Relapse Rate after Opioid Detoxification in Drug Addict Patients
Abstract
Background: Drug addiction is widely regarded as a pathological condition that involves the continued abuse of drugs in the development of drug-seeking behavior and a decrease in the ability to respond to naturally rewarding stimuli.
Objective: To determine the frequency of relapse after opioid detoxification in drug addict patients.
Methods: A descriptive cross-sectional survey was performed in psychiatry department of Pakistan Institute of Medical Sciences, PIMS, Islamabad, from October 2017 to April 2018. All adult patients who were using cannabis for at least 1 year, irrespective of gender ages between 18 to 60 years were included in the study. For drug use characteristics about preferred choice of drugs and injection-related risk behaviors were noted and analyzed. All findings were entered in a structured Proforma. Data was entered in SPSS version 21 and analyzed. Effects modifiers like age, gender, marital status, types of drugs, etc., were controlled by stratification. Post stratification chi square test was applied. A p value ≤ 0.05 was considered significant.
Results: Total 310 patients were included; 83% patients were male and 17% were females. The mean age of the patients was 39.02±21.42 years. 70% patients had relapse after opioid detoxification while 30% patients had NO relapse. The relapse rate after detoxification was more common in first month of detoxification (56%). After 3 months the relapse rate after detoxification was 12.5%. The statistical analysis showed that there was a very significant association between types of drugs, ages of patients, marital status and relapse rate (p ≤ 0.05). There was an insignificant association between gender and relapse rate (p ≥ 0.5).
Conclusion: The study concluded that the relapse within six months of opioid detoxification in drug addicts is very common. Many factors contribute in relapse rate.
References
https://doi.org/10.1016/S2352-3018(19)30180-8
2. Bushra R, Aslam N, Ahmed KZ. Drug misuse, dependence and addiction. J Appl Pharm Sci. 2013;3(03):1-7. https://doi.org/10.7324/JAPS.2013.30301
3. Maehira Y, Chowdhury EI, Reza M, Drahozal R, Gayen TK, Masud I, et al. Factors associated with relapse into drug use among male and female attendees of a three-month drug detoxification–rehabilitation programme in Dhaka, Bangladesh: a prospective cohort study. Harm Reduct J. 2013;10(1):1-3. https://doi.org/10.1186/1477-7517-10-14
4. Noori R, Daneshmand R, Farhoudian A, Ghaderi S, Aryanfard S, Moradi A. Amphetamine-type stimulants in a group of adults in Tehran, Iran: a rapid situation assessment in twenty-two districts. Iran J Psychiatry Behav Sci. 2016;10(4):e7704.2
https://doi.org/10.17795/ijpbs-7704
5. Jafari S, Mathias R, Joe RS, Baharlou S, Nasr A. Effect of law enforcement on drug abuse: A comparison of substance use in Pakistan, Afghanistan, Iran and Turkey. J Subst Use. 2015;20(4):295-300. https://doi.org/10.3109/14659891.2014.900579
6. Bergenstrom AM, Abdul-Quader AS. Injection drug use, HIV and the current response in selected low-income and middle-income countries. Aids. 2010;24(3):20-29.
https://doi.org/10.1097/01.aids.0000390086.14941.91
7. Garai J. Gender and HIV/AIDS in Bangladesh: A review. J Health Soc Sci. 2016;1(3):181-198.
8. Sharma M, Oppenheimer E, Saidel T, Loo V, Garg R. A situation updates on HIV epidemics among people who inject drugs and national responses in South-East Asia Region. Aids. 2009;23(11):1405-1413. https://doi.org/10.1097/QAD.0b013e32832bd7c9
9. Lara GL, Carlos R, Constanza D, Begoña G, Diana B, Laia RC, et al. Risk factors for relapse in drug-dependent patients after hospital detoxification. Adicciones. 2012;24(2):1-2.
10. Reus VI, Fochtmann LJ, Bukstein O, Eyler AE, Hilty DM, Horvitz-Lennon M, et al. The American Psychiatric Association practice guideline for the pharmacological treatment of patients with alcohol use disorder. Am J Psychiatry. 2018;175(1):86-90.
https://doi.org/10.1176/appi.ajp.2017.1750101
11. Smyth BP, Barry J, Keenan E, Ducray KJ. Lapse and relapse following inpatient treatment of opiate dependence. Ir Med J. 2010;103(6):176-9.
12. Bisaga A, Sullivan MA, Glass A, Mishlen K, Carpenter KM, Mariani JJ, et al. A placebo-controlled trial of memantine as an adjunct to injectable extended-release naltrexone for opioid dependence. J Subst Abuse Treat. 2014;46(5):546-552.
https://doi.org/10.1016/j.jsat.2014.01.005
13. Krupitsky E, Nunes EV, Ling W, Illeperuma A, Gastfriend DR, Silverman BL. Injectable extended-release naltrexone for opioid dependence: a double-blind, placebo-controlled, multicentre randomised trial. Lancet. 2011;377(9776):1506-1513.
https://doi.org/10.1016/S0140-6736(11)60358-9
14. Bhandari S, Dahal M, Neupane G. Factors associated with drug abuse relapse: A study on the clients of rehabilitation centers. Al Ameen J Med Sci. 2015;8(4):293-298.
15. Passetti F, Clark L, Davis P, Mehta MA, White S, Checinski K, et al. Risky decision-making predicts short-term outcome of community but not residential treatment for opiate addiction. Implications for case management. Drug Alcohol Depend. 2011;118(1):12-18.
https://doi.org/10.1016/j.drugalcdep.2011.02.015
16. Salimi A, Safari F, Mohajerani SA, Hashemian M, Kolahi AA, Mottaghi K. Long-term relapse of ultra-rapid opioid detoxification. J Addict Dis. 2014;33(1):33-40.
https://doi.org/10.1080/10550887.2014.882727
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