Opioid maintenance treatment (OMT) – not life-long for all women? 10 years follow-up after pregnancy - how many stop OMT and what are the results?
Background: There are few long-term follow-up studies of patients in OMT. There is also a paucity of studies focusing on tapering to zero/stopping the OMT-medication. The aim of our study was to evaluate the outcome of women who tapered completely/stopped their OMT-medication during a 10 years follow-up period after pregnancy.
Methods: We had permission to contact back 90 women who gave birth while in OMT from 2004 to 2009. 66 women who had used OMT-medication in pregnancy were interviewed, which is 73 % of the eligible women. A structured telephone interview covering many aspects of the participants’ lives was performed. The study was approved by the Norwegian Regional Ethical Committee.
Results: The findings are preliminary. At the time of the follow-up interview, the women were 42 years old and had been in OMT for 12 years. Their children’s age was almost 10 years. 82 % of the women had custody of their children and 55 % of the women were working or studying. All the women were in OMT during pregnancy, 56 % used methadone and 44 % used buprenorphine. At follow-up 10 years later, 41 % used methadone, 39 % used buprenorphine and 20 % (13 women) had tapered their OMT-medication to zero. However, 19 of the 66 women (29 %) had a total of 21 episodes of tapering completely/stopping their OMT-medication during the follow-up period. Their reasons for tapering/stopping the OMT-medication were varied – from maturing out of treatment, problems with their job, wanting their newborns to have less abstinence, to dissatisfaction with the OMT-system. The women who were out of OMT at the time of the follow-up interview were younger (38,8 ± 5,7 years vs 42,9 ± 5,6 years, p=0,023) and had fewer years of opioid dependency prior to OMT (6,0 ± 2,9 vs 8,9 ± 4,5, p=0,034) compared to the women who were still in OMT. The severity of abstinences during tapering and abstinences/psychiatric distress after stopping OMT varied greatly among the participants. The women who were out of OMT at follow-up had been in OMT for 94,8 ± 46,0 months, had used 13 ± 18 months on the tapering and had stayed out of OMT 39 ± 38 months (0 – 120 months). 4 of the 6 women, who spent less than 1 month on tapering the OMT-medication, were back in OMT at follow-up. There was no difference in the use of illegal opioids, amphetamines and/or cannabis the last month before the follow-up interview among women who were out of OMT and those who were still in OMT (8,3 % vs 7,8 %).
Conclusion: After a 10 year follow-up period, 20 % of the women who were in OMT during pregnancy had stopped their OMT-treatment. The women who were out of OMT had shorter opioid dependency prior to OMT and were younger than the women who were still in OMT. Most of the women in the cohort had custody of their child(ren) and approximately half of the women were working or studying. There was little use of illegal drugs among the women in the study.