Bente Birkeland

• Marciuch, Anne; Birkeland, Bente; Saltyte Benth, Jurate; Solli, Kristin Klemmetsby; Tanum, Lars Håkon Reiestad & Mathisen, Ida [Show all 7 contributors for this article] (2023). Personal recovery among people with opioid use disorder during treatment with extended-release naltrexone. Heliyon. ISSN 2405-8440. 9(7). doi: 10.1016/j.heliyon.2023.e17516. Full text in Research Archive Show summary

  Background and aims: Recovery from substance use disorders (SUD) has traditionally been equated with abstinence. “Personal recovery” however emphasizes recovery as a unique and personal process, supported by changes in connectedness, hope, identity, meaning and empowerment. This study aimed to examine personal recovery in people receiving extended-release naltrexone (XR-NTX); specifically investigate changes in personal recovery during treatment, identify groups of participants following distinct trajectories of recovery, and characteristics predicting group-belonging. Methods: Overall change in recovery (Questionnaire about the Process of Recovery, QPR) score was assessed by linear mixed model in a subsample of 135 people with opioid use disorder (OUD) participating in a 24 + 28-week trial of XR-NTX. Growth mixture model was used to identify potential groups of people following distinct trajectories of personal recovery. Results: Overall, there was a significant change in QPR score during treatment. Four groups with distinct recovery trajectories were identified: “initially low– increase” (G1), “initially average– no change” (G2), “initially high– no change” (G3) and “initially high– increase” (G4). The groups were different with regards to level of psychological distress, social support, and the use of benzodiazepines. In addition, previous participation in opioid agonist treatment programs, current pain, life satisfaction, employment, heroin craving and previous use of heroin also differed between groups. Conclusions: Personal recovery among people receiving XR-NTX follows different trajectories, and various factors are associated with personal recovery. Particular attention regarding psychological distress, social support and heroin use among patients commencing XR-NTX treatment is important to facilitate successful recovery trajectories.

• Jobling, Nina; Mjåland, Kristian & Birkeland, Bente (2023). Fengselssykepleieres erfaringer med samarbeidet med spesialisthelsetjenesten og fastleger om legemiddelassistert rehabilitering (LAR). Sykepleien Forskning. ISSN 1890-2936. 18. doi: 10.4220/Sykepleienf.2023.91849. Show summary

  Bakgrunn: Legemiddelassistert rehabilitering (LAR) er forankret i spesialisthelsetjenesten og har siden oppstarten i 1998 hatt en kriminalitetsreduserende effekt. Det er likevel mange LAR-pasienter som jevnlig soner dommer i norske fengsler. For at denne pasientgruppen skal få en adekvat LAR-behandling i fengsel, forutsetter det et godt samarbeid mellom ansatte i LAR og fengselshelsetjenesten, hvor også pasienten bør ha en aktiv rolle i sin egen rehabilitering. Det finnes mye forskning på samhandling i helsetjenesten, men det mangler studier som undersøker samhandlingen mellom fengselshelsetjenesten og LAR. Hensikt: Utforske fengselssykepleieres opplevelse av samarbeid med ansatte i LAR-tjenesten. Metode: Undersøkelsen har et kvalitativt design med en induktiv tilnærming. Datasamlingen ble utført med semistrukturerte, individuelle intervjuer. Vi gjorde en tematisk analyse av datamaterialet basert på Johannessen, Rafoss og Rasmussens versjon etter Braun og Clarke. Resultat: Undersøkelsen viser at fengselssykepleierne opplever samhandlingen med LAR-tjenesten som utfordrende ut fra følgende hovedfunn: Det er lite kommunikasjon, informasjonsutveksling og gjensidig forståelse mellom fengselshelsetjenesten og ansatte i LAR. Knappe ressurser og fysisk avstand mellom LAR-foretakene og fengslene kan bidra til at pasienter ikke prioriteres av LAR-ansatte under soning. Fengselssykepleierne erfarer at det er store forskjeller mellom LAR-foretakene på hvordan samarbeidet fungerer, og det er komplisert å finne rett LAR-behandler. Det er særlig utfordrende når fastlegen har behandlingsansvaret. Konklusjon: Studien viser at fengselssykepleiere ved flere fengsler i Norge erfarer trepartssamarbeidet rundt LAR-innsatte som fraværende. LAR-retningslinjen oppfordrer til trepartssamarbeid, noe som ikke ser ut til å fungere i praksis. Konsekvensen kan være at pasienter som mottar LAR-behandling i fengsel, ikke får nødvendig oppfølging i tråd med LAR-retningslinjen.

• Stavnes, Kristin Anne; Ruud, Torleif; Saltyte Benth, Jurate; Hanssen-Bauer, Ketil; Weimand, Bente Margrethe & Solantaus, Tytti [Show all 13 contributors for this article] (2022). Norwegian health personnel’s compliance with new legislation on children of ill parents: an exploratory cross-sectional multicentre study. BMC Health Services Research. ISSN 1472-6963. 22, p. 1–18. doi: 10.1186/s12913-022-08268-9. Full text in Research Archive Show summary

  Background: In 2010 the Norwegian Parliament introduced amendments to the Health Personnel Act requiring all health personnel to inform and offer help to their patients’ children and families. We evaluated whether health per‑ sonnel adhered to their obligations outlined in the Act and investigated whether family and health services charac‑ teristics were associated with the degree of compliance with the legislation. Our study was part of a larger Norwegian multi‑site study conducted in five health trusts across Norway, assessing the situation for families living with parental illness. Method: A cross‑sectional study using quantitative data obtained from 518 patients 246 children and 278 health personnel was performed. All informants completed a questionnaire, including an instrument corresponding to the obligations in the legislation. Descriptive analyses, factor analysis and logistic regression analysis were used. Results: The legislation was only partially implemented in the clinics of the health trusts. Compared to estimates prior to the introduction of the new legislation, the situation had improved somewhat, but much work remains to be done to fulfil the obligations decreed by law. The more time‑consuming the obligations were, the less often they were met. The substance abuse and mental health services followed up on their obligations to a greater extent than did the physical health services. Conversely, children of physically ill parents were better informed by their families than were children of parents with mental health and substance abuse disorders. When asked the same questions, reports from health personnel were more positive compared to those of children and patients regarding the legisla‑ tion’s fulfillment. Conclusion: Data suggest that there has been a change in the support offered to children of ill parents. Additional work is required, however, for the Health Personnel Act to function as fully intended

• Marciuch, Anne; Brenna, Ida Halvorsen; Weimand, Bente; Solli, Kristin Klemmetsby; Tanum, Lars Håkon Reiestad & Røstad, Bente [Show all 7 contributors for this article] (2022). Patients’ experiences of continued treatment with extended-release naltrexone: a Norwegian qualitative study. Addiction science & clinical practice. ISSN 1940-0632. 17(1), p. 1–14. doi: 10.1186/s13722-022-00317-2. Full text in Research Archive Show summary

  Background: The opioid antagonist extended-release naltrexone (XR-NTX) in the treatment of opioid use disorder (OUD) is efective in terms of safety, abstinence from opioid use and retention in treatment. However, it is unclear how patients experience and adjust to losing the possibility of achieving an opioid efect. This qualitative study is the frst to explore how people with opioid dependence experience XR-NTX treatment, focusing on the process of treatment over time. Methods: Using a purposive sampling strategy, semi-structured interviews were undertaken with 19 persons with opioid use disorder (15 men, four women, 22–55 years of age) participating in a clinical trial of XR-NTX in Norway. The interviewees had received at least three XR-NTX injections. Qualitative content analysis with an inductive approach was used. Findings: Participants described that XR-NTX treatment had many advantages. However they still faced multiple challenges, some of which they were not prepared for. Having to fnd a new foothold and adapt to no longer gaining an efect from opioids due to the antagonist medication was challenging. This was especially true for those struggling emotionally and transitioning into the harmful use of non-opioid substances. Additional support was considered crucial. Even so, the treatment led to an opportunity to participate in society and reclaim identity. Participants had strong goals for the future and described that XR-NTX enabled a more meaningful life. Expectations of a better life could however turn into broken hopes. Although participants were largely optimistic about the future, thinking about the end of treatment could cause apprehension. Conclusions: XR-NTX treatment ofers freedom from opioids and can facilitate the recovery process for people with OUD. However, our fndings also highlight several challenges associated with XR-NTX treatment, emphasizing the importance of monitoring emotional difculties and increase of non-opioid substances during treatment. As opioid abstinence in itself does not necessarily equal recovery, our fndings underscore the importance of seeing XR-NTX as part of a comprehensive, individualized treatment approach.

• Brenna, Ida Halvorsen; Marciuch, Anne; Birkeland, Bente; Veseth, Marius; Røstad, Bente & Løberg, Else-Marie [Show all 9 contributors for this article] (2021). ‘Not at all what I had expected’: Discontinuing treatment with extended-release naltrexone (XR-NTX): A qualitative study. Journal of Substance Abuse Treatment. ISSN 0740-5472. p. 1–11. doi: 10.1016/j.jsat.2021.108667. Full text in Research Archive Show summary

  Background: Extended-release naltrexone (XR-NTX), an opioid antagonist, has demonstrated equal treatment outcomes, in terms of safety, opioid use, and retention, to the recommended OMT medication buprenorphine. However, premature discontinuation of XR-NTX treatment is still common and poorly understood. Research on patient experiences of XR-NTX treatment is limited. We sought to explore participants' experiences with discontinuation of treatment with XR-NTX, particularly motivation for XR-NTX, experiences of initiation and treatment, and rationale for leaving treatment. Methods: We conducted qualitative, semi-structured interviews with participants from a clinical trial of XR-NTX. The study participants (N = 13) included seven women and six men with opioid dependence, who had received a minimum of one and maximum of four injections of XR-NTX. The study team analyzed transcribed interviews, employing thematic analysis with a critical realist approach. Findings: The research team identified three themes, and we present them as a chronological narrative: theme 1: Entering treatment – I thought I knew what I was going into; theme 2: Life with XR-NTX – I had something in me that I didn't want; and theme 3: Leaving treatment – I want to go somewhere in life. Patients' unfulfilled expectations of how XR-NTX would lead to a better life were central to decisions about discontinuation, including unexpected physical, emotional, or mental reactions as well as a lack of expected effects, notably some described an opioid effect from buprenorphine. A few participants ended treatment because they had reached their treatment goal, but most expressed disappointment about not achieving this goal. Some also expressed renewed acceptance of OMT. The participants' motivation for abstinence from illegal substances generally remained. Conclusion: Our findings emphasize that a dynamic understanding of discontinuation of treatment is necessary to achieve a long-term approach to recovery: the field should understand discontinuation as a feature of typical treatment trajectories, and discontinuation can be followed by re-initiation of treatment.

• Friesinger, Jan Georg; Birkeland, Bente & Thorød, Anne Brita (2021). Human-Animal Relationships in Supported Housing: Animal Atmospheres for Mental Health Recovery. Frontiers in Psychology. ISSN 1664-1078. 12. doi: 10.3389/fpsyg.2021.712133. Full text in Research Archive
• Birkeland, Bente; Weimand, Bente; Ruud, Torleif; Maybery, Darryl & Vederhus, John-Kåre (2021). Perceived family cohesion, social support, and quality of life in patients undergoing treatment for substance use disorders compared with patients with mental and physical disorders. Addiction science & clinical practice. ISSN 1940-0632. 16(1), p. 1–9. doi: 10.1186/s13722-021-00252-8. Full text in Research Archive Show summary

  Purpose: Support from family and other social network elements can be important in helping patients to cope with practical and emotional consequences of diseases. The aim of the study was to examine perception of family and social support and quality of life (QoL) in patients undergoing treatment for substance use disorders (SUDs). We compared them with patients in treatment for mental disorders (MDs) and physical disorders (PDs). Methods: We used data from a national multicenter study that recruited patients (N  =  518) from three treatment domains; SUD treatment units, MD treatment units, and PD treatment units (severe neurological conditions or cancer). Data on family cohesion, social support, and QoL were compared across patient groups. In addition, data on health variables was collected. We used a multiple linear regression procedure to examine how health and support variables were associated with QoL. Results: Family cohesion and social support in the SUD and MD groups were rated at similarly low levels, substantially lower than in the PD group. The SUD group exhibited a somewhat lower QoL than did the PD group, but their QoL was still in the near-to-normal range. In contrast, the MD group had markedly low QoL. When examining factors associated with QoL, we found that greater family cohesion and social support were positively associated with QoL. Mental distress was the strongest factor, and was negatively associated with QoL (beta − 0.15, 95% CI  =  − 0.17/− 0.14, p  <  0.001). Conclusion: Service providers need to be aware of the weaker networks and less regulatory family and/or social support available to patients with SUDs. Providers should focus consistently on the social networks of patients and include patients’ families in treatment processes.

• Vederhus, John-Kåre; Høie, Magnhild & Birkeland, Bente (2020). One size doesn't fit all: A thematic analysis of interviews with people who have stopped participating in Narcotics Anonymous in Norway. Addiction science & clinical practice. ISSN 1940-0632. 15(18). doi: 10.1186/s13722-020-00191-w. Full text in Research Archive
• Weimand, Bente; Birkeland, Bente; Ruud, Torleif & Høie, Magnhild (2020). “It’s like being stuck on an unsafe and unpredictable rollercoaster” : Experiencing substance use problems in a partner. Nordic Studies on Alcohol and Drugs (NAD). ISSN 1455-0725. 37(3), p. 227–242. doi: 10.1177/1455072520904652. Full text in Research Archive
• Birkeland, Bente; Foster, Kim; Selbekk, Anne Schanche; Høie, Magnhild; Ruud, Torleif & Weimand, Bente (2018). The quality of life when a partner has substance use problems: a scoping review. Health and Quality of Life Outcomes. ISSN 1477-7525. 16:219, p. 1–14. doi: 10.1186/s12955-018-1042-4. Full text in Research Archive
• Birkeland, Bente; Weimand, Bente; Ruud, Torleif; Høie, Magnhild & Vederhus, John-Kåre (2017). Perceived quality of life in partners of patients undergoing treatment in somatic health, mental health, or substance use disorder units: A cross-sectional study. Health and Quality of Life Outcomes. ISSN 1477-7525. 15(1). doi: 10.1186/s12955-017-0750-5. Full text in Research Archive
• Vederhus, John-Kåre; Birkeland, Bente & Clausen, Thomas (2016). Perceived quality of life, 6 months after detoxification: Is abstinence a modifying factor? Quality of Life Research. ISSN 0962-9343. 25(9), p. 2315–2322. doi: 10.1007/s11136-016-1272-z.
• Vederhus, John-Kåre; Timko, Christine; Kristensen, Øistein; Hjemdal, Bente & Clausen, Thomas (2014). Motivational intervention to enhance post-detoxification 12-Step group affiliation: A randomized controlled trial. Addiction. ISSN 0965-2140. 109(5), p. 766–773. doi: 10.1111/add.12471.

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• Friesinger, Jan Georg; Birkeland, Bente & Thorød, Anne Brita (2021). Kommuner kan gjøre enkle grep for bedre psykisk helse. Fædrelandsvennen. ISSN 0805-3790.
• Birkeland, Bente (2019). "Alle har et søskenbarn..." Om forskningsformidling i sosiale lag.
• Birkeland, Bente (2019). Quality of life – why does it matter? Perceived quality of life in partners of patients undergoing treatment in physical health, mental health, or substance use disorder units: a crosssectional study.
• Birkeland, Bente (2019). The quality of life when a partner has substance use problems - a scoping review.
• Birkeland, Bente; Høie, Magnhild; Ruud, Torleif & Weimand, Bente (2019). Quality of life – why does it matter? Perceived quality of life in partners of patients undergoing treatment in physical health, mental health, or substance use disorder units: a crosssectional study. Show summary

  To explore (1) differences in socio-demographic, social/familial, and health variables, and perceived quality of life (QoL) among partners of patients with physical illness, mental illness, or substance use disorders (SUD); and (2) identify factors associated with QoL. Why is this important? Studies comparing the QoL between partners to patients in different illness populations seems to be limited, especially when they share parenthood for children. Examining the partner's QoL, and factors associated with QoL is important to get a broadened picture of these families’ situation and needs in times of parental illness. What are the main discussion points you will raise in this presentation? • No QoL differences between groups but poorer scores on income/work for SUD-partners • 13 % had markedly low QoL indicating a very difficult situation • QoL covers domains in addition to strict health outcomes• Brief QoL tools might give valuable information about partners’ needs for support

• Birkeland, Bente (2019). Quality of life in partners of patioents in the specialist health services: why does it matter?
• Birkeland, Bente (2019). Quality of life (QoL) when your partner has substance use problems (SUP): a scoping review.
• Weimand, Bente; Birkeland, Bente; Hagen, Kristine Amlund & Ruud, Torleif (2015). Hvem er foreldrene, og hvordan er deres situasjon?
• Ruud, Torleif; Birkeland, Bente; Faugli, Anne; Hagen, Kristine Amlund; Hilsen, Marit & Kallander, Ellen Katrine [Show all 13 contributors for this article] (2021). Barn som pårørende. Resultater fra oppfølgingsundersøkelsen. Helsedirektoratet .
• Birkeland, Bente (2019). Life situation when your partner has substance use problems: Quality of life and everyday experiences. Universitetet i Agder. ISSN 978-827117-937-3. Full text in Research Archive
• Ruud, Torleif; Birkeland, Bente; Faugli, Anne; Hagen, Kristine Amlund; Hellman, Anders & Hilsen, Marit [Show all 15 contributors for this article] (2015). Barn som pårørende - Resultater fra en multisenterstudie. Helsedirektoratet.
• Birkeland, Bente & Weimand, Bente (2015). Voksne pårørende til personer med rusmiddelproblemer _ En kvalitativ levekårsstudie - "Det gjennomsyrer jo hele livet". Helsedirektoratet.

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