ArticleThe International journal on drug policy2022
Diagnosis and treatment of opioid-related disorders in a South African private sector medical insurance scheme: A cohort study.
Article in The International journal on drug policy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- Evidence-based framework for identifying opioid use disorder in administrative data: A systematic review and methodological development study.Pain medicine (Malden, Mass.) · 2026Pooled it
- Pilot of Methadone for Recently Incarcerated People with Human Immunodeficiency Virus and Opioid Use in South Africa.Journal of correctional health care : the official journal of the National Commission on Correctional Health Care · 2025Article
- Methadone and Buprenorphine as Medication for Addiction Treatment Diversely Affect Inflammation and Craving Depending on Their Doses.Pharmacy (Basel, Switzerland) · 2025Article
- Evaluating client functioning in a harm reduction program in South Africa: insights from a tool derived from the International Classification of Functioning, Disability and Health.Frontiers in rehabilitation sciences · 2024Article
- Life years lost associated with mental illness: A cohort study of beneficiaries of a South African medical insurance scheme.Journal of affective disorders · 2023Article
- Mental Health, ART Adherence, and Viral Suppression Among Adolescents and Adults Living with HIV in South Africa: A Cohort Study.AIDS and behavior · 2023Article
- Life-years lost associated with mental illness: a cohort study of beneficiaries of a South African medical insurance scheme.medRxiv : the preprint server for health sciences · 2023Article
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Authors and funding
10 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundThe use of opioids is increasing globally, but data from low- and middle-income countries on opioid-related mental and behavioural disorders (hereafter referred to as opioid-related disorders) are scarce. This study examines the incidence of opioid-related disorders, opioid agonist use, and excess mortality among persons with opioid-related disorders in South Africa's private healthcare sector.
methodsWe analysed longitudinal data of beneficiaries (≥ 11 years) of a South African medical insurance scheme using reimbursement claims from Jan 1, 2011, to Jul 1, 2020. Beneficiaries were classified as having an opioid-related disorder if they received an opioid agonist (buprenorphine or methadone) or an ICD-10 diagnosis for harmful opioid use (F11.1), opioid dependence or withdrawal (F11.2-4), or an unspecified or other opioid-related disorder (F11.0, F11.5-9). We calculated adjusted hazard ratios (aHR) for factors associated with opioid-related disorders, estimated the cumulative incidence of opioid agonist use after receiving an ICD-10 diagnosis for opioid dependence or withdrawal, and examined excess mortality among beneficiaries with opioid-related disorders.
resultsOf 1,251,458 beneficiaries, 1286 (0.1%) had opioid-related disorders. Between 2011 and 2020, the incidence of opioid-related disorders increased by 12% (95% CI 9%-15%) per year. Men, young adults in their twenties, and beneficiaries with co-morbid mental health or other substance use disorders were at increased risk of opioid-related disorders. The cumulative incidence of opioid agonist use among beneficiaries who received an ICD-10 diagnosis for opioid dependence or withdrawal was 18.0% (95% CI 14.0-22.4) 3 years after diagnosis. After adjusting for age, sex, year, medical insurance coverage, and population group, opioid-related disorders were associated with an increased risk of mortality (aHR 2.28, 95% CI 1.84-2.82). Opioid-related disorders were associated with a 7.8-year shorter life expectancy.
conclusionsThe incidence of people diagnosed with or treated for an opioid-related disorder in the private sector is increasing rapidly. People with opioid-related disorders are a vulnerable population with substantial psychiatric comorbidity who often die prematurely. Evidence-based management of opioid-related disorders is urgently needed to improve the health outcomes of people with opioid-related disorders.
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