Coercive Treatment of Persons Dependent on Opioids [Internet]

Background In April 2009, the Labour Party commissioned the Norwegian Knowledge Centre for the Health Services (NOKC) to complete a review about the effects of coercive treatment of persons dependent on opioids. The review would help answer the questions of whether and how adults with opioid dependence should be treated with coercive interventions. We addressed one main question: What are the effects of coercive treatment of persons dependent on opioids?

Methods We searched systematically for relevant literature in international scientific databases. We evaluated published systematic reviews, randomized controlled trials (RCTs) and controlled studies for inclusion using a pre-designed inclusion form. We planned to appraise the methodological quality of the included studies with appropriate check lists, and summarize the results in tables and text. We searched for literature concerning ethical issues related to coercive treatment of persons dependent on opioids, and we used 23 sub questions to identify ethical issues.

Results We found neither systematic reviews nor primary studies that evaluated the effects of coercive treatment of persons dependent on opioids. We excluded systematic reviews and studies which did not report results regarding the effects of coercive treatment of persons dependent on opioids, as well as interventions which did not meet the inclusion criteria of being coercive treatment for opioid dependence. We identified several ethical issues concerned with this treatment, which answered to our 23 sub-questions.

Conclusion Our concerted efforts at identifying literature about the effects of coercive treatment of persons dependent on opioids showed that there is little available high quality research on the effects of coercive treatment in general, and on the effects of coercive treatment of persons dependent on opioids specifically. Ethical issues should be considered when designing and planning randomized controlled studies and controlled clinical trials for populations with this type of severe dependence.