{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T08:26:33Z","timestamp":1767169593651,"version":"build-2238731810"},"reference-count":37,"publisher":"S. Karger AG","issue":"5","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur Addict Res"],"abstract":"<jats:p>&lt;p&gt;Introduction: Non-prescribed use of opioid agonist treatment (OAT) medications is a public health concern. This study analyzes the prevalence of non-prescribed use and non-fatal overdoses in Norway in 2013 and 2023, a period marked by an increasingly flexible OAT regimen, and examines associations between non-prescribed use and non-fatal overdoses. Methods: Cross-sectional surveys with two convenience samples (n&lt;sub&gt;1&lt;\/sub&gt; = 611 in 2013, n&lt;sub&gt;2&lt;\/sub&gt; = 523 in 2023) of street-recruited individuals, who reported recent use of opioids and\/or stimulants but were not currently enrolled in OAT, were employed. The primary outcomes were self-reported non-prescribed use of methadone and buprenorphine and non-fatal overdoses in the past month and past year. Covariates included demographics and substance use characteristics. Results: Non-prescribed use of OAT medications significantly declined from 39.4% in 2013 to 28.1% in 2023 (p &lt; 0.001), as did frequency of use (p &lt; 0.01). There was no change in non-fatal overdoses in the past month (8.2% in both years), though past-year non-fatal overdoses decreased (23.6% in 2013 vs. 15.9% in 2023, p = 0.001). Multinomial regression analyses showed no significant association between non-prescribed OAT use and increased risk of non-fatal overdoses. Instead, factors such as injecting drug use, frequent heroin use, stimulant use, younger age, and female sex were associated with non-fatal overdose risk. Conclusion: Even with an increasingly flexible OAT regimen, non-prescribed use declined among street-recruited participants, and no corresponding increase in non-fatal overdoses was observed. These findings challenge the assumption that reduced monitoring in OAT is linked with higher rates of non-prescribed use and adverse outcomes, such as non-fatal overdoses, among individuals not in OAT. &lt;\/p&gt;<\/jats:p>","DOI":"10.1159\/000547909","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T16:03:11Z","timestamp":1754668991000},"page":"347-358","source":"Crossref","is-referenced-by-count":0,"title":["Non-Prescribed Use of Opioid Agonist Medications and Associations with Non-Fatal Overdoses: A Repeated Cross-Sectional Study across a Decade of Reduced Monitoring"],"prefix":"10.1159","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5356-2777","authenticated-orcid":false,"given":"Anne 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