Marciuch Anne, Birkeland Bente, Benth Jūratė Šaltytė, Solli Kristin Klemmetsby, Tanum Lars, Mathisen Ida, Weimand Bente
Department of Research and Development in Mental Health, Akershus University Hospital, Loerenskog, Norway.
Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Heliyon. 2023 Jul 5;9(7):e17516. doi: 10.1016/j.heliyon.2023.e17516. eCollection 2023 Jul.
Recovery from substance use disorders (SUD) has traditionally been equated with abstinence. "Personal recovery" however emphasizes recovery as a unique and personal process, supported by changes in connectedness, hope, identity, meaning and empowerment. This study aimed to examine personal recovery in people receiving extended-release naltrexone (XR-NTX); specifically investigate changes in personal recovery during treatment, identify groups of participants following distinct trajectories of recovery, and characteristics predicting group-belonging.
Overall change in recovery (Questionnaire about the Process of Recovery, QPR) score was assessed by linear mixed model in a subsample of 135 people with opioid use disorder (OUD) participating in a 24 + 28-week trial of XR-NTX. Growth mixture model was used to identify potential groups of people following distinct trajectories of personal recovery.
Overall, there was a significant change in QPR score during treatment. Four groups with distinct recovery trajectories were identified: "initially low- increase" (G1), "initially average- no change" (G2), "initially high- no change" (G3) and "initially high- increase" (G4). The groups were different with regards to level of psychological distress, social support, and the use of benzodiazepines. In addition, previous participation in opioid agonist treatment programs, current pain, life satisfaction, employment, heroin craving and previous use of heroin also differed between groups.
Personal recovery among people receiving XR-NTX follows different trajectories, and various factors are associated with personal recovery. Particular attention regarding psychological distress, social support and heroin use among patients commencing XR-NTX treatment is important to facilitate successful recovery trajectories.
物质使用障碍（SUD）的康复传统上等同于戒断。然而，“个人康复”强调康复是一个独特的个人过程，受到人际关系、希望、身份认同、意义和赋权等方面变化的支持。本研究旨在探讨接受长效纳曲酮（XR-NTX）治疗的患者的个人康复情况；具体研究治疗期间个人康复的变化，识别遵循不同康复轨迹的参与者群体，以及预测群体归属的特征。
在135名患有阿片类物质使用障碍（OUD）且参与为期24 + 28周的XR-NTX试验的患者子样本中，通过线性混合模型评估康复（康复过程问卷，QPR）得分的总体变化。使用生长混合模型识别遵循不同个人康复轨迹的潜在人群组。
总体而言，治疗期间QPR得分有显著变化。识别出四组具有不同康复轨迹的人群：“初始低 - 上升”（G1）、“初始中等 - 无变化”（G2）、“初始高 - 无变化”（G3）和“初始高 - 上升”（G4）。这些组在心理困扰程度、社会支持以及苯二氮䓬类药物的使用方面存在差异。此外，各组在先前参与阿片类激动剂治疗项目、当前疼痛、生活满意度、就业、海洛因渴望以及先前海洛因使用情况方面也有所不同。
接受XR-NTX治疗的患者的个人康复遵循不同轨迹，且各种因素与个人康复相关。对于开始接受XR-NTX治疗的患者，特别关注心理困扰、社会支持和海洛因使用情况对于促进成功的康复轨迹很重要。
