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Article History

Received: 13 July 2025

Accepted: 8 October 2025

First Online: 22 October 2025

Declarations

:

: The study was conducted as approved by the Swedish Ethics Review authority (No. 2020–00796), as stated in the manuscript on page 6. The study adhered to the Helsinki Declaration. The study was submitted for consideration, comment, guidance, and approval by the national Swedish Ethics Review Authority, before start. Obtaining individual consent to participate and for publication is not necessary or applicable in this case. The study is based on electronic medical records data, which is similar to register-based research and to quality data within the health care system. Research data are exclusively based on already given treatment according to clinical routines, registered in electronic medical records. The study does not in any way affect the treatment or treatment access of any individual or expose participants to any risks. Conversely, the risk of only collecting data from patients where consent can be obtained, is that the most unstable patients, who may not be possible to contact for different reasons (no longer are at the clinic, in inpatient or treatment facilities elsewhere, incarcerated or deceased) would not to be included in the follow-up. This would risk biasing results towards more positive outcomes and spuriously increase the positive effects of the treatment. Individual consent was waived by the Ethics Review Authority. Similar approaches are used in the clinical follow up of other severe conditions such as cancer treatment. Data is coded and analyzed and presented at a group level, where no individual participants are possible to identify, to ensure integrity of the participants.

: Not applicable. No individual level data are presented in this manuscript.

: AJC has received speaker’s fees and participated in advisory board meetings for Indivior, Dne pharma, Camurus, Nordic Drugs, Lundbeck, all outside the scope of this study. MS has served as consultant and received speaker’s fees from Indivior, Camurus, Dne pharma and Nordic Drugs all outside the scope of this work. For the remaining co-authors none were declared.