It is estimated that up to a third of patients on opioid agonist therapy (OAT) have attention deficit hyperactivity disorder (ADHD). Treatment by ADHD medication, including a centrally acting stimulant (CAS) or atomoxetine is one of the essential approaches. This study evaluates the use of dispensed ADHD medications in the Norwegian OAT population in the period from 2015 to 2017. Types and doses of ADHD medications, co-dispensations of other potentially addictive drugs like benzodiazepines, z-hypnotics, gabapentinoids, and non-OAT opioids, as well as direct-acting antivirals (DAA) against hepatitis C infection, are investigated. Information about all dispensed ADHD medication, OAT opioids, and the defined potentially addictive drugs were recorded from the Norwegian Prescription Database. Dispensation rates, the types, and the doses of dispensed ADHD medications were estimated by summarizing the number of dispensations, and the dispensed doses. Logistic regression analyses were employed to assess the associations between ADHD medication, and OAT opioid use, and dispensations of other potentially addictive drugs and DAAs against hepatitis C infection. A total of 9235 OAT patients were included. The proportion of patients who were dispensed ADHD medication increased from 3.5 to 4.6% throughout the study period. The three most dispensed CAS were short- and intermediate-acting methylphenidate (55%), lisdexamphetamine (24%), and dexamphetamine (17%) in 2017. Buprenorphine, rather than methadone, as OAT opioid (adjusted odds ratio: 1.6, CI: 1.2–2.1) was associated with being dispensed ADHD medication. Among patients who received CAS and OAT opioids each calendar year, the dispensed doses of methylphenidate increased from 63 mg/day in 2015 to 76 mg/day in 2017 (p = 0.01). Sixty percent of patients receiving ADHD medications were also dispensed other addictive drugs concomitantly in 2017. Similar results were found in 2015 and 2016. Co-prescription of ADHD medications was low among patients on OAT in Norway, considering a high prevalence of ADHD in this patient group. On the other hand, concurrent dispensations of multiple addictive drugs were common in this population. Understanding the underlying reasons for such prescribing is essential, and research on how to optimize ADHD medication of patients with ADHD receiving OAT is needed.

中文翻译：

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在接受阿片类激动剂治疗的患者中分配注意力缺陷多动障碍（ADHD）药物；2015年至2017年在挪威进行的国家前瞻性队列研究。

据估计，接受阿片类药物激动剂治疗（OAT）的患者中，多达三分之一患有注意力缺陷多动障碍（ADHD）。通过包括中枢性兴奋剂（CAS）或托莫西汀在内的ADHD药物进行治疗是必不可少的方法之一。这项研究评估了2015年至2017年期间挪威OAT人群中所分配的ADHD药物的使用情况。ADHD药物的类型和剂量，其他可能上瘾的药物（如苯二氮卓类药物，Z-催眠药，加巴喷丁类药物和非OAT）共同​​分配阿片类药物以及抗丙型肝炎感染的直接作用抗病毒药（DAA）已得到研究。有关所有已分发的ADHD药物，OAT阿片类药物和已定义的潜在成瘾药物的信息均记录在挪威处方数据库中。分配率，类型，并通过汇总分配次数和分配剂量来估算已分配的ADHD药物剂量。使用逻辑回归分析来评估ADHD药物与OAT阿片类药物的使用以及其他可能上瘾的药物和DAA对丙型肝炎感染的分配之间的关联。总共包括9235名OAT患者。在整个研究期间，分配ADHD药物的患者比例从3.5％增加到4.6％。2017年分配量最大的三个CAS是短效和中效哌醋甲酯（55％），赖氨苯丙胺（24％）和右苯丙胺（17％）。丁丙诺啡而不是美沙酮作为OAT阿片类药物（调整比值比：1.6，CI ：1.2–2.1）与分配的ADHD药物有关。在每个日历年接受CAS和OAT阿片类药物的患者中，哌醋甲酯的分配剂量从2015年的63毫克/天增加到2017年的76毫克/天（p = 0.01）。在2017年，也有60％的接受ADHD药物治疗的患者也同时配发了其他成瘾性药物。2015年和2016年发现了类似的结果。在挪威，OAT患者中ADHD药物的共同处方率很低，因为该患者的ADHD患病率很高组。另一方面，多种成瘾药物的同时分发在该人群中很常见。了解此类处方的根本原因至关重要，因此需要研究如何优化接受OAT治疗的ADHD患者的ADHD药物。在2017年，也有60％的接受ADHD药物治疗的患者也同时配用了其他成瘾性药物。2015年和2016年也发现了类似的结果。在挪威，OAT患者中ADHD药物的共同处方率很低，因为该患者的ADHD患病率很高组。另一方面，多种成瘾药物的同时分发在该人群中很常见。了解此类处方的根本原因至关重要，因此需要研究如何优化接受OAT治疗的ADHD患者的ADHD药物。在2017年，也有60％的接受ADHD药物治疗的患者也同时配用了其他成瘾性药物。2015年和2016年也发现了类似的结果。在挪威，OAT患者中ADHD药物的共同处方率很低，因为该患者的ADHD患病率很高组。另一方面，多种成瘾药物的同时分发在该人群中很常见。了解此类处方的根本原因至关重要，因此需要研究如何优化接受OAT治疗的ADHD患者的ADHD药物。在该人群中，多种成瘾药物的同时分发很常见。了解此类处方的根本原因至关重要，因此需要研究如何优化接受OAT治疗的ADHD患者的ADHD药物。在该人群中，多种成瘾药物的同时分发很常见。了解此类处方的根本原因至关重要，因此需要研究如何优化接受OAT治疗的ADHD患者的ADHD药物。