Substance Abuse Patients Research Articles

Predictors of Suicidal Thoughts among Substance Abuse Patients: Problem-Solving Ability and Hopelessness

Background: Substance abuse has become a serious health issue. Ineffective problem solving among Substance abuser can lead to hopelessness and loss of control to commit suicide. This study was aimed to investigate the ability to solve problems and hopelessness as predictors of suicidal thoughts among patients with drug abuse. A descriptive research design was utilized in this study. A purposive sample of 162 patients with substance abuse disorder was selected from El-Azazi Hospital for Mental Health in Abo-Hamad City, Sharkia Governorate. Participants completed the Socio-demographic and clinical data sheet, Drug Abuse Screen Test, Problem-Solving Inventory, The Beck Hopelessness Scale, and Suicide Probability Scale. The results revealed that the majority of studied participants had suicidal thoughts. More than one-third of them had severe level of drug abuse, mild level of hopelessness and was unable to solve their problems. There were statistically significant positive correlations between suicidal thought, problem solving ability, and feeling of hopelessness. Hopelessness, drug abuse, patients' age, and monthly income were significant predictors for suicidal probability among drug abuse patients. Therefore, it is recommended to conduct an intervention programs for drug abuse patients to strengthen their problem solving ability and develop adaptive coping strategies.

Histamine H3 receptor gene variants associated with drug abuse in patients with cocaine use disorder.

Preclinical work revealed significant interactions between ligands of the histamine H3 receptor and different drugs of abuse. In the case of psychostimulants, the results reported are somewhat controversial and human data are still scarce, despite the fact that an inverse agonist of the H3 receptor (pitolisant) has reached the market after approval for the treatment of narcolepsy. We have studied associations between histamine H3 receptor gene variants and cocaine use disorder to increase the knowledge of the possible involvement of histamine H3 receptor in drug abuse. Seven single nucleotide polymorphisms of the histamine H3 receptor gene were genotyped by using a multiplexing assay in 248 samples of subjects with cocaine use disorder and 500 randomized samples of subjects representative of the Spanish population. The study of the epidemiological information associated to the samples revealed that subjects with cocaine use disorder broadly abused alcohol, tobacco and cannabinoids. Two single nucleotide polymorphisms (rs3787430 and rs74627870) were found significantly associated with the occurrence of addiction and one more (rs13042865) was specifically related to the severity of cocaine dependence within drug abusers. The associations found in this study further extend the hypothesis that histamine H3 receptor function could be relevant in drug abuse in general and cocaine addiction in particular.

KOMUNIKASI TERAPEUTIK DALAM KONSELING ANTARA KONSELOR DAN PASIEN PENYALAHGUNAAN NARKOBADI KLINIK BADAN NARKOTIKA NASIONAL PROVINSI JAWA BARAT

The purpose of this study was to determine Therapeutic Communication in Counseling between Counselors and Drug Abuse Patients. To answer the research objectives, the four focus of the researcher, namely the pre-interaction phase, the orientation phase, the working phase, and the termination phase of Counselor Therapeutic Communication in Rehabilitating Drug Abuse Patients at the National Narcotics Agency Clinic of West Java Province.This study uses qualitative research methods with descriptive studies. The number of informants in this study were four people, consisting of three key informants and one supporting informant. Data collection techniques used in this study are literature study, internet searching, indepth interviews, non-participant observation and documentation.The results of research conducted by the Clinical Counselor of the National Narcotics Board of West Java Province are the pre-interaction phase where the counselor studies patient data. The orientation phase in which the counselor performs the Screening approach and builds trusting relationships with the patient and the Assessment of the counselor ensures patient safety as well as establishes a counseling service plan, and a termination phase where a drug abuse counseling service has been completed and will be referred to post-rehabilitation

Evaluation of Drug Abuse in Patients With Lifelong Premature Ejaculation: A Cross-Sectional Study.

IntroductionMost studies investigate sexual dysfunction in drug abusers; however, there are no data available about the pattern of drug abuse in patients with lifelong premature ejaculation (PE).AimTo assess the pattern of drug abuse in patients with lifelong PE and to evaluate its potential effect on their hormonal profile.MethodsA cross-sectional study included patients with lifelong PE (n = 76) with no prescribed medications for 1 month and age-matched control without PE (n = 48). Participants were evaluated by history, examination, Arabic index of PE, and hormonal profile. A urine sample was screened by dipstick kits for the following drug abuse tramadol, opiate, tetrahydrocannabinol (cannabis), amphetamine, barbiturate, cocaine, and benzodiazepines. Positive results were confirmed with a immunoassay drug analyzer.Main outcome measuresThe outcomes of this study are positive and negative drug abuse and hormonal profile changes.ResultsControl patients and patients with PE showed median (interquartile range) of age 43 (33–46.8) and 38.5 (31–45) years, respectively. Drug abuse testing results showed significantly high positive drug abuse in patients with PE, 26 of 76 (34.2%), in comparison with control, 9 of 48 (19.1%) (P = .05). The most commonly abused drug was tetrahydrocannabinol in control, 3 of 9 (33.3%), and tramadol, 12 of 26 (46.2%), in patients with PE. Control patients and patients with PE with positive drug abuse had significantly higher smoking percent (P < .0001) and higher positive drug abuse history (P < .0001). However, there was no relationship between drug abuse and PE severity, and there were no significant changes in their hormonal profile.ConclusionsDrug abuse is high among patients with lifelong PE in Upper Egypt, with tramadol being the comment drug. Drug abuse is common among smokers. However, no hormonal disturbance could be shown in drug abuse patients. Drug abuse might be considered in the evaluation of patients with PE.Mohammed SA, Abdelhamed A, El Sayed RM. Evaluation of Drug Abuse in Patients With Lifelong Premature Ejaculation: A Cross-Sectional Study. Sex Med 2020;8:608–614.

Gluteal Compartment Syndrome After Prolonged Immobilization in Drug Abusers.

BackgroundThere has been an increasing incidence of drug abuse patients presenting with rhabdomyolysis after prolonged immobilization. Our study was to assess etiology and management challenges with patients presenting with gluteal compartment syndrome after drug abuse.MethodologyWe did a retrospective analysis of five patients who presented with gluteal compartment syndrome secondary to drug abuse over one year.ResultsWe had a 100% association with rhabdomyolysis and acute renal injury necessitating hemodialysis. There was a frequent association with the involvement of additional compartments like thigh and leg.ConclusionPatients with drug overdose can present with unusual compartment syndrome involvement like the gluteal compartment. Compartment syndrome is a surgical emergency and needs multidisciplinary involvement.

Treating Chronic Pain in Substance-Abusing Patients

At least 25% of patients with substance use disorders (SUDs) have chronic pain, which complicates treatment of both disorders. These researchers

Phenomenology of Counseling Psychologists

Substance abuse can produce/incur significant costs for the society. Around 6.9 million adults were estimated to be addicted to illicit drugs in 2013. Adolescents constitute the most vulnerable segment of the population in this regard between the ages of 16-35. Although the rate/number of drug addicts is rising substantially, an adequate supply of qualified counseling psychologists and mental health professionals for their treatment is still unavailable. Therefore, this research was undertaken to explore some of these crucial aspects from the counselors’ perspective. This mix-method study focused on the effectiveness of these clinical professionals in treating substance abuse patients in Karachi. The qualitative research design used for this study was based on phenomenological interviews. Ten semi-structured interviews were conducted with professional counselors and clinical counseling psychologists currently working with substance abuse patients. Data was categorized into different themes and significant aspects of the phenomenological experiences of participants were processed using thematic analysis. Data on success rate, dropout rate and relapse rate was collected from clinical institutes to measure the positive outcomes of the treatment of drug addicts. The results showed that substantial opportunities are/support was provided by counseling psychologists and their clinical institutes to ensure proper treatment for substance abuse patients. Major aspects of the treatment process such as group and family counseling, relapse and culture were catered by them. However, major changes must be brought in order to cater for individual needs.

Outcomes of Surgical and Endovascular Treatment for Arterial Lesions in Intravenous Drug Abusers

The objective of this study is to report an 18-year single-center experience in the surgical and endovascular treatment of arterial complications due to self-injection in drug abuser patients. This retrospective single-center study was conducted analyzing a prospectively collected database including all endovascular or surgical procedures performed from January 2007 to December 2019 for any arterial complication due to self-injection in drug abuser patient. Collected data were patient demographic and comorbidity, site and type of arterial lesion (pseudoaneurysm [PA], arteriovenous fistula [AVF]), signs of systemic or local infection, and procedural data (endovascular/surgical treatment). End points were rate of postoperative complications, reintervention rate, limb salvage, and patients' early and long-term survival. In 11 patients (median age 36years, range 27-47; male 73%), 13 arterial lesions were treated: 10 (77%) PA, 2 (15%) PA associated with AVF, and 1 (8%) isolated AVF. Arterial lesion involved common femoral artery in 5 (38%), superficial femoral artery in 4 (31%), profunda femoral artery in 1 (8%), brachial artery in 2 (15%), and subclavian artery in 1 (8%). Signs of infections were present in 9 of the 13 cases (69%). The treatment was surgical in 11 (85%) cases: 7 interposition graft (6 great saphenous vein, 1 arterial cryopreserved homograft), 2 direct reconstruction, 1 patch plasty with pericardium bovine patch, and 1 arterial ligation. Endovascular treatment was performed in 2 cases: 1 noninfected PA of the superficial femoral artery, and 1 55-mm PA of the postvertebral segment of the right subclavian artery with clinical sign of hemodynamic instability. At 1month, postoperative complication rate was 8% (one lower limb claudication after superficial femoral artery ligation). Reintervention rate was 8% (interposition graft rupture for repeated self-injections). Limb salvage and patient survival were both 100%. Median follow-up was 5years (range 1month to 11.3years); surgical group: median 8.2years (range 2months to 11.3years); endovascular group: median 3.5months (range 1-6). During follow-up, neither complications nor reinterventions occurred, and limb salvage was 100% for both groups. At 2, 4, and 6years, overall estimated patient survival was 91%, 81%, and 81%, respectively, with no procedure-related death. After surgical or endovascular management of arterial lesions due to self-injection in drug abuser patients, complications occur mainly in the postoperative period. During follow-up, the surgical procedures have low rate of complications, reinterventions, and procedure-related mortality, whereas for the endovascular treatment the mid-term outcomes remain unknown.

Changes in clients’ well-being (ORS) and state hope (SHS) during inpatient substance abuse treatment

Aims:During inpatient substance abuse treatment, professionals seek to help clients to achieve improvement in various life domains affected by substance abuse. Progress monitoring during substance abuse treatment has been called for, and in this study we examine how clients’ levels of well-being and hope change during inpatient substance abuse treatment.Methods:Clients (N = 168) entered the treatment facility between January 1, 2017 and August 31, 2018. The prospective data were gathered from one treatment unit located in central Finland on entry into treatment, during and at the end of treatment. Using the Outcome Rating Scale (ORS) as a therapeutic tool was standard procedure in the treatment unit. Demographic information on participants, information on their previous substance use and scores on the State Hope Scale (SHS) were collected through structured questionnaires. Non-parametrical tests (Mann–Whitney U test; Kruskal–Wallis χ2; Spearman’s rho) were used to study changes in indicators of well-being and hope.Results:As hypothesised, inpatient treatment had a positive effect on both ORS and SHS and they were interrelated. Differences in gender, living situation and previous admissions were found when studying how the background information of the participants was related to the change achieved in ORS and SHS.Conclusions:Inpatient substance abuse treatment seemed to enhance both well-being and hope of the clients of inpatient substance abuse treatment.

The Effectiveness of Trauma-Focused Psychodrama in the Treatment of PTSD in Inpatient Substance Abuse Treatment.

This single group pretest-posttest study explores the effectiveness of trauma-focused psychodrama in the treatment of post-traumatic stress disorder (PTSD) at an inpatient addiction treatment center. The results contribute to the limited research bases of both psychodrama and PTSD treatment outcomes in inpatient addiction treatment. The present study supports the potential effectiveness of two trauma-focused psychodrama models, the Therapeutic Spiral Model and the Relational Trauma Repair Model. Findings of the research demonstrate clinically significant reductions in overall PTSD symptoms (over 25% change) and each PTSD symptom cluster (i.e., re-experiencing and intrusion, avoidance and numbing, and hyper-arousal). Additionally, patient satisfaction exit survey data support overall treatment effectiveness and highlight its tolerability, and capacity for establishing emotional safety, connection, and group cohesion. Patients even described the trauma-focused psychodrama treatment approach as enjoyable and helpful. Overall, the results of this study are promising, and support continued clinical application of trauma-focused psychodrama treatment with other subpopulations diagnosed with PTSD. However, the ability to isolate effects of trauma-focused psychodrama in this study is compromised due to the absence of a control group and participants’ involvement in other inpatient treatment services.

Acceptance and action questionnaire − substance abuse: translation into arabic, content validity and reliability

Background Substance abuse is a chronic illness with complex and intervening treatment process. It is important to have measurement scale to help in the follow-up of individuals throughout the therapeutic and rehabilitation process. It helps to make patients confident in treatment phases and assist health professionals to track their clients’ progress, measuring acceptance and action towards therapeutic process, and its effect on commitment to treatment plan is essential for patients with substance use disorder. Objective The aim was to validate the Arabic version of acceptance and action questionnaire − substance abuse (AAQ-SA) and assess reliability of this questionnaire and translation into Arabic. Patients and methods AAQ-SA has been translated into Arabic. Methodological design was used to investigate content validity index (CVI) reported by eleven expert jurors. Judgment was done by eight psychiatry professors, one psychiatry assistant professor, one psychiatry consultant and an assistant lecturer of psychology, and then, the Arabic version was distributed among 45 substance abuse patients in recovery. Among them, six patients did not attend the second interview. A total of 39 rehabilitated substance abuse patients with remission period from 3 weeks to 28 months completed their interviews. Intraclass correlation coefficient ICC (inter-rater and intrarater agreement) and Cronbach’s α reliability coefficients were addressed to investigate reliability. Results The I-CVI Item CVI for relevance ranged from 0.717 to 1.0 and for clarity from 0.636 to 1.0. The S-CVI Scale CVI was 0.873 for both relevance and clarity. On the contrary, the e-CVI expert CVI ranged from 0.667 to 1.0 for relevance and from 0.778 to 0.944 for clarity. All inter- rater and intrarater correlation coefficients are positive and significant and ranges from 0.48 to 0.92 for inter-rater and from 0.44 to 0.9 for intrarater. The inter-rater and intrarater correlation coefficients of the total score were 0.83 and 0.85, respectively. The total Cronbach’s α of the total scale was 0.92. Cronbach’s α for value commitment and defused acceptance are 0.92 and 0.91, respectively. The mean total scores of pretest rater 1, pretest rater 2, and post-test rater 1 were 68.6±15.7, 70.7±17.9, and 70.6±17.1, respectively, with no statistically significant differences. Conclusion In conclusion, AAQ-SA Arabic version based on the results is valid, reliable, and stable, and its translation is convenient to the culture. More research studies should be done in the field of therapy and rehabilitation for patients with addiction problems in Egypt and the Arabic world.

Ulysses Coercion Through Psychiatric Advanced Directives in Homeless People With Substance Use Disorder: A Qualitative Study of the Colombian Perspective

Homeless substance users (HSUs) represent a public health challenge given their high social impact and the numerous barriers they have to overcome to receive mental health treatment. Recent public debate in Colombia is concerned with how to approach HSUs within the health system. The aim of this publication was to explore the possibility of implementing Psychiatric Advance Directives (PADs) in HSUs as an alternative to coercive treatment, to favor substance abuse treatment adherence and service retention in this population. For this purpose, the authors conducted 3 in-depth interviews of individuals who previously experienced homelessness and were voluntarily admitted to an inpatient substance abuse treatment ward at the moment of the interview. This research indicates that substance abuse in homeless individuals does not imply an impairment of their mental or legal capacity. Moreover, restraining HSUs during intense craving episodes within inpatient settings by implementation of PAD does not seem to be a viable option given the multiple risks and challenges it poses to mental health care providers. Finally, the use of any coercive measure toward HSUs, and this type of PADs in particular, could potentially be associated with violent episodes or human rights violations within mental health institutions.

Transcranial direct current stimulation (tDCS) as an intervention to improve empathic abilities and reduce violent behavior in forensic offenders: study protocol for a randomized controlled trial

BackgroundRecent studies show that changes in one of the brain areas related to empathic abilities (i.e. the ventromedial prefrontal cortex (vmPFC)) plays an important role in violent behavior in abusers of alcohol and cocaine. According to the models of James Blair, empathy is a potential inhibitor of violent behavior. Individuals with less empathic abilities may be less susceptible and motivated to inhibit violent behavior, which causes a higher risk of violence. Recent neuroscientific research shows that modulating (stimulation or inhibition) certain brain areas could be a promising new intervention for substance abuse and to reduce violent behavior, such as the neurostimulation technique transcranial direct current stimulation (tDCS). This study aims to investigate tDCS as an intervention to increase empathic abilities and reduce violent behavior in forensic substance use offenders.Methods/designA total sample of 50 male forensic substance abuse patients (25 active and 25 sham stimulation) will be tested in a double-blind placebo-controlled study, from which half of the patients will receive an active stimulation plus treatment as usual (TAU) and the other half will receive sham stimulation (placebo) plus TAU. The patients in the active condition will receive multichannel tDCS targeting the bilateral vmPFC two times a day for 20 min for five consecutive days. Before and after the stimulation period, the patients will complete self-report measurements, perform the Point Subtraction Aggression Paradigm (PSAP) and a passive viewing empathy task. Resting state electroencephalography (rsEEG) will be performed before and after the treatment period. A follow up will be conducted after 6 months. The primary outcome is to investigate multichannel tDCS as a new intervention to increase empathic abilities and reduce violent behavior in offenders with substance abuse problems. In addition, we will determine whether electrophysiological responses in the brain are affected by the tDCS intervention. Finally, the effects of tDCS on reducing craving will be investigated.DiscussionThis study is one of the first studies using multichannel tDCS targeting the vmPFC in a forensic sample. This study will explore the opportunities to introduce a new intervention to improve empathic abilities and reduce violence in forensic substance use offenders. Specifically, this study may give insight into how to implement the tDCS intervention in the setting of daily clinical practice in this complex, multiple-problem target group and with that contribute to reduction of recidivism.Trial registrationDutch Trial Register, NTR7701. Registered on 12 January 2019. Prospectively registered before the recruitment phase. https://www.trialregister.nl/trial/7459.Recruitment started on the 1st of February 2019 and will be finished approximately in the winter of 2019. Protocol version 1. 22 May 2019.

Neuropsychological performance in patients with substance use disorder with and without mood disorders

Background: Mood disorders commonly co-occur in patients with substance use disorders (SUD). This combination may increase the risk of pathological effects and impair cognitive functioning.Aim: The aim of the study was to examine the effects of mood and substance use disorders on specific neuropsychological measures.Methods: The participants comprised 164 hospitalised patients, 88 with (SUD + MD) and 76 (SUD–MD) without mood disorders, ranging in age from 19 to 65 years. Their diagnostic assessment was based on a psychiatric interview (ICD-10). Neuropsychological tests were carried out after a minimum of one month of abstinence.Results: Processing speed (p = 0.029), and perceptual reasoning (p = 0.039) were more impaired in the SUD + MD group than in the SUD–MD group. An Analysis of covariance (ANCOVA) controlled for age, education level, learning difficulties and polysubstance use revealed that the groups were most powerfully separated by the Digit Symbol test and the Block Design test.Conclusions: Patients with substance abuse and mood disorders seem to have more deficits in speed processing and perceptual reasoning than substance abuse patients without mood disorders. These processing speed difficulties and perceptual problems may impact prognosis and treatment. The Digit Symbol test and the Block Design test are a fast and sensitive ways to examine treatment effectiveness and monitor treatment progress.

The relationship between disturbed Eating behavior and Substance abuse in an Egyptian sample

Abstract Background Substance use disorder (SUD) is a significant public health concern and the comorbidity between eating disorders also, substance use disorders (SUDs) in general have been sought in causal or common etiology. Personality traits have been suggested as shared influences on both of them .Early screening for risk factors for the development of co-occurring eating disorders and substance use disorder as well as sociocultural factors can improve the prognosis of patients Aim of the work to estimate the occurrence of disturbed eating behavior in patients with substance use disorder. Subjects and Methods The present study is a cross sectional observational study aimed to investigate the relation between disturbed eating behavior and the severity of substance abuse in patients with substance use disorder. Illustrate the Association between disturbed eating behavior and the severity of substance. Results The results are divided in to 2 parts: Descriptive part of the socio demographic data, disturbed eating behaviors and analytical part consists of relation between disturbed eating behavior and socio demographic data, as well as relation between addiction severity and sociodemographic data, and finally between disturbed eating behaviors and addiction severity index. Conclusion As the duration of SUD increases the interparental conflicts and interparental violence increases which increases the risk of internalizing, externalizing and total behavioral problems among their children.

Comorbilidad entre síntomas depresivos y consumo de sustancias en pacientes hospitalizados por enfermedades no psiquiátricas

IntroductionEpidemiological studies have shown a high prevalence and concurrence between depression and substance use. This is known as “dual diagnosis” and is associated with a worse prognosis for patients. ObjectiveTo establish the comorbidity between depressive symptoms and substance abuse in patients admitted with acute or chronic diseases to a public hospital. MethodsA descriptive, cross-sectional study of prevalence which included 296 patients aged 18 to 65, to whom the PHQ-9 and ASSIST 3.0 scales were applied to determine the prevalence of depressive symptoms and substance abuse. Other clinical and sociodemographic variables were also taken into account. Results50.7% were women with a median age of 41 and an interquartile range of 27 years. Moderate-to-severe depressive symptoms were found in 27.4% of the patients. Alcohol was the substance with the highest consumption in the previous 3 months with 53.7%, followed by cigarettes (47.6%), marijuana (26.7%) and cocaine (14.5%). A significant association was found between severe depressive symptoms PHQ-9 ≥20 and problematic use of alcohol, marijuana and cocaine (ASSIST score>26); alcohol (RP 27.30, 95% CI [2.37-314.16], P=0.01); marijuana (RP 15.00, 95% CI [3.46-64.96], P=0.001) and cocaine (RP 10.65, 95% CI [2.23-51.10], P=0.01). DiscussionA high prevalence of depressive symptoms and substance use was found in patients hospitalized for non-psychiatric medical conditions, which worsens the prognosis of the underlying medical condition. ConclusionsTo provide better hospital care for patients, we need to give visibility to the problem of dual pathology. This could be achieved by conducting more related research in these clinical scenarios.

The Association between Trauma History, Trauma-Related Psychopathology and Treatment Completion at an Adolescent Inpatient Substance Abuse Treatment Center in Turkey

Some adolescents are at great risk for early attrition from inpatient substance abuse treatment. We aimed to examine the effect of sociodemographic features, substance use patterns, childhood traumas and trauma-related psychopathology on the completion of an adolescent substance abuse inpatient treatment program in order to acquire information about adapting treatment strategies to enhance patient retention. Our study included 105 adolescents who were referred with a diagnosis of substance use disorder to our Child and Adolescent Substance Abuse Treatment Center's inpatient treatment program in Istanbul, Turkey from February to December 2017. The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version, the Hamilton Depression Rating Scale, the Conners-Wells Adolescent Self Report Scale, the Childhood Trauma Questionnaire, the Childhood Abuse and Neglect Question List, the Dependency Profile Index-Practitioner Form and the Adolescent Dissociative Experiences Scale were administered to the study group. The treatment completion rate was 26.7%. The patients who did not complete the inpatient treatment program had more history of childhood emotional neglect and/or abuse. The most common type of psychosocial trauma was emotional neglect (34%). Early attrition from the inpatient treatment program was related to dissociative amnesia, more severe attention deficit hyperactivity disorder, depression and synthetic cannabinoids use (p < 0.05). Our findings indicate that childhood psychosocial trauma and related clinical characteristics were associated with attrition from the adolescent inpatient substance abuse treatment program. Substance abuse treatment programs should adopt early assessment tools to identify those at risk for early attrition from treatment and provide targeted interventions for them.

Predictors of length of abstinence among drug abuse patients of a behavioral modification program in specialized center in Saudi Arabia.

Background:Long-term abstinence in substance abuse patients is a great clinical challenge. A novel behavior modification program (BMP) for ensuring abstinence in substance abuse patients was being run in a tertiary care hospital in Jeddah, Saudi Arabia. The aim of this study was to evaluate the factors associated with the length of abstinence in substance abuse patients who were enrolled in this BMP.Methods:This was a record-based study, where patients were identified from the records of Al-Amal hospital. The study group consisted of adult male patients suffering from drug addiction, exposed to an initial detoxification treatment program and subsequently enrolled into BMP during the year 1424 Hijri, the reason of period selection that it was before the modification of inpatient BMP in the facility toward more outpatient one. Multiple stepwise regression with backward elimination was done to identify factors independently associated with length of abstinence in the BMP program.Results:Mean (SD) age of the participants was 31.9 (8.4) years and a majority had 6–9 years of education (65%), were single (63%), and unemployed (72%). Presence of mood disorder (b = 111.3; 62.3–160.3), good program attendance score (b = 33.2; 21.0–45.4), and higher total number of previous hospital admissions (b = 6.4; 3.1–9.6) were associated with a longer length of abstinence in the BMP program.Conclusion:A number of factors as described above can be utilized to modify the BMP and target different groups of patients who are less likely to stay abstinent for a longer duration, ensuring greater effectiveness of the BMP.

Prevalence of Substance Abuse in Patients with Schizophrenia

Prevalence of Substance Abuse in Patients with Schizophrenia

Cognitive impairment and pregabalin dependence

Background One of the major consequences of substance misuse is its effect on patient cognition. Pregabalin is a new-generation antiepileptic which is believed to have an addictive effect. Objective This cross-sectional study is aimed to estimate the prevalence of cognition impairment among patients with pregabalin misuse. This study includes 300 patients and 100 controls with matched age, sex, and education. The drug abuse patients were divided into two groups: the first group patients used pregabalin alone and the second was a polysubstance group; each group was formed of 150 patients matched in sex, age, and educational level to the pregabalin group. For the diagnosis we used urine screening for drugs. We used the Montreal cognitive assessment test in Arabic edition to evaluate the cognitive function of the patient. Result Cognitive impairment was more in pregabalin misuse patients (M=25.4, SD=3.3) than in the control group (M=27.5, SD=3.7) according to the Montreal cognitive assessment test, P value less than 0.001. The most affected domains were visuoconstruction, digit span, verbal fluency, and recall, with dose (M=625, SD=400). There was no association between cognitive impairment and dose of pregabalin or duration of substance abuse. Conclusion This study concluded that pregabalin misuse patients were likely to have cognitive impairment due to the drug effect and their cognitive impairment was less than the polysubstance misuse group.