Lopes-Rosa Ronaldo, Kessler Félix P, Pianca Thiago G, Guimarães Luciano, Ferronato Pedro, Pagnussat Esequiel, Moura Helena, Pechansky Flavio, von Diemen Lisia
a Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , RS , Brazil.
b Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , RS , Brazil.
J Addict Dis. 2017 Apr-Jun;36(2):136-143. doi: 10.1080/10550887.2017.1295670. Epub 2017 Feb 15.
Relapse is associated with a poor prognosis among drug users. Crack cocaine users are more prone to severe dependence because of the intensity of use. Additionally, initiating drug use during adolescence worsens users' prognosis due to the increased rates of impulsivity and other risk behaviors. This study aimed to identify the predictors of early relapse among adolescent crack users discharged from inpatient treatment. A cohort study was conducted with 89 psychiatric inpatients aged 12-17 years from two different hospitals in southern Brazil who met the criteria for crack abuse or dependence. Demographic data, substance use disorders, psychiatric comorbidities, and crack consumption profile were assessed during hospitalization using the Teen Addiction Severity Index, Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime, and Crack Consumption Profile. Participants were re-assessed at 1 and 3 months after hospital discharge to determine their crack cocaine use based on self-report, family/caregiver information, and urine tests, whenever possible. There were extremely high rates of relapse (valid percent) in the first and third months, 65.9 and 86.4%, respectively. Statistically significant associations were observed between relapse in the first month and length of cocaine/crack cocaine use, and length of hospital stay. Data at 3 months were not analyzed because of the small number of patients who did not relapse. The high rates and significant associations found in this study suggest that intensive outpatient treatment strategies targeting this population should be developed and implemented to prevent early relapse after detoxification. One of the possible approaches, based on recent studies, might explore motivation as a strategy to reduce the rate of early relapse.
复发与吸毒者预后不良相关。由于使用强度，快克可卡因使用者更容易产生严重依赖。此外，在青少年时期开始吸毒会因冲动性和其他风险行为发生率的增加而使使用者的预后恶化。本研究旨在确定住院治疗出院的青少年快克使用者早期复发的预测因素。对巴西南部两家不同医院的89名年龄在12至17岁、符合快克滥用或依赖标准的精神科住院患者进行了一项队列研究。在住院期间，使用青少年成瘾严重程度指数、学龄儿童情感障碍和精神分裂症量表（目前和终生）以及快克消费概况评估人口统计学数据、物质使用障碍、精神共病和快克消费情况。在出院后1个月和3个月对参与者进行重新评估，尽可能根据自我报告、家庭/照顾者信息和尿液检测来确定他们是否使用快克可卡因。在第一个月和第三个月，复发率（有效百分比）极高，分别为65.9%和86.4%。在第一个月的复发与可卡因/快克可卡因使用时长和住院时长之间观察到具有统计学意义的关联。由于未复发患者数量较少，未对3个月时的数据进行分析。本研究中发现的高复发率和显著关联表明，应制定并实施针对该人群的强化门诊治疗策略，以预防戒毒后的早期复发。基于最近的研究，一种可能的方法可能是探索将动机作为降低早期复发率的策略。
