Sammanfattning
Background: Opioid maintenance treatment (OMT) secures a low mortality in a vulnerable
population and is often a lifelong treatment. One would therefore expect an increasing prevalence
of OMT among the elderly. This article describes a study with three elements; a literature review,
an investigation of occurrence and an exploration of elderly patients’ needs and experiences.
Material and methods: PsycINFO, Ovid Medline and Embase were searched with reference
words for opioid maintenance and age. Norway has a national cohort study of patients in OMT
describing recruitment, retention in treatment, age and mortality. A prognosis of numbers in
treatment older than 50 and 60 years were extrapolated based on probabilistic premises. Finally, a
qualitative interview study of OMT patients in two municipalities near Oslo was performed. Five
OMT patients aged between 58 and 64 years were interviewed with open questions on thoughts,
needs and experiences. Findings: The review points to an increasing population with psychiatric
and somatic comorbidities and diverse needs. Their opinions and experiences seem largely
unexplored. The population estimates indicate that Norway by 2018 will have between 3084 and
3567 individuals older than 50 years and between 201 and 302 individuals older than 60 years in
OMT. The qualitative study demonstrated that the elderly OMT patient typically attributes their
being alive to OMT. It is a life with a high prevalence of ailments and diseases. Their somatic
diseases are mostly adequately treated by their GP, but they feel left alone with a high level of
mental problems and loneliness. They miss follow-up from the OMT and social services and are not
met on existential thoughts and sorrow for their life. A wish to end OMT during their lifetime is
noteworthy. This would necessitate a close collaboration with the OMT services and support from
a social network. Conclusions: The study points to insufficient knowledge of and strategies to
meet an increasing number of individuals with composite problems in OMT. The numbers will
remain too small to warrant specially designed local projects, but large enough to necessitate
awareness and competencies in the ordinary municipal health and social services.