The trend over the last decade was a greater gap between the amount of research performed in Europe versus the USA. There were thematic differences. Smaller European countries had a greater relative publication rate. The citations were relatively evenly distributed. CONCLUSIONS It has been claimed that 85% of the world's research within the field of drug abuse and dependence is carried out in the USA. This study challenges this figure, but European research within this field is lagging behind.
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Bramness JG. Rus, rusmiddel, rusgift, misbruk og skadelig bruk. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2014; 134:1968. [DOI: 10.4045/tidsskr.14.0905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Abstract
OBJECTIVE The use of central stimulant medication in adults with attention deficit hyperactivity disorder (ADHD) who receive opioid maintenance treatment remains controversial and empirical evidence is limited. Because of the abuse potential of stimulant drugs, Norway has restrictions on prescribing central stimulants to individuals who have substance use disorders or who are on opioid maintenance treatment. In this naturalistic study, we describe experiences from a program through which central stimulant medication was administered to patients with ADHD receiving opioid maintenance treatment. METHODS This report is based on a program evaluation of a combined treatment project designed to provide stimulant medication to patients with adult ADHD who were receiving opioid maintenance treatment. As part of the clinical treatment, patients were monitored closely for any medical issues or adverse medication reactions and provided regular urine samples for analysis and information regarding demographics, treatment goals, legal involvement, diagnoses, substance abuse, and ADHD symptoms. Monitoring occurred at baseline, at 2 months (after patients being stabilized on the central stimulant), and again at 3, 6 and 24 months. RESULTS Among 42 patients initially offered the combined treatment, 24 were actually eligible, 20 started the combined treatment, and 10 stayed in the program. We were not able to identify a single major cause of treatment dropout. Patients reported significantly fewer symptoms of ADHD at the 6- to 8-week point, regardless of whether the data were analyzed using an intent-to-treat (all participants) or per-protocol (only those with complete data at all points) method. Even though self-assessed ADHD scores dropped significantly during treatment, the scores still remained fairly high, suggesting persistent functional impairment. Neither severe complications nor increase in substance abuse were observed during treatment with central stimulants. CONCLUSIONS These findings show some promise with regard to the safety and utility of central stimulant medications for patients with ADHD who are receiving opioid maintenance treatment. Our study has methodological limitations, and systematic, well-designed clinical investigations are needed to increase the knowledge base.
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Bramness JG. Godt om makt og maktesløshet ved avhengighet. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2014. [DOI: 10.4045/tidsskr.14.0901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Neupane SP, Lien L, Hilberg T, Bramness JG. Vitamin D deficiency in alcohol-use disorders and its relationship to comorbid major depression: a cross-sectional study of inpatients in Nepal. Drug Alcohol Depend 2013; 133:480-5. [PMID: 23916323 DOI: 10.1016/j.drugalcdep.2013.07.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Revised: 07/05/2013] [Accepted: 07/08/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Mounting evidence suggests that deficiency of vitamin D may be associated with major health problems, including alcohol-use disorders (AUD) and major depression (MD). This study aimed to identify the vitamin D status of Nepalese inpatients with an AUD. We explored socio-demographic and alcohol-use related correlates and the relationship between vitamin D deficiency and comorbid MD. METHODS A cross-sectional study was conducted on AUD inpatients (N=174) at eight alcohol/drug treatment centres around Kathmandu. Structured questionnaires were administered to assess the socio-demographic and alcohol-use parameters and to establish DSM-IV diagnoses of AUD and MD. Vitamin D deficiency was defined as a serum 25-hydroxyvitamin D (25(OH)D) concentration of <50 nmol/L. RESULTS The prevalence of vitamin D deficiency was 64%. Higher age, having a stable job or business, shorter time since last alcohol intake and winter serum samples were related to having lower 25(OH)D levels. Several features of AUD severity were associated with low vitamin D levels: guilt about drinking, using alcohol as eye-opener, and history of relapse after alcohol treatment (p ≤ 0.03). Patients with a comorbid major depression, in particular secondarily depressed cases, were less likely to have vitamin D deficiency (X(2)=6.8; p=0.01). CONCLUSIONS This study confirms high rates of vitamin D deficiency in alcohol treatment sample and shows a positive association between vitamin D deficiency and severity of alcohol-use disorders. Competing risk and other confounders may help explain the vitamin D status among patients with alcohol-use disorders and comorbid major depression.
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Bukten A, Herskedal A, Skurtveit S, Bramness JG, Clausen T. Driving under the influence (DUI) among patients in opioid maintenance treatment (OMT): a registry-based national cohort study. Addiction 2013; 108:1954-61. [PMID: 23773400 DOI: 10.1111/add.12275] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 01/16/2013] [Accepted: 06/03/2013] [Indexed: 11/30/2022]
Abstract
AIMS To investigate convictions for driving under the influence (DUI) before, during and after opioid maintenance treatment (OMT) and to examine factors associated with convictions for DUI during treatment. DESIGN, SETTING AND PARTICIPANTS Treatment data on all patients who started OMT in Norway between 1997 and 2003 (n = 3221) were cross-linked with national criminal records using unique person identifiers. Patients were followed over a 9-year period, before, during and in periods out of opioid maintenance treatment. MEASUREMENTS Data were formal charges leading to convictions recorded during four different time-periods: 3 years prior to application, waiting-list, in-treatment and in periods out of treatment. FINDINGS During OMT, convictions for DUI were reduced by almost 40% compared with pre-application levels. The conviction rate for DUI for males in the pre-application period was 9.59 per 100 person-years (PY) and for females, 3.44 per 100 PY. During OMT, rates of DUI convictions were reduced to 5.97 per 100 PY among men and to 1.09 per 100 PY among women. However, when estimating the effect of OMT on convictions for DUI, the interaction between gender and exposure to OMT was not statistically significant. Patients who remained in continuous treatment had fewer convictions for DUI during treatment compared with patients in discontinuous treatment. Compared with patients having no road traffic convictions during the pre-application period, patients with two or more pre-application convictions for DUI had higher odds [odds ratio (OR) = 3.69 (2.30-5.93)] for further convictions for DUI during OMT. CONCLUSION In Norway, patients receiving opioid maintenance treatment (OMT) have reduced convictions for driving under the influence (DUI) compared with their pre-treatment levels. Being male and having a previous history of several convictions for DUI were found to be important risk factors for convictions for DUI during OMT.
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Holdø I, Handal M, Skurtveit S, Bramness JG. Association between prescribing hypnotics for parents and children in Norway. Arch Dis Child 2013; 98:732-6. [PMID: 23845695 DOI: 10.1136/archdischild-2013-303646] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To describe the dispensing of the hypnotic alimemazine to children aged 0-3 years and investigate the association between dispensing of alimemazine to children and dispensed hypnotics to their parents. DESIGN An observational cohort study linking information from the Medical Birth Registry of Norway and the Norwegian Prescription Database. Hypnotics dispensed to parents in a 1-year period before pregnancy was associated with dispensed alimemazine for children aged 0-3 years. PATIENTS AND SETTING All children born in Norway in 2008 (N=59 325) and their mothers and fathers were included. MAIN OUTCOME MEASURES Dispensed alimemazine to children during the first 3 years of life. RESULTS Three percent of children received alimemazine. Dispensed hypnotics to mothers increased the risk of the child receiving a prescription for alimemazine, OR of 2.3 (1.7-3.0) for boys and 1.7 (1.2-2.4) for girls. When both parents had been dispensed prescriptions for hypnotics, the risk increased nearly threefold. A dispensed alimemazine prescription was also associated with dispensed prescriptions for antidepressants to both mother and father, mother's smoking, the child's gender and child's prescriptions for antibiotics, respiratory drugs and dermatological steroids. CONCLUSIONS Dispensed alimemazine to children under 3 was associated with parents' previous use of hypnotics, indicating that factors other than the child's health influence the use of hypnotic drugs in infancy and toddler years. The frequent usage of alimemazine in children below 3 years and the association with parents' use of hypnotics should concern prescribing doctors.
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Westin AA, Bramness JG, Chalabianloo F, Rygnestad T, Slørdal L. [Pregabalin should be moved to the prescription group B]. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2013; 133:615-6. [PMID: 23552152 DOI: 10.4045/tidsskr.13.0013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Medhus S, Mordal J, Holm B, Mørland J, Bramness JG. A comparison of symptoms and drug use between patients with methamphetamine associated psychoses and patients diagnosed with schizophrenia in two acute psychiatric wards. Psychiatry Res 2013; 206:17-21. [PMID: 23036490 DOI: 10.1016/j.psychres.2012.09.023] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Revised: 09/13/2012] [Accepted: 09/16/2012] [Indexed: 10/27/2022]
Abstract
Psychosis induced by the use of amphetamine or methamphetamine leads to dramatic symptoms and frequent readmissions and poses diagnostic challenges. Earlier studies have often relied on history taking and/or urine samples to reveal drug use. The aim of this study was to compare the psychotic symptoms of two groups: (1) acutely admitted patients who tested positive for methamphetamines and were diagnosed with drug-induced or methamphetamine-induced psychoses and (2) acutely admitted patients who tested negative for methamphetamines and were diagnosed with schizophrenia. Blood and urine samples were used. In addition, we investigated whether the severity of symptoms, in those who tested positive, was related to the blood concentration of methamphetamine. Of 285 patients who volunteered blood and/or urine samples within 48h of admission, 37 (13%) had recently taken methamphetamine. Positive psychotic symptoms between the two groups were compared by PANSS using the positive subscale. The results showed no differences in positive psychotic symptoms between the two groups. The severity of positive psychotic symptoms in patients with three different levels of urine/blood methamphetamine concentrations, were compared. We found no clinically or statistically significant relationship between blood methamphetamine levels and severity of psychotic symptoms.
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Gjersing L, Jonassen KV, Biong S, Ravndal E, Waal H, Bramness JG, Clausen T. Diversity in causes and characteristics of drug-induced deaths in an urban setting. Scand J Public Health 2013; 41:119-25. [PMID: 23302498 PMCID: PMC3621508 DOI: 10.1177/1403494812472007] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS To assess demographic characteristics, treatment utilization and circumstances of death among those who died from drug-induced deaths in an urban setting and to identify possible subpopulations that should be targeted specifically to further develop preventive public health policies. METHODS Subjects (N = 231) who died, from drug-induced deaths, in the Norwegian capital Oslo (2006-2008) were identified through the National Cause of Death Registry. Data on toxicology, prison release and contact with health and social services in Oslo were collected. RESULTS Majority of cases were men (78%) and the mean age was 37 years. Nearly all cases (90%) were polydrug intoxications. Heroin was implicated in 67%. Residential address was the most common place of death (67%). Most cases (82%) had been in contact with health and social services in the year before death. Women were 4 years older, more often Oslo residents (82% vs. 64%) and fewer died from heroin intoxication. Non-Oslo residents were younger and more likely to have been found outdoors with heroin as the main intoxicant. Other identified subpopulations were those who died after prison release and those discharged from drug treatment. CONCLUSIONS The findings suggest that the majority of cases could have been available for preventive measures through their contacts with health and social services. Yet, the heterogeneity among cases indicates that such measures need to be multifaceted. Finally, it is important for policymakers and health and social workers in various countries to consider subpopulations such as women and non-city residents when developing public health interventions to prevent overdose deaths.
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