History of Alcohol and Opioid Use Impacts on the Long-Term Recovery Trajectories of Methamphetamine-Dependent Patients.

Haoye Tan,Yan Zhao,Na Zhong,Min Zhao,Di Liang,Zhikang Chen,Haifeng Jiang

doi:10.3389/fpsyt.2019.00398

Abstract

Methamphetamine (MA) has become one of the most widely used illicit substances in China and the rest of the world as well. Relapse, incarceration or death was observed after compulsory rehabilitation. However, the knowledge of recovery patterns among MA-dependent patients, early or late occurrence of these negative consequences, is limited. The aims were to explore the long-term recovery patterns and associated factors among MA-dependent patients in Shanghai, China. MA-dependent patients discharged from Shanghai compulsory rehabilitation facilities in 2009–2012 were recruited in a baseline survey. The baseline data of 232 patients were then linked with their long-term follow-up data from official records. Group-based trajectory modeling was applied to identify distinctive trajectories of the occurrence of negative consequences (incarceration, or readmission to compulsory rehabilitation, or death). Patients with monthly status data were found recovering with three distinctive trajectories: rare, late, and early occurrence groups. Multinomial logistic regression showed that having alcohol use history was associated with an increased likelihood of being in the late occurrence group relative to the rare occurrence group. Having opioid use history was associated with an increased likelihood of being in the early occurrence group relative to the rare occurrence group. In addition, being female was associated with decreased likelihood of being in the late occurrence group relative to the rare occurrence group.

Highlights

While ranking second in the share of the global burden of disease attributable to drug use disorders after opioids, amphetamine-type stimulants (ATS) are the most frequently used class of illicit drugs in China, and people using opioids gradually switched to ATS [1, 2]
By using group-based trajectory modeling (GBTM), we identified three groups among MA-dependent patients: early occurrence group, late occurrence group, and rare occurrence group
We found that baseline alcohol use history was associated with increased likelihood of being in the late occurrence group relative to the rare occurrence group, and baseline opioid use history was associated with increased likelihood of being in the early occurrence group relative to the rare occurrence group

Summary

Introduction

While ranking second in the share of the global burden of disease attributable to drug use disorders after opioids, amphetamine-type stimulants (ATS) are the most frequently used class of illicit drugs in China, and people using opioids gradually switched to ATS [1, 2]. Relapse is associated with more than a single factor. Previous studies found that both biological and sociocultural characteristics of patients could influence relapse [10, 11]. It was revealed that some demographic factors such as age, gender and education level related to relapse among ATS users [12, 13]. Crime is related to a combination of drug use and sociocultural characteristics [12]. It was found that frequent drug and alcohol use were risk factors for incarceration among Thai MA users [16]. There was a picture of mutual influence between relapse and crime. Among Japanese patients with MA use disorder, history of incarceration was associated with treatment retention [13]

Methods

Results

Conclusion