Anne Berit Bech

• Skeie, Ivar; Bech, Anne Berit; Clausen, Thomas; Hjemsæter, Arne Jan; Landheim, Anne Signe & Monsbakken, Bent Berntsen [Vis alle 8 forfattere av denne artikkelen] (2026). Comparison of mortality and causes of death between treatment-engaged individuals with severe alcohol or opioid use disorder: a prospective 19-year clinical cohort study. BMC Psychiatry. 26(1), s. 1–11. doi: 10.1186/s12888-026-07832-5. Fulltekst i vitenarkiv Vis sammendrag

  BACKGROUND: Comparisons of long-term mortality between alcohol-use-disorder (AUD) and opioid-use-disorder (OUD) groups within clinical cohorts are scarce. This study aimed to do this within one clinical cohort comprising groups suffering various severe substance use disorders. METHODS: Design: Observational cohort design. Prospective study of mortality 1998–2016, Cox regression. Sample/setting: 464 persons in specialist SUD treatment at start of observation period. Three subgroups defined by SUD characteristics at the beginning of the observation period, were studied: participants with 1) OUD, on opioid agonist treatment (OAT), (OUD/OAT-group), 2) AUD, no other SUDs (AUD-alone group), 3) AUD as part of a poly-substance-use disorder (AUD/PSUD group). Measures/covariates: Comparison of mortality risks and causes of death (somatic diseases/traumatic causes/substance-induced deaths/unknown cause) between OUD/OAT versus AUD-alone, and AUD-alone versus AUD/PSUD groups. Hazard ratio (HR) adjusted for baseline age (1 January 1998), sex, and socioeconomic/SUD characteristics. RESULTS: AUD-alone versus OUD/OAT: Unadjusted mortality risk was higher in the AUD-alone group [HR 1.99 (95% CI 1.33–2.99)]. However, in adjusted analysis type of SUD showed no statistically significant association with increased mortality [aHR 0.91 (0.54–1.54)], only male sex and increasing baseline age were independently associated with increased mortality risk. Cause-of-death distributions were very similar and somatic diseases caused over 50% of deaths in both groups. AUD-alone versus AUD/PSUD: Unadjusted mortality risk was higher in the AUD-alone group [(HR 2.57 (1.65–4.00)]. However, in adjusted analysis type of SUD showed no statistically significant association with increased mortality [aHR 1.40 (0.81–2.44)], only male sex, increasing baseline age, and “not being in work or education at study inclusion” were independently associated with increased mortality risk. Substance-induced deaths were most common in the AUD/PSUD group (43%). CONCLUSION: In adjusted analyses there were no statistically significant differences in mortality risk between the three subgroups. Somatic diseases were the main cause of death. Besides efforts to improve social rehabilitation and to treat the substance use disorders as such, early and targeted lifestyle interventions, and measures for early detection, treatment and follow-up of somatic disorders are essential to reduce mortality in both AUD and OUD populations. CLINICAL TRIAL NUMBER: Not applicable

• Mcdonald, Rebecca Silvia; Bech, Anne Berit & Clausen, Thomas (2023). Flexible delivery of opioid agonist treatment during COVID-19 in Norway: qualitative and quantitative findings from an online survey of provider experiences. BMC Health Services Research. 23(1). doi: 10.1186/s12913-023-09959-7. Fulltekst i vitenarkiv Vis sammendrag

  Background For patients receiving daily opioid agonist treatment (OAT) for opioid dependence, several countries relaxed treatment guidelines at the beginning of the COVID-19 pandemic. This involved longer take-home intervals for methadone and buprenorphine doses as well as a reduction in supervised dosing and drug screening. To date, little is known about the medium or long-term experience of OAT deregulation. Therefore, we conducted a survey to explore how OAT providers perceived greater flexibility in OAT service delivery at the end of the second year of the pandemic. Methods Nationwide cross-sectional study of twenty-three OAT units in 19 publicly funded hospital trusts in Norway. OAT units were sent a 29-item online questionnaire comprising closed-format and open-ended questions on treatment provider experiences and changes in OAT service delivery during the past 12 months (January to December 2021). Results Twenty-three (of whom female: 14; 60.8%) managers or lead physicians of OAT units completed the questionnaire reporting that, in 2021, most OAT units (91.3%, n = 21) still practiced some adjusted approaches as established in the beginning of the pandemic. The most common adaptions were special protocols for COVID-19 cases (95.7%, n = 22), increased use of telephone- (91.3%, n = 21) and video consultations (87.0%, n = 20), and longer take-home intervals for OAT medications (52.2%, n = 12). The use of depot buprenorphine also increased substantially during the pandemic. According to the OAT providers, most patients handled flexible treatment provision well. In individual cases, patients’ substance use was identified as key factor necessitating a reintroduction of supervised dosing and drug screening. Collaboration with general practitioners and municipal health and social services was generally perceived as crucial for successful treatment delivery. Conclusions Overall, the Norwegian OAT system proved resilient in the second year of the COVID-19 pandemic, as its healthcare workforce embraced innovation in technology (telemedicine) and drug development (depot buprenorphine). According to our nationally representative sample of OAT providers, most patients were compliant with longer take-home doses of methadone and buprenorphine. Our findings suggest that telemedicine can be useful as adjunct to face-to-face treatment and provide greater flexibility for patients.

• Bech, Anne Berit; Clausen, Thomas; Waal, Helge; Delaveris, Gerd Jorunn Møller & Skeie, Ivar (2021). Organ pathologies detected post-mortem in patients receiving opioid agonist treatment for opioid use disorder: a nation-wide 2-year cross-sectional study. Addiction. ISSN 0965-2140. s. 1–9. doi: 10.1111/add.15705. Fulltekst i vitenarkiv Vis sammendrag

  Aims: To document organ pathologies detected post-mortem in patients receiving opioid agonist treatment for opioid use disorder and estimate the extent to which individual characteristics are associated with pulmonary, cardiovascular, hepatic or renal pathologies. Design: Two-year cross-sectional nation-wide study. Setting: Norway. Participants: Among all 200 patients who died during opioid agonist treatment between 1 January 2014 and 31 December 2015, 125 patients (63%) were autopsied. Among these, 122 patients (75% men) had available autopsy reports and were included. The mean age at the time of death was 48 years. Measurements: Information on pulmonary, cardiovascular, hepatic and renal pathologies were retrieved from forensic or medical autopsy reports, with no (0) and yes (1) as outcome variables and age, sex and body mass index as covariates in logistic regression analyses. Findings: Pathologies in several organs were common. Two-thirds (65%) of the decedents had more than two organ system diseases. The most common organ pathologies were chronic liver disease (84%), cardiovascular disease (68%) and pulmonary emphysema (41%). In bivariate analyses, only older age was associated with any pulmonary pathology [odds ratio (OR) = 1.06; 95% confidence interval (CI) = 1.01-1.10], cardiovascular pathology (OR = 1.11; 95% CI = 1.05-1.17) and renal pathology (OR = 1.05; 95% CI = 1.00-1.11). Older age remained independently associated with cardiovascular pathology (OR = 1.10; 95% CI = 1.04-1.16) and renal pathology (OR = 1.06; 95% CI = 1.01-1.12) adjusted for body mass index and sex. Conclusions: Among autopsied Norwegians who died during opioid agonist treatment in 2014 and 2015, two-thirds had more than two organ system diseases, despite their mean age of 48 years at the time of death. Older age was independently associated with at least one cardiovascular or renal pathology after adjusting for sex and body mass index. Keywords: Ageing; autopsy; buprenorphine; forensic; methadone; multi-morbidity; opioid substitution treatment; pathology; postmortem. © 2021 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

• Bech, Anne Berit; Clausen, Thomas; Waal, Helge; Vindenes, Vigdis; Edvardsen, Hilde Marie Erøy & Frost, Joachim [Vis alle 7 forfattere av denne artikkelen] (2020). Postmortem toxicological analyses of blood samples from 107 patients receiving opioid agonist treatment: substances detected and pooled opioid and benzodiazepine concentrations. Addiction. ISSN 0965-2140. doi: 10.1111/add.15211. Fulltekst i vitenarkiv Vis sammendrag

  Aims: To present the substances and their concentrations detected post-mortem in patients receiving opioid agonist treatment (OAT) stratified by cause of death, estimate the pooled opioid and benzodiazepine concentrations using established conversion factors for blood concentrations from the Norwegian Road Traffic Act, and explore the association between drug-induced cause of death and the pooled opioid and benzodiazepine concentrations. Design: Cross-sectional nationwide study. Setting: Norway. Participants: One hundred and seven patients who died during OAT (i.e. within 5 days after the last intake of OAT medication) between 1 January 2014 and 31 December 2015, with post-mortem femoral blood available for toxicology. Data were collected from hospital records, the Norwegian Cause of Death Registry and autopsy reports. Measurements: Presence of alcohol and non-alcohol substances in the bloodstream at time of death, determined through records of toxicology of post-mortem femoral blood. Findings: A median of four substances was detected across the causes of death. At least one benzodiazepine was detected in 81 (76%) patients. The median pooled opioid concentration was significantly higher in drug-induced deaths compared with other causes of death (362 ng/mL versus 182 ng/mL, P < 0.001), in contrast to the pooled benzodiazepine concentration (5466 versus 5701 ng/mL, P = 0.353). The multivariate regression analysis showed that only increasing pooled opioid concentration (ng/ML) was associated with increased odds of a drug-induced cause of death (odds ratio, 1.003; 95% confidence interval: 1.001-1.006). Conclusions: In Norway, overall opioid concentration seems to play an important role in drug-induced deaths during opioid agonist treatment in patients prescribed methadone or buprenorphine. Patients prescribed buprenorphine tend to replace their agonist with full agonists, while patients prescribed methadone tend to have high opioid concentrations from methadone as the only opioid.

• Bech, Anne Berit; Clausen, Thomas; Waal, Helge; Benth, Jurate Saltyte & Skeie, Ivar (2019). Mortality and causes of death among patients with opioid use disorder receiving opioid agonist treatment: A national register study. BMC Health Services Research. 19(1). doi: 10.1186/s12913-019-4282-z. Fulltekst i vitenarkiv Vis sammendrag

  BACKGROUND: Mortality rates and causes of death among individuals in opioid agonist treatment (OAT) vary according to several factors such as geographical region, age, gender, subpopulations, drug culture and OAT status. Patients in OAT are ageing due to effective OAT as well as demographic changes, which has implications for morbidity and mortality. Norway has one of the oldest OAT populations in Europe. Because of the varying mortality rates and causes of death in different subgroups and countries, research gaps still exist. The aims of this study were to describe the causes of death among OAT patients in Norway, to estimate all-cause and cause-specific crude mortality rates (CMRs) during OAT and to explore characteristics associated with drug-induced cause of death compared with other causes of death during OAT. METHODS: This was a national, observational register study. Data from the Norwegian Cause of Death Registry and the Norwegian Patient Registry were combined with data from medical records. We included all patients in the Norwegian OAT programme who died not more than 5 days after the last intake of OAT medication, between 1 January 2014 and 31 December 2015. RESULTS: In the 2-year observation period, 200 (1.4%) of the OAT patients died. A forensic or medical autopsy was performed in 63% of the cases. The mean age at the time of death was 48.9 years (standard deviation 8.4), and 74% were men. Somatic disease was the most common cause of death (45%), followed by drug-induced death (42%), and violent death (12%). In general, CMRs increased with age, and they were higher in men and in patients taking methadone compared with buprenorphine. Increasing somatic comorbidity, measured by the Charlson comorbidity index, reduced the odds of dying of a drug-induced cause of death compared with other causes of death. CONCLUSIONS: Both somatic and drug-induced causes of death were common during OAT. Improved treatment and follow-up of chronic diseases, especially in patients aged > 40 years, and continuous measures to reduce drug-induced deaths appear to be essential to reduce future morbidity and mortality burdens in this population.

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• Bech, Anne Berit; Wechsler, Theresa Friederike; Mühlberger, Andreas; Lien, Lars & Leonhardt, Marja (2026). Improving social functioning in people with substance use and mental health disorders using virtual reality (ROPVR): study protocol for a multi-center, pragmatic randomized controlled trial. doi: 10.1186/s13063-026-09676-6. Fulltekst i vitenarkiv Vis sammendrag

  Background In individuals with substance use disorders (SUDs), impairment of social, occupational, and/or rec reational functioning is common. Social functioning encompasses social skills, social behavior, and cognitive skills, which are relevant for establishing meaningful relationships and effective functioning across different domains in life. The main aim of the study is to determine the effectiveness of tailored virtual reality (VR) social functioning training as an adjunct to in-patient SUD treatment in improving functionality, measured by World Health Organization Disabil ity Assessment Scale 2.0 at 6 months post-intervention. Methods The study is designed as a two-arm, statistician-blinded, pragmatic, multi-cite, randomized controlled trial. Eligible participants will be randomly assigned to either the intervention or control group using 1:1 allocation. The control group receives standard in-patient SUD treatment, and the intervention group receives additionally VR social functioning training (8 sessions). Both the intervention and control groups will be assessed for between-group differ ences in functioning change from before randomization (T0), to 6-week (T1), and to 6-month (T2). Both groups will also be assessed before (T0), at 6-month (T2), and at 12-month follow-up (T3) for a health economic evaluation. Discussion Evidence suggests that VR training can enhance patients’ social functioning and thereby improve rela tions and promote community participation in people with SUD. To the best of our knowledge, this is the first study that aim to explore the use of VR in improving social functioning in patients with SUD. Thus the results of this trial can provide valuable insights for clinicians and health authorities. Trial registration ClinicalTrials.gov NCT06677515. Registered on November 11, 2024.

• Bech, Anne Berit (2025). Sykelighet og dødelighet i LAR. Fulltekst i vitenarkiv
• Bech, Anne Berit (2024). Bruk av VR for å fremme sosial deltakelse blant personer med ROP-lidelse: en randomisert kontrollert studie. Fulltekst i vitenarkiv
• Bech, Anne Berit; Leonhardt, Marja & Lien, Lars (2024). The use of VR to promote social participation in people with mental health and substance use disorders: a randomized controlled trial. Fulltekst i vitenarkiv
• Bech, Anne Berit (2023). Somatisk helse og levevaner. Fulltekst i vitenarkiv
• Bech, Anne Berit & Toft, Helge (2023). Psykisk helse og rus: Slik kan sykepleiere ivareta pasieners somatiske helse. Tidsskriftet sykepleien. ISSN 0806-7511. doi: 10.4220/Sykepleiens.2023.93125. Fulltekst i vitenarkiv
• Nesse, Linda; Mcdonald, Rebecca Silvia; Bech, Anne Berit & Clausen, Thomas (2023). Medborgerskap: Et perspektiv for brukermedvirkning i LAR. Rus & samfunn. ISSN 1500-8614. Fulltekst i vitenarkiv
• Bech, Anne Berit (2023). Somatisk sykelighet og dødelighet-hva kan gjøres. Fulltekst i vitenarkiv
• Bech, Anne Berit (2023). Cannabis- forbud, avkriminalisering, legalisering. Fulltekst i vitenarkiv
• Bech, Anne Berit (2023). Cannabis-forbud, avkriminalisering, legalisering. Fulltekst i vitenarkiv
• Bech, Anne Berit (2022). Cannabis - erfaringer med forbud, avkriminalisering, legalisering. Fulltekst i vitenarkiv
• Bech, Anne Berit (2022). Stigmatisering i språk og begreper. Fulltekst i vitenarkiv
• Bech, Anne Berit; Clausen, Thomas & Mcdonald, Rebecca Silvia (2022). Revised service delivery of opioid agonist treatment in Norway in 2021, the second year of the pandemic: a national cross-sectional study of treatment provider experiences. Fulltekst i vitenarkiv
• Bech, Anne Berit (2018). Sykepleiere kan forebygge lekkasje av LAR-legemidler. Sykepleien.no. Fulltekst i vitenarkiv
• Bech, Anne Berit (2018). Bedre sykepleie til kreftpasienter med ruslidelse eller psykisk lidelse. Tidsskriftet sykepleien. ISSN 0806-7511. Fulltekst i vitenarkiv
• McDonald, Rebecca Silvia; Bech, Anne Berit & Clausen, Thomas (2025). Evaluering av implementeringen av revidert nasjonal faglig retningslinje for legemiddelassistert rehabilitering (LAR) ved opioidavhengighet. Universitetet i Oslo. doi: https:/www.med.uio.no/klinmed/forskning/sentre/seraf/publikasjoner/rapporter/2025/seraf-rapport-2-2025---evaluering-av-implementeringen-av-revidert-nasjonal-faglig-retningslinje-for-lar.pdf. Fulltekst i vitenarkiv
• Bech, Anne Berit (2022). Mortality during opioid agonist treatment in Norway: a comprehensive study of the years 2014-2015. Universitetet i Oslo. ISSN 9788234800498. Fulltekst i vitenarkiv
• Bech, Anne Berit; Clausen, Thomas & Lillevold, Pål Henrik (2022). SERAF rapport 1/2022 - Forebygging og håndtering av covid-19 i LAR-tiltakene i spesialisthelsetjenesten 2021 - Erfaringer og tiltak. 7Letras. Fulltekst i vitenarkiv
• Bech, Anne Berit; Bukten, Anne; Lobmaier, Philipp Paul; Skeie, Ivar; Lillevold, Pål Henrik & Clausen, Thomas (2022). SERAF RAPPORT 2/2022 Statusrapport 2021-Siste år med gamle LAR-retningslinjer. 7Letras. Fulltekst i vitenarkiv

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