I received six daily doses of LAR medication, found dead

As a consequence of the coronary pandemic, the woman received six daily doses of LAR drugs at the same time, instead of one dose per day. Now it is suspected that she died of an overdose.

This is in line with what Aftenbladet knows about the first possible overdose death that is linked to measures as a result of the crown crisis in Norway.

– There is no continuously available system nationwide for reporting overdose deaths, even during the crown crisis. But I’m not aware that an overdose death so far has been linked to the crown crisis, says one of Norway’s top investigators of overdose deaths, Thomas Clausen, a professor at the Center for Substance Abuse and Addiction Research ( Seraph) of the University of Oslo.

I have big doses of LAR at the door

User organizations have warned for some time that various measures by authorities to prevent infection among addicts can lead to death.

The Rogaland County Governor has filed a case against Helse Stavanger and Stavanger Township after a woman in her 50s died in late March of this year.

The reason is that LAR, the drug-assisted rehabilitation service in Helse Stavanger, changed routines after the crown eruption in March. Most of its around 550 LAR patients in Rogaland went from having to take their medications on a daily basis, to receiving LAR medications at home for one week at a time. Therefore, patients were suddenly given a great responsibility: they had to administer their own medications themselves.

According to the new routine, the 50-year-old woman received six doses of LAR at the same time. In addition to that, he received other medications, as well as known substance abuse.

After receiving the LAR medication, she was found dead in her own municipal department.

They called 113 and an ambulance arrived, but life was not going to save.

“The patient is suspected to have died of an overdose,” writes the Norwegian National Health Authority, which asked the county governor to establish a monitoring case.

It was the municipality of Stavanger that routinely reported the death as an unexpected incident to the Norwegian Board of Health.

From physical to telephone meetings

As LAR changed its distribution routines, Stavanger Township also changed its monitoring of intoxicants, including patients with LAR.

Especially people with the combination of severe substance abuse and mental illness, so-called RP patients, are designated as a risk group during the pandemic.

For many of these, the municipality went from physical monitoring in their homes to telephone contact. Also this to prevent infection.

Sissel Kjøde, Senior Advisor to the Rogaland County Governor, will now investigate the case. Among other things, you will find out if the woman received good and justifiable services.

– Did you consider the needs of women?

– Both LAR and the municipality have room for maneuver, despite having received guidance and directives from the central authorities. The question is: did you do an individual assessment of the woman’s needs? Cold asks.

– How were you informed about the new routines and about your rights? Did they confirm that she understood the information she received? Was there any reason to worry about it, given the new frameworks that were developed? We want those questions answered, Kjøde tells Aftenbladet.

She recalls that RP patients are defined as a risk group during the crown crisis.

– It is a vulnerable group that does not scream out loud, and often escapes help. It is important that we carefully observe how they are cared for during the crown crisis.

Routine changes after death?

The county governor also wants answers on whether the deaths have already caused changes in visits and distribution of medications. LAR Health Stavanger will respond on Tuesday of next week, while the municipality of Stavanger has extended the response period to June 5.

Randi Mobæk, Head of the Substance Abuse and Addiction Treatment Department at Helse Stavanger, will not comment on the death until the county governor has concluded. But she confirms that toward the end of March they switched to a main program where LAR patients administer their medications for one week at a time.

– The reason we changed the distribution routine was precisely because people should not have to go to the distribution points and risk being infected by our employees or other patients.

Mobæk says they evaluated for each patient whether changing the routine was justifiable.

– We are always worried

They have not made any changes to the new scheme during the crown crisis.

– But we have become hardened for people where there has been a danger of overdosing or that the change in routine has affected their physical and mental health. Then we have withdrawn self-administration and returned to the normal recovery system, says Mobæk.

– So you are not concerned that increased drug self-administration has led to increased risk?

– We are always concerned that what we do may harm people. But we have not noticed any deterioration. On the contrary, we are surprised at how well it has gone. None have been reported infected. And more patients are being treated. But we are not naive. We must care for and follow the patients, “says Mobæk.

Just increased risk of suicide

The woman in her 50s lived in a municipal residence with monitoring of the municipality’s environmental service. He also received health and care services. The Norwegian Health Inspectorate notes that “the patient had complex long-term health challenges,” but emphasizes at the same time: the woman was not considered to be at increased risk of suicide.

– He oriented himself

Eli Karin Fosse, director of health and wellness for Stavanger Township, does not want to comment on the death before the county governor has concluded.

Fosse says Health Stavanger informed the municipality of the routine change.

– We were not involved until the decision was made, as far as I have an overview, says Fosse.

Each rated

She says that in the institutions, in home nursing and in community life, the municipality had to have one-on-one contact even during the crown crisis.

– But in all other areas, the main rule was to avoid this as much as possible. Then we use phone, video and exceptionally outdoor meetings, says Fosse.

The environmental service in the municipality monitors 200 users.

– We reviewed them to assess what type of follow-up they should receive and if there was anyone to whom we should pay special attention. These individual evaluations were maintained throughout the period, says Fosse.

– The phone is not as good as a home visit, but the staff has shown great professionalism and attention. It was a demanding decision, because we know that users must know their contacts. But when the community closed, it wasn’t difficult. That’s what we had to do, says Fosse.

The relatives of the deceased woman know that Aftenbladet refers to death.