Addiction Rehabilitation Centers Research Articles

Predictors of Drug Abuse Relapse for Iranian Addicted Women: An Application of Social Cognitive Theory

Objectives: Substance abuse prevalence has risen over the past decade among women, and accordingly, sex-specific barriers impede women’s access and participation in treatment programs, while the chief issue in providing treatment programs for women with substance abuse is the high relapse rate seen in the subjects. With all these in mind, the present study was conducted with the objective of recognizing the sociocognitive factors that concern the relapse of substance abuse in women. Methods: Two hundred women subjects under treatment in outpatient addiction treatment and rehabilitation centers in Kurdistan province in 2019 participated in this descriptive study. Data were obtained by means of a questionnaire that included demographic questions, history of substance use, and structures of social cognitive theory. Data were analyzed by SPSS software version 21 that further used logistic regression, χ2, and independent t tests. Results: The average age of the respondents was estimated 37.75±10.49. The relapse rate amounted to 80% among the participants. Logistic regression test analysis designated that the structures of situational perception, social support, and self-efficacy act as the factors that predict substance abuse relapses in women (R=0.42; P<0.05). Conclusions: Social cognitive theory is considered a valid theoretical method for deciphering the relation observed between substance abuse relapse predictors in women. Therapists’ consciousness on gaining social support and strengthening self-efficacy in the subjects may serve to improve the aftermaths of substance abuse treatment programs in women.

The relationship between severity of drug problems and perceived interdependence of drug use and sexual intercourse among adult males in drug addiction rehabilitation centers in Japan

BackgroundConsuming drugs in conjunction with sexual intercourse may shape the perceived interdependence of drug use and sexual intercourse (PIDS). Additionally, the severity of drug problems may have a significant impact on PIDS. However, this relationship remains unverified. Therefore, this study investigates whether the severity of drug problems is associated with PIDS among adult males in drug addiction rehabilitation centers (DARC) in Japan.MethodsThis study was a secondary analysis of the “DARC Follow-Up Study in Japan” conducted by the National Center of Neurology and Psychiatry in 2016, in which participants from 46 facilities completed a self-report questionnaire. A total of 440 males with drug dependence were included in the analysis. We analyzed participants’ demographic characteristics, history of sexually transmitted disease diagnoses, and responses to questions related to drug use (e.g., primary drug use and PIDS). Additionally, we measured the severity of drug problems using the Japanese version of the Drug Abuse Screening Test-20 (DAST-20).ResultsThe median age of the participants was 42 years. The median DAST-20 score was 14.0, the primary drug was methamphetamine (61.4%) and new psychoactive substances (NPS: 13.6%). Multivariate analysis indicated that participants’ experiences with unprotected sexual intercourse (“mostly a non-condom user”: adjusted odds ratio (AOR) = 4.410), methamphetamine use (AOR = 3.220), new psychoactive substances use (AOR = 2.744), and the DAST-20 score (AOR = 1.093) were associated with PIDS.ConclusionsThis study indicated that the frequency of unprotected sexual intercourse under the influence of drugs, methamphetamine and NPS use were strongly associated with PIDS. The severity of drug problems was also significantly associated with PIDS. It is necessary to develop culturally appropriate treatment programs adapted to the needs of patients who experience strong PIDS.

Christos Mandzios – pomiędzy Polską a Grecją

The work of Christos Mandzios, a Greek born and resident in Poland, although formally diverse, multithreaded, going beyond traditional media, disciplines and means of artistic expression, is related to the tradition of (ancient) Greek art, especially in the sense of understanding the essence of all creative activities in terms of Truth and Beauty. What can be considered a reminiscence of that bond is the presence of the human figure, taking the shape of an “anthropoid” (according to the artist’s definition), as if derived from pre-archaic times, from Cycladic or Mycenaean Bronze Age idols. Made of various materials – granite, bronze, wrapping paper, glass, bread, fire, earth, grain, grass, the “matter” of light and shadow – it becomes a carrier of existential, religious, spiritual and sometimes political meanings. In addition to permanent and ephemeral works, the sculptor undertakes para-artistic activities, usually in places marked by homelessness: in an orphanage, a prison, the Monar addiction rehabilitation centre, the Wrocław-Główny Railway Station. Apart from the series of works and performative activities entitled Realizacje Paschalne [Paschal Works], related to the symbolism and rituals of the Holy Week, the paper analyses the cycle Zjawiska Świetlne [Light Phenomena], varied in artistic means and related to the metaphysics of light. Particular attention is paid to the happenings: Wypalanie – Brama [Burning out – Gate] and Ślady [Traces], performed on the walls of Prison No. 1 in Wrocław on 11th November 1997. On the one hand, the sculptor shows a strong inclination towards formal experiments, towards constantly transgressing the boundaries of art, to functioning at the boundary of various artistic disciplines; on the other hand, he consistently treats a significant part of his oeuvre as a medium of other, non-formal values, grounded in the transcendentals of classical Christian metaphysics.

Common Drugs Abused by The Drug Addicted Young People in Dhaka City

Background: Drug addiction is a burning problem in Bangladesh affecting a majority of population especially the youths. Multiple drug use has aggravated the overall situation affecting our personal, economical, social life and impairing health status.
 Objective: The objective of this study was to find out the variety of common drugs used by drug addicted young population in Dhaka City.
 Materials and Methods: This descriptive cross sectional study was performed during July 2016 to December 2016 at five drug addiction treatment and rehabilitation centre in Dhaka. A total of 57 habitual drug addicted young people aged 15 to 24 years were selected by purposive and convenient method of sampling. The primary data was collected by repeated visit to centers and face to face interview with addicts and their family members using a pre tested semi structured questionnaire containing both closed and open ended query. Collected data were compiled and analyzed.
 Results: Most 45(78.95%) of the drug addicted were male and among them 12(21.05%) belonged to age group 15-17 years. Considering occupation, majority were students 14(24.56%) followed by unemployed 12(21.05%). Thirty five (61.40%) were the lone earning member of the family. Thirty seven (75.51%) collected money for drug from family members and stealing from house followed by criminal activities 26(53.06%). Majority of the addicts (85.96%) started taking drugs after being influenced by friends. Causes of drug addiction included unemployment 12(21.05%) followed by peer pressure 9(15.79%). The commonly used drugs included-Barbiturates/Sedatives 32(56.14%), Yaba 28(49.12%), Toluene/Aica 22(38.59%).
 Conclusion: The dangers of drug addiction have affected all class population of our country. Preventive measures for drug smuggling and addiction are needed to be taken. More drug addiction treatment and rehabilitation centres are required to combat present situation.
 KYAMC Journal Vol. 11, No.-2, July 2020, Page 73-76

The Influence of a Family Support Group on the Motivation of Drug Users Undergoing the Rehabilitation Process in Syifa Medika Clinic Addiction Rehabilitation Center

Introduction: One form of intervention is the rehabilitation of drug users. This takes time, money and effort. It takes a family support group to ensure that the drug users are motivated. The aim of this research was to determine the influence of family support on the motivation of the drug users undergoing rehabilitation at Syifa Medica Clinic in Kediri. Methods: This study used a correlation analytical design and a cross-sectional approach. The population of this research consisted of all of the drug users undergoing the rehabilitation process with the 25 samples taken using the accidental sampling technique. The independent variables of family support and motivation are needed to undergo rehabilitation process. These variables were collected using a questionnaire and analyzed using the Spearman Rank test. Results: The results of this study show that most of the respondents have positive support, totaling 15 respondents (60%). Nearly half had low motivation, totaling 12 respondents (40%). No family support relationships were found to pair with the motivation to undergo rehabilitation among the drug users (Spearman, p = 0,000 < 0,05: Ho is rejected). The level of relations included ‘quite strong’ and ‘positive’ (+0,732). Conclusion: Family support allows the drug users to obtain emotional closeness, causing a sense of security and a high motivation to undergo rehabilitation.

The effects of repetitive transcranial magnetic stimulation on cue-induced craving in male patients with heroin use disorder.

BackgroundCraving is a central feature of addiction. Early evidence suggests that repetitive transcranial magnetic stimulation is effective in reducing cue induced craving for patients with opioid use disorder (OUD). However, trials in large populations of patients with OUDs are lacking.MethodsWe randomly assigned 118 male heroin patients into three groups (i.e., 10 Hz rTMS, 1 Hz rTMS and a wait-list control group) from two addiction rehabilitation centers. rTMS was applied to the left dorsolateral prefrontal cortex (DLPFC) for 20 daily consecutive sessions.FindingsResults showed that 10 Hz rTMS and 1 Hz rTMS were both effective in reducing cue-induced craving scores in heroin users when compared to the wait list group. The treatment effects lasted for up to 60 days after rTMS treatment cessation.InterpretationOur results suggest that rTMS applied to the DLPFC is effective in reducing craving severity in heroin use disorder patients. Our results also suggest that such treatment effects can last for up to 60 days after treatment cessation.

Effect of Low-Frequency Repetitive Transcranial Magnetic Stimulation on Impulse Inhibition in Abstinent Patients With Methamphetamine Addiction

Impulsivity during periods of abstinence is a critical symptom of patients who use methamphetamine (MA). To evaluate changes in impulse inhibition elicited by repetitive transcranial magnetic stimulation (rTMS) in patients with MA addiction. This randomized clinical trial was conducted in Da Lian Shan Addiction Rehabilitation Center, Nanjing, China, from December 1, 2018, to April 20, 2019. Effects of the intervention were examined at 3 time points: after a single session (day 1), 24 hours after 10 repeated sessions (day 11), and at 3 weeks of follow-up (day 31). Men with MA addiction and healthy male control participants were recruited for this study. Data analysis was performed from March 2019 to October 2019. Patients who use MA were randomized to undergo sham rTMS (36 patients) and or 1-Hz rTMS (37 patients) to the left prefrontal cortex, receiving daily TMS treatments for 10 consecutive days. The primary outcome was impulse inhibition, which is primarily embodied by accuracy reduction (ie, accuracy cost) from standard to deviant trials in a 2-choice oddball task (80% standard and 20% deviant trials). The study included 73 men with MA addiction (mean [SD] age, 38.49 [7.69] years) and 33 male healthy control participants without MA addiction (mean [SD] age, 35.15 [9.68] years). The mean (SD) duration of abstinence for the men with MA addiction was 9.27 (4.61) months. Compared with the control group, patients with MA addiction exhibited greater impulsivity (accuracy cost, 3.3% vs 6.2%). The single session of 1-Hz rTMS over the left prefrontal cortex significantly increased accuracy from 91.4% to 95.7% (F1,36 = 9.58; P < .001) and reaction time delay from 50 milliseconds to 77 milliseconds (F1,36 = 22.66; P < .001) in deviant trials. These effects were seen consistently after 10 sessions of 1-Hz rTMS treatment (day 11 vs day 1, t26 = 1.59; P = .12), and the behavioral improvement was maintained at least for 3 weeks after treatment (day 31 vs day 1, t26 = 0.26; P = .80). These improvement effects of impulse inhibition were coupled with a reduction in addictive symptoms as measured by cue-induced craving. The pretest accuracy cost was positively correlated with the change in impulse inhibition (r = 0.615; P < .001) and change in craving (r = 0.334; P = .01), suggesting that these 2 behaviors may be modified simultaneously. These findings suggest that repeated rTMS sessions have sustained effects on impulse inhibition in patients with MA addiction and provide novel data on impulsivity management strategies for addiction rehabilitation. ChiCTR-ROC-16008541.

Patterns of Substance Use among Patients in Addiction Rehabilitation in Jordan.

Background: This study aimed to identify pattern of substance use among patients at two public addiction rehabilitation centers in Amman. It provided a description of substance use career and assessment of addiction severity, quality of life and quality of sleep among participants.Methods: A quantitative cross-sectional study using a structured data collection form consisting of 4 parts: 1. General data including the demographic characteristics, medical history and career of drug abuse. 2. Severity of addiction using the severity of dependence scale (SDS). 3. Quality of life measured by the EQ-5D and 4. Quality of sleep measured by the insomnia severity index (ISI) scale.Results: A total of 93 patients from 2 treatment settings were recruited over 5 months. The total number of actively used substances was 196, with an average of 2 substances per patient. Alcohol and synthetic cannabinoids were the two most commonly used substances (39.8% and 38.7% respectively) followed by benzodiazepines (33.4%). A notable drop in heroin use was observed (5.4%, 5 out of 23 opioid user) compared to the years 2007-2009. The mean SDS score among patients was 11.43 (SD ± 3.48) indicating high dependence. Sleep problems were reported by 45% of patients. Data showed a significant role of community pharmacies in supplying drugs of abuse for users.Conclusion: Pattern of substance use changed significantly in Jordan with synthetic cannabinoids being of the top substances used and heroin use dropping. Actions should be taken to reframe the legalization of dispensing certain drugs by pharmacists without a prescription.

Factors Influencing Change in Behavior Among Residents With Drug Addiction in a Mental Hospital in Ghana

Objective: The objective of this study was to explore the factors that influence the achievement of the state of sobriety in a drug addiction rehabilitation center. Materials and Methods: A qualitative research approach using an exploratory descriptive design was used. In-depth interviews of 12 residents who received care at a drug addiction rehabilitation center in southern Ghana were interviewed using a semistructured interview guide. The participants (residents) were purposively selected for the study from December 2015 to May 2016. The average length of each interview was about an hour. All interviews were audiotaped, transcribed verbatim, and analyzed using content analysis. Results: The research revealed that the attitude of health professionals/counselors, residents, and their social support network influenced the change process. Moreover, discomfort produced by drugs/substances and a broadened knowledge base in drugs/substances influenced change. Conclusions: The factors that influenced behavior change were multifactorial. However, positive and negative human factors and the rehabilitation program were instrumental. No single change agent could bring about the desired behavioral change in drug addiction rehabilitation.

Associations between methamphetamine use, psychiatric comorbidities and treatment outcome in two inpatient rehabilitation centers

The use of methamphetamine is spreading globally and provokes the need for effective treatment options. Previous research showed increased psychiatric comorbidities in methamphetamine users, but its impact on treatment success is still unclear. This study investigates data from two German addiction rehabilitation centers including 108 methamphetamine using individuals. The participants were tested and interviewed at the beginning of the addiction treatment program and at the end of treatment after about six months. In total, 95% of the participants had at least another psychiatric diagnosis. At admission, substance related comorbid diagnoses (meaning abuse or addiction of other substances than methamphetamine) showed a significant effect on treatment dropout. Within the substance related diagnoses, the majority of participants (62%) suffered from cannabinoid dependency. Non-substance related comorbidities and the total number of comorbid diagnoses did not have an impact on treatment outcome. The most frequent non substance specific diagnosis at admission was a depressive disorder (15%). Diagnoses patients had at discharge did not show any effects on the treatment completion. Comparing diagnoses at admission and discharge revealed slight differences, which may rise from a better assessment at discharge due to the fact that clinicians got to know the patients better during the therapeutic process.

Alcohol use disorder and associated factors among individuals living with HIV in Hawassa City, Ethiopia: a facility based cross- sectional study

BackgroundIndividuals living with HIV/AIDS with co-occurring harmful alcohol use may require specialized intervention or even multi-disciplinary team follow-up and management. This study was aimed to assess alcohol use disorder and associated factors among people living with HIV/AIDS in Hawassa city, Ethiopia, 2019.MethodsA facility based cross-sectional study was conducted among 195 people living with HIV/AIDS who had follow-up visit at Hawassa University Comprehensive Specialized hospital. A systematic sampling technique was used to recruit the study participants. Alcohol used disorders identification test (AUDIT) was used to measure alcohol consumption, drinking behaviors, and alcohol-related problems. The binary logistic regression model was used to see the association between alcohol use disorder (AUD) and the independent variables. The strength of association was measured by odds ratios with 95% confidence intervals. Statistical significance declared at P < 0.05.ResultsThe mean age of the study participants was 29.88 (±SD = 10.89) years. The magnitude of alcohol use disorder among people living with HIV/AIDS was 31.8%. Being male [AOR = 2.43, (95% CI: 1.76, 5.76)], having poor social support [AOR = 1.34, (95% CI: 1.12, 6.73)], being medication non-adherent [AOR = 1.78, (95% CI: 1.33, 6.79)], current khat chewing [AOR = 1.67, (95% CI: 1.16, 5.45)] and current cigarette smoking [AOR = 3.76, (95% CI: 2.16, 7.54)] had statistically significant association with alcohol use disorder.ConclusionIn the current study, magnitude of alcohol use disorder among people living with HIV was high and, calls for integrating services provided to HIV patients in HIV care and treatment clinic which enhances timely detection and management of AUD cases. This also alerts the stakeholders in HIV prevention and control programs to invest a greater efforts to retain patients in addiction treatment and rehabilitation centers. Lastly, appropriate screening and health education on consequences of alcohol use disorder is warranted.

Craving-induced effects of different drug cues on persons abstaining from heroin

Background: The key factors of inducing drug cravings in persons abstaining from drug use remain a focus of addictions research. Given the accumulating evidences, the scope of cues investigated in the cue-reactivity paradigm has increased considerably. Yet, few studies have examined the effects of the intensity and endurance of different types of cues on their ability to induce craving. This study investigated differences among drug-cue words, negative physiological-cue words, and negative social-cue words in the induction of drug cravings among persons abstaining from heroin.Methods: The sample consisted of 149 male abstinent heroin abusers from four addiction rehabilitation centers in China. Based on their abstinence lengths, they were labeled as short-term, medium-term, and long-term abstainer participants respectively. All participants completed a stress-imagery task and rated craving by visual analog scale.Results: There was a significant interaction of cue type and abstinence length. There was no difference on the craving induced by three types of cue words in the short-term group. In the medium-term group, craving induced by negative social-cue words was significantly stronger than that by negative physiological-cue words, but not that by drug-cue words. In the long-term group, the craving induced by negative social-cue words remained the strongest, significantly stronger than that by both drug-cue words and negative physiological-cue words.Conclusion: Negative social-cue words presented in the current study retain the ability to induce craving in heroin abstainers; this finding suggests that negative social cues encountered under more general circumstances could be a risk factor for relapse.

Effectiveness of gratitude on psychological well-being and quality of life among hospitalized substance abuse patients

Background: Substance abuse is a chronic phenomenon that affects many physical, psychological, social, familial and economic elements. Objective: This study was conducted in order to investigate the effectiveness of gratitude on individual�s well-being as well as the quality of life (QoL) of hospitalized substance abuse patients. Methods: The current study was clinical trial study. The research was conducted on 64 addicted patient which had been referred to the addiction rehabilitation center (Modarres hospital) of Isfahan city, that divided to two groups that each one included 32 patients.GQ-6, WHOQOL, and WHO-6 questionnaires used for estimate of gratitude, QoL, and well-being scores respectively. The SPSS 16 software was used for analyzing the collected data. Results: There is a relationship between gratitude, well-being, and QoL after the intervention in two groups of the study while there is no any significant difference between these variables before the intervention. Also, there were significant correlation between the gratitude, QoL, and well-being pre and post follow up of patients. Conclusion: It seems that gratitude improves and increased of QoL and psychological well-being during addiction treatment program. © 2019 by the authors; licensee Modestum Ltd., UK.

Dental and oral health status of an Iranian population of drug abusers: A comparative study

Purpose: To evaluate the effects of hallucinogens, opioids and methamphetamines abuse on oral and dental health of an Iranian population. Methods: In this descriptive cross sectional survey conducted in 2017, 500 drug abusers referred to addiction rehabilitation centers in Tehran Province in Tehran were selected as the study population. A questionnaire was developed to evaluate demographic data, self-reported oral health experiences during periods of substance abuse and details of substance abuse including types of substances abused, patterns and period of substance abuse. Results: After excluding 23 addicts due to incomplete data, 500 peoples participated. Of the 500 included subjects, 390 (88 %) were male and 110 (22 %) were female. As for the qualitative variables the differences were found to be significant for route of abuse (p < 0.001), smoking (p < 0.03), pain (p < 0.001) and abnormal sounds (p < 0.001) of TMJ, sensitivity of chewing muscles (p = 0.002), smoking melanosis (p < 0.05), hypertrophic lesions (p = 0.01) and bleeding on probing (p = 0.001). Conclusion: The findings reveal the poor dental and oral health status of drug addicts in Iran, especially methamphetamine abusers. Therefore, the results call for the design and implementation of oral health improvement programs for addicts in Iran. Keywords: Drug abuse, Dental health, Addicts, Hypertrophic lesions, Chewing muscles, Smoking melanosis, Methamphetamine

Differences in Psychopathology among Patients with Dual Diagnosis that are Entering Mental Health Services in Cyprus in Correlation with Alcohol Dependence

Introduction: Dual diagnosis is undoubtedly one of the most important problems that mental health services are currently facing. The common problem of all patients is that they resort to psychiatric services due to complications caused by the use or abuse of legal and illegal substances and at the same time due to the presence of another psychiatric disorder. The literature supports the hypothesis that psychiatric disorders and substance abuse disorders coexist more frequently than initially estimated. Aim: The aim of this study is to examine, assess and compare the characteristics and the psychopathology between patients with dual diagnosis receiving treatment for mental disorders and those receiving treatment for substance abuse disorders within the framework of the substance abuse treatment programs provided by the Mental Health Services of Cyprus. Furthermore, this study examines the differences in psychopathology in correlation with alcohol dependence, duration of treatment and the number of hospitalizations in relation with dual diagnosis. Methods: In this study three hundred patients were used: 150 of them were dually diagnosed and admitted to drug addiction therapeutic and rehabilitation centers for legal and illegal substances and 150 were dually diagnosed and admitted to psychiatric units in the Mental Health Center in Cyprus. The EuropASI the AUDIT, and the PDQ4 were administered individually to each participant. The Statistical Package for Social Sciences (SPSS) version 20.0 was used for data analysis. Results: The results revealed that the dually diagnosed patients who were admitted to psychiatric units had higher figures of diagnosis (mhuM=3.03, duM=2.55, pvalue), higher figures of hospitalization in Mental Health Services (mhuM=12.25, duM=7.73) and significantly more psychological problems (mhuM=63.02, duM=18.78), as well as longer prison time (mhuM=5.55, duM=2.10), compared to those that entered substance abuse treatment programs. The mean age of first use for men was 17.88 for psychiatric patients and 17.52 for patients entering substance abuse treatment programs (p value=0.001). For women, the mean starting age was 17.50 in psychiatric units and 17.60 in substance abuse treatment programs (p value=0.01).In most cases, the main substance of dependence was cannabis, followed by cocaine, in both study groups (57.5% the case of cannabis, 20% for cocaine in psychiatric units and 30% for cannabis, 20% for cocaine in substance abuse treatment programs). A total of 53.4% of the patients admitted to substance abuse treatment programs had a family history of alcoholism, while the corresponding figure for those in psychiatric units was 46.6%; 50% of both groups had a family history of drug addiction. The patients with anti-social disorder according to the PDQ-4 questionnaire had a higher incidence of alcohol dependence than patients without anti-social disorder. The use of alcohol over the last 30 days was associated with an increase in the frequency of alcohol dependency. Implications for Mental Health Nursing: The results indicate that the lack of a specialized treatment center creates a significant gap for treatment, which leads to Mental Health Services overuse and misuse, and to continuous hospitalizations and relapses, leading dual diagnosis patients to disorganization and isolation. Mental health specialists should learn and be educated in new therapeutic approaches in order to treat dually diagnosed patients holistically.

Effectiveness of EMDR in patients with substance use disorder and comorbid PTSD: study protocol for a randomized controlled trial

BackgroundEye Movement Desensitization and Reprocessing (EMDR) is an evidence-based treatment for PTSD. However, it is unclear whether EMDR shows the same effectiveness in patients with substance use disorders (SUD) and comorbid PTSD. In this trial, we examine the effectiveness of EMDR in reducing PTSD symptoms in patients with SUD and PTSD.Methods/DesignWe conduct a single-blinded RCT among 158 patients with SUD and comorbid PTSD admitted to a German addiction rehabilitation center specialized for the treatment of patients with SUD and comorbid PTSD. Patients are randomized to receive either EMDR, added to SUD rehabilitation and non-trauma-focused PTSD treatment (TAU), or TAU alone. The primary outcome is change from baseline in PTSD symptom severity as measured by the Clinician-Administered PTSD Scale at 6-month follow-up. Secondary outcomes are change from baseline in substance use, addiction-related problems, depressive symptoms, dissociative symptoms, emotion dysregulation and quality of life. Assessments are carried out by blinded raters at admission, at end of treatment, and at 3- and 6-month follow-up. We expect that EMDR plus TAU will be more effective in reducing PTSD symptoms than TAU alone. Mixed models will be conducted using an intention-to-treat and per-protocol approach.DiscussionThis study aims to expand the knowledge about the effectiveness of EMDR in patients with SUD and comorbid PTSD. The expected finding of the superiority of EMDR in reducing PTSD symptoms compared to non-trauma-focused PTSD treatment may enhance the use of trauma-focused treatment approaches for patients with SUD and co-morbid PTSD.Trial registrationGerman Clinical Trials Register: DRKS00009007; U1111-1172-9213. Retrospectively registered 01 Juni 2016.

Evaluation of phosphatidylethanol by ELISA for detection of excessive alcohol use compared with traditional biomarkers: a case-control study

ABSTRACTObjective: The highly sensitive chromatographic methods for quantifying phosphatidylethanol (PEth) require high levels of expertice and expensive instrumentation. Enzyme-linked immunosorbent assay (ELISA) kits have been developed for research purposes, but the implementation of PEth immunoassays to screen alcohol consumption has not been applied to the analysis of clinical samples. Our aim was to examine the ELISA method for PEth analysis in clinical samples.Methods: We examined the alterations of the PEth serum levels of 22 male inpatients diagnosed with alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, during alcohol withdrawal (at days 1, 7, and 14) compared to 32 healthy controls using ELISA. All patients were admitted for detoxification treatment at the Alcohol and Substance Addiction Treatment and Rehabilitation Center, Trakya University School of Medicine, Edirne, Turkey. Control subjects were assessed with an initial clinical intervi...

Socio-economic Status of Drug Addicted Young People in Dhaka City

Introduction: Drug addiction is a burning problem in Bangladesh affecting vast population especially the youths. The spread of multi drug use has aggravated the overall situation affecting our personal, economical and social life, impairing health status, increasing crime and other unwanted risky behaviour.&#x0D; Objective: To find out the socio-economical status of drug addicted young population in Dhaka City.&#x0D; Materials and Methods: This descriptive cross sectional study was performed during August 2016 to December 2016 at five drug addiction treatment and rehabilitation centre in Dhaka. A total of 57 habitual drug addicted young people were selected by purposive and convenient method of sampling. The primary data was collected by repeated visit to centers and face to face interview with addicts and their family members using a pre tested semistructured questionnaire containing both closed and open ended query. Collected data were compiled and analyzed later on.&#x0D; Results: Most 45(78.95%) of the drug addicted young people were male and among them 12(21.05%) belonged to age group 15-17 years. Majority of addicts 46(80.71%) were Muslim. Educational qualification of 16(28.07%) samples was upto primary level, 21(36.84%) upto secondary level. Considering occupation, majority were students 14(24.56%) followed by unemployed 12(21.05%), day labourer 9(15.79%). Thirty five (61.40%) were the lone earning member of their family. Twelve people (21.05%) had monthly income of family below 10,000 taka. Most of the samples (64.91%) stayed in extended type of family. Thirty seven (75.51%) collected money for drug from family members and stealing from house followed by criminal activities 26(53.06%). Majority of the addicts (85.96%) started taking drugs after being influenced by friends. Causes of drug addiction included unemployment 12(21.05%), peer pressure 9(15.79%) and influence of foreign culture 8(14.03%). The commonly used drugs included- Barbiturate/sedatives 32(56.14%), Yaba 28(49.12%), Toluene/aica 22(38.59%). Oral route was the commonest 48(84.21%) followed by Injection 9(15.79%). Commonest place of drug addiction included dance bar/club house 18(31.58%), isolated room/mess 14(24.56%), open field 12(21.05%) and railway/ bus station 9(15.79%).&#x0D; Conclusion: The dangers of drug addiction have been shifted from upper to middle and lower middle class population of our country. Elaborate national plan is needed to motivate young generation for involvement in study and productive activities. Preventive measures for drug smuggling and addiction are needed to be taken with great caution. More drug addiction treatment and rehabilitation centres are required to combat present situation.&#x0D; Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 15-20

Typologies of Individuals Attending an Addiction Rehabilitation Center Based on Diagnosis of Mental Disorders

ObjectivesThis study aimed to: (1) identify clusters based on the diagnostic status of mental disorders among individuals with problematic substance use treated in an addiction rehabilitation center (ARC), and (2) characterize these clusters according to socio-demographic variables, neighborhood characteristics, and health service utilization. MethodsData were compiled for 4526 individuals with problematic substance use who received services from an ARC in 2004. The data were compiled by merging four databases: the ARC data registry, the Quebec Health Insurance Board database, the Quebec provincial database for hospitalizations, and the Quebec National Institute of Public Health database. A two-step cluster analysis was performed to generate distinct groups based on diagnostic categories of mental disorders. Complementary comparative analyses were conducted to test differences among the clusters. ResultsThree clusters were identified. The first cluster consisted of individuals who did not receive any diagnosis of a mental disorder, including substance use disorders (SUDs), and who were low users of health services. The second cluster was composed of individuals who received a diagnosis of mental disorder, but not of SUD, and who primarily used mental health services. The third cluster included individuals who had a dual diagnosis (co-occurring SUD and mental disorder), and who were high users of acute care services. ConclusionsThis study highlights the heterogeneity of individuals with problematic substance use treated in an ARC. Treatment will be more effective, overall, if tailored to the varying needs of individuals with problematic substance use. Recommendations of the study geared toward improving the effectiveness of care for this population include systematic diagnostic screening for SUDs by physicians, developing strong primary care for individuals with problematic substance use, and ensuring a continuing care model for individuals with a dual diagnosis.

Factors associated with high use of general practitioner and psychiatrist services among patients attending an addiction rehabilitation center.

BackgroundThis study aimed to 1) identify the characteristics of individuals with substance use disorders (SUDs) who make high use of services provided by general practitioners (GP) and psychiatrists while receiving services concurrently from an addiction rehabilitation center (ARC), and 2) to compare high service users to moderate and low service users.MethodsData were compiled for 4,407 individuals with SUDs who were receiving services from an ARC in 2004. The data came from the merging of four databases: the ARC data registry (January 1st, 2004–December 31, 2004), the Quebec Health Insurance Board database (March 31, 2003–April 1st, 2005), the Quebec provincial database for hospitalizations (March 31, 2003–April 1st, 2005), and the Quebec National Institute of Public Health database (2004). Independent variables were grouped according to the Andersen Behavioral Model of Health Services Use: predisposing, enabling and need factors. Generalized estimating equations analyses were performed to assess the influence of individual and neighborhood-level characteristics on high use of services outside the ARC provided by GPs and psychiatrists. Benjamini-Hochberg’s procedure was applied to correct for multiple comparisons.ResultsAbout 97 % of individuals attending the ARC consulted a GP or a psychiatrist during the two-year study period, for a mean of 1.5 consultations per month. Findings revealed that 5 % of the sample made 26 % of all consultations over the two years, and they were defined as high users. No single predisposing factor was associated with high use. One enabling factor significantly increased the risk of being a high user of services from general practitioners and psychiatrists: receiving services at the ARC for three years prior to 2004. Four needs factors, all related to mental health diagnoses (schizophrenia, mood disorder, anxiety disorder, personality disorder), predicted high use of general practitioner and psychiatrist services.ConclusionsThis study found that nearly all individuals with SUDs receiving services from an ARC were users of health services from GPs and psychiatrists outside the ARC. High users most probably accessed them in inpatient settings. No previous study has compared high service users with low and moderate users among individuals with SUDs. Considering that ARCs are treating individuals with complex needs, some of whom make high use of medical professionals, both ARCs and their clients could benefit from increased collaboration and integration between the addictions and mental healthcare sectors.