Factors Associated with Relapse Among Opiate Addicts in an Out-patient Detoxification Programme

1992 ◽  
Vol 161 (5) ◽  
pp. 654-657 ◽  
Author(s):  
Sujata Unnithan ◽  
Michael Gossop ◽  
John Strang
Keyword(s):  
Drug Users ◽  
Negative Mood ◽  
Patient Treatment ◽  
Opiate Withdrawal ◽  
Social Psychological ◽  
Factors Associated ◽  
Opiate Use ◽  
Interpersonal Factors ◽  
Opiate Addicts ◽  
Opiate Withdrawal Syndrome

Relapse is a central problem in the treatment of addictive behaviour, and a specific problem in the out-patient treatment of the opiate withdrawal syndrome. This study investigated factors associated with relapse among 42 opiate addicts receiving out-patient detoxification treatment at a London drug-dependence clinic. All subjects completed a questionnaire about their social, psychological, and environmental circumstances in the week before interview, and were interviewed within the first two weeks of the programme. Forty per cent had lapsed to illicit heroin abuse within the previous week. Interpersonal factors and drug-related cues were associated with lapse to opiate use. Most subjects encountered a range of high-risk situations, such as regularly meeting other drug users and being offered drugs, and persistent negative mood states.

Immune parameters and level of cortisol in patients with opiate addiction during withdrawal syndrome

2017 ◽  
pp. 38-45
Author(s):  
Т.П. Ветлугина ◽  
Е.В. Матафонова ◽  
Н.А. Бохан ◽  
В.Б. Никитина ◽  
А.И. Мандель ◽  
...  
Keyword(s):  
Cortisol Level ◽  
Withdrawal Syndrome ◽  
Physical Dependence ◽  
Serum Levels ◽  
Opiate Withdrawal ◽  
Opiate Addiction ◽  
Laboratory Methods ◽  
Immune Parameters ◽  
Opiate Withdrawal Syndrome

Цель исследования: изучение динамики показателей иммунитета и уровня кортизола у больных опийной наркоманией в процессе терапии синдрома отмены. Методика. В исследование включено 136 больных опийной наркоманией (инъекции экстракта опия) с сформировавшейся физической зависимостью. Пациенты получали в стационаре стандартную терапию с полной отменой наркотика. Исследование проводилось на следующих этапах: при поступлении в стационар (опийный абстинентный синдром - ОАС); на 5-7-е сут. терапии (переход в постабстинентное состояние - ПАС); на 25-28-е сут. лечения (становление терапевтической ремиссии - СТР). Лабораторные методы включали определение количества лимфоцитов с рецепторами CD3, CD4, CD8, СD16, с рецепторами к дофамину (D-RFC); содержание иммуноглобулинов М, G, А, уровня кортизола и циркулирующих иммунных комплексов (ЦИК) в сыворотке крови. Результаты. Основной иммуноэндокринный паттерн на всех этапах терапии синдрома отмены характеризуется дефицитом субпопуляций Т-лимфоцитов CD3, CD4, СD8; увеличением числа лимфоцитов с рецепторами к дофамину (D-RFC); активацией гуморальных факторов иммунитета (IgM, IgG, ЦИК); высокой концентрацией кортизола. На этапе ОАС и ПАС эти изменения были наиболее выражены; на 25-28-е сут. лечения отмечена позитивная динамика Т-лимфоцитов СD3 и цитотоксических Т-лимфоцитов (СD8); хелперы/индукторы CD4 оставались устойчиво сниженными; D-RFC лимфоциты, параметры гуморального иммунитета и концентрация кортизола - повышенными. Длительный срок наркотизации при употреблении высоких доз наркотика связан с большей выраженностью нарушений. Заключение. Установленная дизрегуляция параметров иммуноэндокринной системы у больных опийной наркоманией на всех этапах терапии синдрома отмены в наблюдаемые сроки (25-28 сут.) свидетельствует о неустойчивости достигнутой терапевтической ремиссии и необходимости проведения дальнейших реабилитационных мероприятий. The purpose: investigate changes in immunity parameters and cortisol level in subjects with opiate addiction during the treatment of opiate withdrawal syndrome. Methods. The study enrolled 136 subjects with opiate addiction with physical dependence receiving injections of opium extract. Patients received conventional therapy with complete opiate withdrawal. The study was performed at the following stages: at admission to the hospital (acute withdrawal syndrome (AWS); on days 5-7 of therapy (transition into post-withdrawal state - PWS); on days 25-28 of therapy (formation of therapeutic remission - FTR). Laboratory methods included determination count of lymphocytes with receptors CD3, CD4, CD8, СD16, with receptors to dopamine (D-RFC); the serum levels of IgМ, IgG, IgА, cortisol, circulating immune complexes (CIC). Results. The principal immunoendocrine pattern for all stages of withdrawal syndrome therapy is characterized in comparison to the reference normal values quantitative deficit of CD3, CD4, СD8 Т-lymphocyte subpopulations, increased count of lymphocytes with receptors to dopamine, activation of humoral immunity factors (IgM, IgG, CIC), high cortisol level. At AWS and PAS stages such changes are most pronounced; on days 25-28 of therapy positive changes in cytotoxic Т-lymphocytes (СD8) and Т-lymphocytes СD3 was revealed. CD4 count remained steadily reduced, count of lymphocytes with receptors to dopamine and cortisol level were elevated. Clinical and immunological analysis demonstrated that consumption of high opiate doses, long-term narcotization are associated with higher intensity of disorders detected. Conclusion. Dysregulation of immunoendocrine parameters was revealed in subjects with opiate addiction at all stages of withdrawal syndrome therapy within the term observed evidencing instability of therapeutic remission achieved and necessity in further rehabilitation events.

scholarly journals P1-385 Risk factors associated with last-month illegal drug polyconsumption in a population of drug users

2011 ◽  
Vol 65 (Suppl 1) ◽  
pp. A173-A174
Author(s):  
F. Alonso ◽  
M. L. Garmendia ◽  
M. E. Alvarado ◽  
G. Acuna
Keyword(s):  
Risk Factors ◽  
Drug Users ◽  
Illegal Drug ◽  
Factors Associated

Circumstances Surrounding the Initial Lapse to Opiate Use Following Detoxification

1989 ◽  
Vol 154 (3) ◽  
pp. 354-359 ◽  
Author(s):  
Brendan P. Bradley ◽  
Grania Phillips ◽  
Lynette Green ◽  
Michael Gossop
Keyword(s):  
Social Pressure ◽  
Patient Treatment ◽  
Drug Availability ◽  
Treatment Approaches ◽  
Opiate Use ◽  
External Events

Seventy-eight opiate abusers were followed up after successful in-patient detoxification in order to examine renewed opiate use. The greatest number of initial lapses occurred within a week of subjects leaving in-patient treatment. Eleven categories of lapse precipitant were identified: cognitive, mood, external, withdrawal, interpersonal, leaving a protected environment, drug availability, drug-related cues, craving, priming, and social pressure. Cognitions, negative moods and external events emerged as the most commonly mentioned factors; these often occurred together, either in clusters or in a sequence. Implications of these results for models of relapse and for treatment approaches are discussed.

scholarly journals Factors associated with retention in faith-based drug treatment centers in the Mexican-American border

Salud Mental ◽  
2018 ◽  
Vol 41 (4) ◽  
pp. 169-177 ◽  
Author(s):  
Ietza Bojorquez ◽  
◽  
Daniel Rodríguez ◽  
Olga Odgers ◽  
Ramiro Jaimes ◽  
...  
Keyword(s):  
Residential Treatment ◽  
Mexican American ◽  
Drug Users ◽  
Religious Orientation ◽  
Retention Rate ◽  
Religious Affiliation ◽  
Logistic Regression Models ◽  
Factors Associated ◽  
Faith Based ◽  
Treatment Facilities

Introduction. Faith-based centers are major providers of residential treatment for substance use problems in Mexico, but relatively few studies have been conducted in this context. Objective. To explore factors associated with treatment retention in two faith-based (with different religious orientation) residential treatment facilities for male drug users in Tijuana, Mexico. Method. We conducted an exploratory follow-up study of 328 clients admitted during 2014-2015 to either an Evangelical Pentecostal center or a faith-based center without a specific religious affiliation. The main outcome was retention, defined as remaining in treatment for at least three months. Results. Among participants, the retention rate was 38.7%. Multivariate logistic regression models showed that age (OR 1.04; 95% CI [1.01, 1.06]; p = .002) and having used heroin or opioids in the past 30 days (OR .50; 95% CI [.25, 1.00]; p = .049) were associated with retention. Having a personal religious affiliation was associated with retention in the Evangelical Pentecostal center, but not in the center without a specific religious affiliation. Discussion and conclusion. The retention rate was low, but within the previously reported range. The interaction of personal religious affiliation and the religious orientation of the center suggests that a match between a person’s religious convictions and those of the center could be important for retention. More research is needed to clarify the utility of faith-based centers for religious and non-religious drug users.

scholarly journals Identification and solution of drug-related problems in the neurology unit of a tertiary hospital in China

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Pengpeng Liu ◽  
Guangyao Li ◽  
Mei Han ◽  
Chao Zhang
Keyword(s):  
Tertiary Care ◽  
Patient Treatment ◽  
Major Type ◽  
Drug Related Problems ◽  
Dose Selection ◽  
Nasogastric Feeding ◽  
Factors Associated ◽  
Clinical Pharmacists ◽  
Medication Therapy ◽  
Medication Error Reporting

Abstract Background The prevalence and characteristics of drug-related problems (DRPs) and factors associated with the occurrence of DRPs in the neurology unit in China remain unknown. This study aimed to determine the prevalence, characteristics and severity ratings of DRPs and identify factors associated with the occurrence of DRPs in the neurology unit of a tertiary care and academic teaching hospital in China. Methods A retrospective study of DRPs and pharmacists’ interventions for neurology patients was performed during a non-consecutive 24-month study period. Patient demographics and clinical characteristics, and pharmacist’s intervention records were collected. The characteristics and severity ratings of DRPs were categorized using the Pharmaceutical Care Network Europe (PCNE) DRP classification tool V9.00 and the National Coordinating Council for Medication Error Reporting and Prevention (NCC-MERP) classification respectively. Results A total of 242 DRPs were detected for 974 admitted patients, an average of 0.25 DRPs per patient. Treatment safety was the major type of DRPs (106;43.8%) followed by treatment effectiveness (78;32.2%). The primary causes of DRPs were drug selection (124;44.1%) and dose selection (92;32.7%). Clinical pharmacists provided 525 interventions, and most interventions occurred at the prescriber level (241;45.9%). A total of 91.4% of these interventions were accepted, contributing to solving 93.0% of the identified problems. The majority of DRPs (210;86.8%) were rated at severity categories B to D (causing no patient harm). Multiple logistic regression showed that creatinine clearance, number of medications used, nasogastric feeding, diabetes, and infectious diseases were associated with more frequent DRPs (p < 0.05). Conclusions DRPs are relatively common in the neurology unit in China, with primary causes of drug and dose selection, and clinical pharmacists can effectively reduce and prevent DRPs to optimize medication therapy.

Motivations for Use of Opiates among Addicts Seeking Treatment in Shiraz

2000 ◽  
Vol 87 (3_suppl) ◽  
pp. 1158-1164 ◽  
Author(s):  
Jamshid Ahmadi ◽  
Ahmad Ghanizadeh
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Social Pressure ◽  
Common Reason ◽  
Patient Treatment ◽  
Semistructured Interview ◽  
Treatment Facility ◽  
The West ◽  
Cultural Attitudes ◽  
Opiate Use

This study assessed the characteristics and motivation for substance use among addicts referred to the Shiraz Self-identified Center, an out-patient treatment facility. Data were gathered by a semistructured interview from 306 consecutive addicts seeking treatment and referred from July to September, 1998. Their mean age was 37 yr., and the majority (73.9%) were married. Of these addicts, 28.4% were workers, 13.4% drivers, and 11.4% were unemployed. Modeling or social pressure (43.1%) was identified as the first and enjoyment (fun) was the second most common reason given for opiate use. The majority (97.1%) used opium and 71.9% used alcohol; however, only 2.6% reported current use of alcohol. Other subjects were current users of cigarettes (72.2%), opium (67%), heroin (35%), hashish (2%), hallucinogens (0.3%), and cocaine (0.3%). The most common reason given for currently using opiates was habit (56.5%). About 36% of the subjects reported that they had frequently used opiates for more than a decade. These findings are quite different from those carried out in the West, although there is some overlap. Cultural attitudes toward drug use likely affect the types and amount of use.

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