Singh Virendra V, Dhawan Anju, Sarkar Siddhartha, Mishra Ashwani K, Chadda Rakesh K
Department of Psychiatry, Army College of Medical Sciences and Base Hospital, Delhi Cantt, Delhi, India.
National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India.
Ind Psychiatry J. 2023 Jul-Dec;32(2):361-368. doi: 10.4103/ipj.ipj_87_22. Epub 2023 Oct 4.
Opioid use is a cause of concern in many parts of the world. About 2.1% Indians use opioids. Opioids are also the most common drugs used by injection drug users in India. Despite various treatment strategies used to manage opioid use disorders (OUDs), relapse is common. A good treatment program would make efforts to address lapses and prevent relapse. Hence, there is a need to understand the factors associated with relapse in OUD.
One hundred and twenty patients completed a baseline assessment that included socio-demographic details and the Maudsley Addiction Profile (MAP). They were followed up for three months and assessed using telephonic interview for opioid use. All those who relapsed were assessed using the Reasons for Relapse Questionnaire (RRQ). The patients who relapsed were compared with the patients who were abstinent. Relapse was defined as any use of opioid during follow-up.
Forty participants relapsed during the 90 days of the study period. Relapsed patients had a greater number of conflict days with family members, used a higher amount of heroin and cannabis at baseline, were less likely to be discharged on buprenorphine, and were more likely to drop out. Participants cited mood and social reasons more often than cue/craving and unwell domains of RRQ.
Baseline treatment and prospective factors are associated with relapse in OUD. Addressing these factors can help in reducing relapse in OUD patients.
阿片类药物的使用在世界许多地区都是一个令人担忧的问题。约2.1%的印度人使用阿片类药物。阿片类药物也是印度注射吸毒者最常用的毒品。尽管采用了各种治疗策略来管理阿片类药物使用障碍(OUD),但复发很常见。一个好的治疗方案会努力解决失误问题并预防复发。因此,有必要了解与OUD复发相关的因素。
120名患者完成了包括社会人口学细节和莫兹利成瘾量表(MAP)在内的基线评估。对他们进行了为期三个月的随访,并通过电话访谈评估阿片类药物的使用情况。所有复发的患者都使用复发原因问卷(RRQ)进行评估。将复发的患者与戒断的患者进行比较。复发定义为随访期间任何阿片类药物的使用。
在研究期间的90天内,40名参与者复发。复发患者与家庭成员发生冲突的天数更多,基线时使用的海洛因和大麻量更高,不太可能接受丁丙诺啡出院治疗,且更有可能退出。参与者提到情绪和社会原因的频率高于RRQ中的提示/渴望和不适领域。
基线治疗和前瞻性因素与OUD复发有关。解决这些因素有助于减少OUD患者的复发。