The funding from the RCN makes it possible for SERAF to conduct clinical drug research at a high international level. Our research has contributed to a better, more evidence-based treatment of substance use disorders, and has achieved important results. We maintain a strong focus on our traditional research areas, as OMT, overdose deaths and heroin addiction. We do extensive research dissemination, through publications, lectures, university courses, supervision and teaching of master and doctoral students. We maintain our national and international network activity in the addiction research field. SERAF is involved in the development and implementation of courses in the Norwegian medical specialty «Addiction medicine».
SERAF has since its inception recruited both national and international researchers, which have brought valuable research expertise to us and has laid the foundation for a formalized national network for clinical drug research.
SERAF's future focus and emphasis will depend on access to external funding. Our position as a leading national and international institution in the addiction research field will therefore to some extent follow developments that are prioritized by actors who fund drug research.
Networking through collaboration in large multicenter research projects such as NorComt, Naloxone nasal spray, prison research and the Naltrexone study have been key initiatives. SERAF has recruited national and international researchers, who have laid the foundation of a formalized national network for clinical drug research and a large international network.
The research at SERAF is currently organized under two research groups:
1. Opioid maintenance treatment
SERAF is central to overseeing, collaborating and reporting to the authorities on OMT treatment and overdoses in Norway. We have contributed to a comprehensive survey of overdoses in Denmark which has led to further Nordic collaboration. In recent years, changes in mortality associated with opioids have received increasing attention. SERAF considers opioid users receiving prescriptions for chronic pain as an important future research field. In 2019, SERAF received funding from Hdir to work with FHI to strengthen the knowledge on the use of opioids in chronic pain management.
Research on drug use and health in prisons, and among prisoners released from prisons, has been awarded funds from Helse Sør-Øst and RCN for new studies, including a Nordic collaboration. Another important project is the testing of naloxone nasal spray for overdose prevention. The research on naloxone has been subject of international interest. The research group also conducts a national clinical study, the NorComt study, a study of people starting in OMT or day care treatment. Three PhD projects were completed in 2017/18. An extension of the project, with a special focus on aging in OMT, was funded by Helse Sør-Øst 2019. Naltrexone as relapse measure was an important study at SERAF. The study resulted in the world's first RCT on injections of naltrexone's effect on overdose prevention. The main result was published in a highly ranked journal in 2017. Several PhD projects were completed in 2018/19. The project is being continued at AHus, where SERAF is a partner.
2. E-health and addiction treatment
SERAF has focused on online technology for use in addiction treatment and interventions. The smoking cessation program «Balance» is an eHealth program to support health-promoting behavior. «Balance» is an early intervention on alcohol use where the main intention is to prevent future problems. The effect of Balance» has been evaluated through two RCT studies and was part of a broad international collaboration.
In 2019, SERAF has developed a pilot for a broader «health-promoting eHealth platform» that includes smoking, alcohol use, diet and physical activity. The pilot will be tested in 2020. SERAF aims to strengthen the prevention of harmful drug use and contribute to health-promoting behavior where a focus area is via eHealth-based interventions. eHealth research is included in applications from SERAF in 2020.
Together with NIVA, as part of an EU consortium, SERAF has looked at wastewater to investigate the use of legal and illegal drugs in urban populations. SERAF was central to the development of the application of this new technology.
SERAF's most developed methodology in the drug research field has been via registry-based studies. Over the past 10 years, SERAF has strengthened the register-based research and aims to expand the method, with special focus on Nordic collaboration projects.
In the fall of 2018, SERAF was elected to investigate a treatment program in Heroin-assisted treatment. The project was adopted according to SERAF's recommendation as a 5-year trial project. The investigation is the basis for a large treatment trial in the addiction field in Norway. The project will provide international relevant knowledge in the future.
SERAF har bidratt med et betydelig volum av kunnskap om rusmiddelbehandling og utfall. Det er publisert mer enn 500 vitenskapelig artikler, avlagt mer enn 35 PhD-grader og over 50 Mastergrader. I stor grad vurderes det at SERAF har nådd målsettingen; å styrke kunnskapsgrunnlaget og kompetansen i fagfeltet i Norge. SERAF ble, har vært og er i dag en sentral fagaktør med sterke nasjonale og internasjonale kontaktnett og samarbeid. SERAFs aktivitet, forskning og fagproduksjon har bidratt til endring i klinisk praksis på overdosefeltet i Norge, samt bidratt til forbedring i nasjonale retningslinjer og strategier. Sentrale SERAF ansatte brukes som medlemmer i offentlige utvalg, faglige referansegrupper og utvikling av nasjonale faglige retningslinjer. SERAF har god dialog med brukerorganisasjoner i rusfeltet og involverer brukermedvirkning i pågående forskningsprosjekter. I alle landets helseforetak finnes det i dag ansatte i rusfeltet med PhD eller Mastergrad fullført ved SERAF.
The aim is to establish a national centre for clinically oriented addiction research. The centre will be administered from Institute of psychiatry and built with an interdisiplinary profile. An advisory board with participation from internal and external collaborating partners will bridge different medical and social science institutes.
The South and East Regional Health Corporations have decided to support the centre. Within the regions four main hospital trusts have signed declarations of intent. The se health regions contain by far the largest population of substance users; problematic useres, alcohol dependents and new trendes in substance use.
Institute of Psychiatry allocates resources from en existing Unit for Addiction Medicine to the new cent re and will together with the hospital trusts in Oslo have locations for the centre. This enables the creation of a centre with above 20 positions with externally funded fellowships and academic postions as add ons.
Unit for Addiction Medicine has a n established cooperation with National Institute of Public Health, National Institute of Substance Abuse Research for research conferences and projects, a national research forum and post graduate courses. A special graduate school for addicition researc h will be core activity in the new centre. A Master Degree program is under planning. These activities will be enlarged. In the start up process, other universities will be invited to contracted cooperation, also regarding improved teaching. At present University of Stavanger has signed a declaration of intent.
The planned centre will dispose know-how in epidemiology, basic nevrobiological methods, brain imageing, social science research methods and treatment and health service reseach. The research program is planned with four arms: 1 The development of substance use problems and dependency, 2. Problems and diseases related to substance use, 3 Treatment and interventions research, 4. Health service research.