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Web pages in Norwegian
Section for Clinical Addiction Research - RusForsk - is a research section at Oslo University Hospital. Our main objective is the development and improvement of treatment for patients with substance use and addiction disorders. Through close collaboration with the clinical environments at Oslo University Hospital and other health care institutions, we promote high-quality research that benefits the patients. All our projects have user representation.
Our projects
Hooked on work
People with substance use and addiction disorders are mainly unemployed, but at the same time work is health-promoting in many ways. The aim of the research project is to examine the feasibility and effect of the employment support method Individual Placement and Support (IPS) for people with substance use disorders. The project contributes to documenting whether IPS is an appropriate method to introduce in substance use and addiction treatment.
"Hooked on work" is a multi-method project with an RCT study, an observational study and a qualitative study. The project was initiated by RusForsk, and implemented in three of the treatment sections (both in- and outpatient clinics) at the Department for Substance use and Addiction Treatment at Oslo University Hospital. The project also recruited participants from the IPS services at the Oslo municipal addiction outpatient clinic, Haugenstua resource center and the Tyrili Foundation.
Recruitment in the study is now completed.
See project pages on OUS-research
Increasing medication options in low threshold Opioid Agonist Treatment
LASSO is a low threshold clinic for Opioid Agonist Treatment (OAT) for individuals dependent on heroin and other opioids who do not engage with the conventional offerings of Medication-Assisted Rehabilitation (MAR).
From 2010 until 2017, only the combination preparation of buprenorphine and naloxone was available as a medication for OAT at LASSO. As of spring 2017, buprenorphine monopreparation (Subutex Ⓡ) became accessible at LASSO, and from 2020, methadone and the long-acting buprenorphine (Buvidal) became available.
We aim to investigate whether a broader array of medications in low-threshold OAT enhances treatment outcomes and leads to an improvement in the well-being of more individuals with opioid dependence.
LASSO is a collaborative effort between the Agency for Welfare and Social Services (Oslo Municipality), and the Department of Addiction and Substance Abuse Treatment (Oslo University Hospital Health Trust).
See more info about the project (in Norwegian)
See project pages on OUS-research
PriSUD - Diagnosing and treating substance use disorders in prison
The main aim of the project is to improve the health of people with substance use disorders in prison.
Through analysis of unique register data and collaboration with good research environments and user organizations, the project will map access to adequate substance use treatment in prison, as well as examine the outcome of such treatment. In addition to register data, the project will build on data from a comprehensive survey of drug use and health in prison, the Norwegian Offender Mental Health and Addiction study (NorMA).
See more info about the project
See project pages on OUS-research
Anabolic steroids and effects on brain and behavior
This is a longitudinal research initiative that investigates the impact of prolonged anabolic-androgenic steroids (AAS) use on brain health, cognition, cardiovascular function and mental well-being. Our primary goal is to advance our comprehension of the enduring repercussions stemming from extended AAS consumption, while also shedding light on the underlying factors contributing to the development of dependence. The project is highly interdisciplinary, involving various hospital, university and international expertise. This collaborative approach ensures a comprehensive grasp of the interplay between endocrine, cardiovascular, and neuroimmunological factors and implications for brain health and dependence.
See more info about the project (in Norwegian)
See project pages on OUS-research
INTACT - Integrated trauma and addiction treatment
A high proportion of patients in interdisciplinary specialized drug treatment (TSB) have trauma disorders, but receive little knowledge-based treatment for the trauma disorder. INTACT will investigate a specific treatment method called Eye Movement Desentizitation and Reprocessing, abbreviated EMDR, in the Section of Addiction Outpatient Clinics at Oslo University Hospital. Previous research has shown that EMDR is effective in trauma treatment, but little research has been done on EMDR in people who have concomitant trauma and substance abuse disorders.
See more info about the project (in Norwegian)
See project pages on OUS-research
Heroin-assisted treatment
The Government has decided to initiate a trial project involving heroin-assisted treatment (HAT) as part of medication-assisted rehabilitation (MAR). The trial project is set to run for a duration of 5 years, commencing in 2021 in Oslo and Bergen. The clinical trial's objective is to expand MAR to encompass medical heroin (diacetylmorphine) in either injectable or oral (tablet) form, aimed at treating individuals for whom the standard MAR protocol has not yielded satisfactory outcomes.
The overarching goals of the research project is to assess how HAT, as a novel clinical intervention, can be implemented and integrated within the MAR framework, the clinical outcomes of the treatment, and the potential cost-benefit effects of the initiative.
The study is intended to culminate in an evaluation report with recommendations to the public authorities regarding whether HAT should be continued, expanded, or terminated after the trial period.
The project is led by the Norwegian Centre for Addiction Research (SERAF) at the University of Oslo, and run in collaboration with RusForsk (Oslo University Hospital), Bergen Addiction Research (BAR) (Helse Bergen), the Centre for Substance Abuse Research (CRF) at Aarhus University, and the user organization proLAR Nett.
RusForsk will lead the research efforts in sub-studies related to the following thematic areas:
- Attitudes and experiences regarding HAT among patients, family members, and staff
- Process evaluation of the implementation of the HAT treatment program
See more info about the project (in Norwegian)
See project pages on OUS-research
AlcoTail - Work Package 3
The
interplay between substance use, health, and use of health care services in
people who use drugs
The objective of the AlcoTail study is to investigate the implementation and effects of interventions aimed at reducing alcohol and pharmaceutical drug use among Norwegian patients hospitalized for somatic illnesses, as well as the subsequent impact of such interventions on patients' health and substance use. Additionally, the study aims to assess the health status and investigate treatment and service trajectories for patients with other types of substance use disorders. This study is a collaboration between the Agency for Welfare and Social Services (Oslo Municipality), Oslo University Hospital Health Trust (OUS), Lovisenberg Diaconal Hospital (LDS) in Oslo, St. Olav's Hospital in Trondheim, and the University of Southeast Norway.
Funded by the Research Council of Norway, the project comprises 5 work packages. Work Packages 1 and 2 focus on surveying patients in the acute medical departments of LDS, OUS, and St. Olav's Hospital for alcohol use, psychoactive pharmaceutical drug use, and illicit substance use before and after the implementation of new substance assessment procedures in the hospitals. Work Package 4 involves conducting qualitative interviews with patients and staff from the same departments, while Work Package 5 aims to conduct cost-benefit analyses related to the new assessment procedures.
RusForsk is responsible for Work Package 3, which aims to identify treatment and service needs, as well as investigate treatment and service trajectories in specialist and primary healthcare settings for patients using illegal substances.
Prevalence and Symptoms of COVID-19 Among Individuals with Substance Use Disorders in Oslo During the Coronavirus Pandemic
Throughout the pandemic caused by the novel coronavirus (SARS-CoV-2), significant concern has been raised regarding both the spread of infection and the development of severe coronavirus disease (COVID-19) in individuals with severe substance use disorders. There are several reasons for this concern. Many individuals within the substance use community may struggle to adhere to governmental infection prevention guidelines, for various reasons. Additionally, a substantial portion of this population presents with multiple comorbidities that could elevate the risk of severe COVID-19 outcomes. Moreover, a tenuous connection to healthcare services among these individuals poses the risk of delayed medical intervention for those experiencing a severe progression of COVID-19.
However, remarkably few individuals in this cohort tested positive for SARS-CoV-2 during the initial wave of infections, despite comprehensive testing efforts within municipal substance use facilities. Those few individuals who did test positive either exhibited mild symptoms or were asymptomatic. Similar observations have been reported internationally.
The primary objectives of this study were to investigate whether these findings stem from the fact that individuals within this cohort:
1. Had not been exposed to SARS-CoV-2 infection,
2. Underwent asymptomatic courses of the illness, thus avoiding testing, or
3. Had developed immunity against COVID-19 through prior exposure to other viral infections.
4. Additionally, we aimed to examine the immune responses elicited by vaccines targeting SARS-CoV-2.
The research project is a collaborative endeavor involving RusForsk (Oslo University Hospital Health Trust), the Agency for Welfare and Social Services (Oslo Municipality), the Department of Immunology and Transfusion Medicine (Oslo University Hospital Health Trust), and the Norwegian Institute of Public Health.
Read more here
PhD-projects
Substance use disorders in the Norwegian prison population – needs, treatment and post-release outcomes.
About half of the Norwegian prison population has challenges with substance use, often in combination with mental health problems and social challenges. Although the inmates have the right to the same treatment as they do outside prison, there is reason to believe that the substance use and addiction treatment offered in prisons differs from the treatment outside prison. This applies to both access and the content of the treatment. We know little about how substance use and addiction problems are identified among the prison population, if those with problems are offered treatment, or how the treatment affects the inmates after release from prison.
Method/design
The project uses quantitative data from the Norwegian Mental Health and Addiction study (NorMA), the prison register KOMPIS and the Norwegian patient register. The NorMA cohort consists of 733 individuals who were in prison in 2013-2014 and who answered a large questionnaire about their background, substance use and general health. The cohort and register data combined make it possible to study the inmates with substance use and addiction disorders in a lifetime perspective. Among other things, we can look at all sentences they have had and look at the use of health services before, during and after the sentence.
Anabolic-androgenic steroid use - impact on brain health and dependence
Co-subervisor: Lars Westlye, Professor at the University of Oslo.
Background
Use of anabolic-androgenic steroid (AAS) has increased in recent years, posing a significant threat to public health via somatic and psychiatric consequences, including increased risk of cardiac problems, aggression, and higher crime rates. While these substances are not considered addictive in the same way as psychoactive substances, many users appear to become dependent. This project aims to identify patterns and traits, both psychiatric and biological, which may indicate vulnerability for the development of AAS dependency.
Method/design
Longitudinal and cross-sectional measurements of psychiatric symptoms, personality traits, as well as biomarkers and neuroimaging techniques will be used to identify both the consequences of long-term use and potential mechanisms for dependency development. The project will initiate by identifying profiles of dependency, and progress to identify biological and psychiatric associations with these groups. The results of this project will be relevant not only for the AAS-user population, but will likely have relevance for several broader populations including next-of-kin, non-AAS-using weightlifters, and clinicians in the addiction and dependence field.
The PhD-project is part of the Anabolic steroids and effects on brain and behavior project.
Health risks and treatment of anabolic-androgenic steroid dependence – a pilot study exploring off-label use of endocrine therapy to reduce withdrawal symptoms.
Background
The use of anabolic steroids can cause serious health problems such as disturbances in the sex hormones axis, where the body’s own testosterone production is reduced or stopped indefinitely. The symptoms of low testosterone levels can last from months to years: including severe fatigue, depression, sleep problems and reduced sexual function. Many choose to continue with steroids to avoid these ailments, despite the fact that they really want to stop using. This can cause an increased health risk. Today, steroid addicted users are offered treatment and follow-up in TSB (Interdisciplinary specialized treatment of addiction disorders), but there has never been research into whether hormone therapy should be part of the treatment.
Method/design
This is a longitudinal intervention study where a group of steroid-addicted men will receive off-label treatment with the drug clomiphene (antiestrogen) to try to stimulate the body’s own production of testosterone after steroid use has ended. They will be compared with participants in another ongoing study of men who end their steroid use without such treatment. We will investigate whether the hormone therapy produces fewer signs of testosterone deficiency compared to ending without it. We will also look at the physical - and mental state of health before, during and after the treatment to assess how the state of health changes over time, up to 12 months after the end of steroid use.
An investigation of the significance of work and feasibility of Individual Placement and Support (IPS) for patients with substance use disorders.
PhD candidate: Erlend M. Aas, MS Sociology
Main Supervisor: Eline Borger Rognli, Researcher OUH
Co-supervisiors: Ingrid Amalia Havnes, Reseracher OUH - Silje Endresen Reme, Professor UIO.
Background
Many people with substance use and addiction disorders experience that the transition to a drug free everyday life is demanding. Loneliness and boredom are cited as the most common reasons for a relapse into substance use. Work is associated with better outcomes of substance use treatment and fewer relapses. Nevertheless, around 80-90 % of patients in substance use and addiction treatment are out of work, and evidence-based employment support methods are lacking in the addiction field.
IPS is an evidence-based employment support method developed for patients with severe mental illnesses, and has very good results. The PhD project explores whether one can take this method developed for one patient group and apply it to another patient group without significant changes, or if the IPS method needs adjustments to be better adapted to patients with substance use and addiction disorders.
Method/design
The PhD project is part of the
research project Hooked on Work. The PhD candidate carries out a qualitative study where interviews are conducted with patients who receive IPS, IPS employment specialists and clinicians who collaborate with the Hooked on Work project. The analyses of the interviews are carried out in an interdisciplinary analysis group with Thematic Analysis as the leading method. In addition to that, the candidate will carry out a quantitative study where the aim is to investigate and compare key characteristics between patients with substance use and addiction disorders and patients with severe mental illnesses who apply for IPS.
Finished projects
Drug use in survivors of overdoses
(Finished 2023)
Effective overdose prevention depends on knowledge of risk factors. We know too little about what distinguishes a fatal overdose from a non-fatal overdose. This project will provide detailed analysis results of drugs, pharmaceuticals and fentanyls among overdose survivors. The purpose is to increase knowledge about what distinguishes the drug use of those who survive overdoses from those who die from overdoses. Inclusion in the project has now ended.
Read more here