Presentatörer: Lenka Katila, Annica Rhodin, PhD, Rolf Karlsten, PhD.

Dept. of surgical sciences, Uppsala University

Bakground: Opioid agonist therapy (OAT) is used for the treatment av opioid use disorder(OUD) of chronic pain patients(CPP) with iatrogenic OUD. Ongoing study “Substitution therapy of opioid treated patients with iatrogenic addiction development” studies the structure of patients and treatment results of all patients included in the OAT during the last 30 years. Drug induced mortality in OAT was identified to be 42% previously ( Bech et al,2019).

Aim: The aim of this communication is to identify reasons of treatment´s termination of OAT for pain patients with iatrogenic OUD.

Method: Observation study. All CPP accepted for OAT since 1993 were identified through journal notes and a previous study database. Data considering the reason of termination of treatment and cause of death were analyzed descriptively.

Results: In total, 232 persons (48,7% female) were identified. More than one third, (37%) of patients, are still treated. Another one third (31%) completed OAT  treatment due to opioid tapering  or dose minimizing with referral to general practitioner or pain clinic. In total, there were only 18 patients who died (8%) and of those majority died in. somatic diseases (73%), mainly cardiovascular diseases (45%). Overdose was ascertained only in 1 case (5%) and suicide in 1 case (5%) in contrast with usual outcome  in OAT programs.

Conclusion: Cardiovascular diseases are the most prevalent causes of death in çhronic pain patients in OAT program of OUD. OAT with methadone or buprenorphine is mostly terminated because of the total tapering or dose minimizing.