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Wang J, Deane FP, Kelly PJ, Robinson L. A narrative review of outcome measures used in drug and alcohol inpatient withdrawal treatment research. Drug Alcohol Rev 2023; 42:415-426. [PMID: 36633552 PMCID: PMC10108086 DOI: 10.1111/dar.13591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/20/2022] [Accepted: 11/28/2022] [Indexed: 01/13/2023]
Abstract
ISSUES Assessing drug and alcohol inpatient withdrawal treatment programs is important, as these represent a first step of treatment among people with alcohol and drug problems. However, there are many ways of measuring outcomes making it difficult for service providers to decide which domains and methods to use. This narrative review aims to clarify frequencies of the domains and methods used to assess withdrawal treatment outcomes. APPROACH We reviewed published studies that examined outcomes of inpatient drug and alcohol withdrawal treatment. The types of outcome measures used and the frequency of use were summarised. KEY FINDINGS The review showed that assessment of withdrawal treatment outcomes goes beyond traditional abstinence measures. Outcomes mainly focus on biological and psychological outcomes, with social outcomes rarely measured. Even within outcome domains (e.g., cravings), there were many assessment methods. IMPLICATIONS The review provides service providers with an outline of common outcome domains and measures. Given the importance of social functioning to recovery from alcohol and drug problems, greater emphasis on such measures is desirable. Future research could develop greater consensus on outcome measures for use in withdrawal management services to facilitate clarity around factors associated with treatment success. CONCLUSION Outcome assessment in withdrawal treatment goes beyond abstinence to include holistic measurement of biological, psychological and some social outcomes; but more work needs to be done to cohere the different assessment methods and broaden the scope to include social functioning.
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Affiliation(s)
- Jing Wang
- School of Psychology, University of Wollongong, Wollongong, Australia
- Illawarra Health and Medical Research Institute, Wollongong, Australia
| | - Frank P Deane
- School of Psychology, University of Wollongong, Wollongong, Australia
- Illawarra Health and Medical Research Institute, Wollongong, Australia
| | - Peter J Kelly
- School of Psychology, University of Wollongong, Wollongong, Australia
- Illawarra Health and Medical Research Institute, Wollongong, Australia
| | - Laura Robinson
- School of Psychology, University of Wollongong, Wollongong, Australia
- Illawarra Health and Medical Research Institute, Wollongong, Australia
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Tang X, Fan C, Wang C, Wang W, Chen Z, Xu C, Ling L. The risk assessment of relapse among newly enrolled participants in methadone maintenance treatment: A group-LASSO based Bayesian network study. Front Public Health 2023; 10:1032217. [PMID: 36733286 PMCID: PMC9886899 DOI: 10.3389/fpubh.2022.1032217] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 12/23/2022] [Indexed: 01/18/2023] Open
Abstract
Background Relapse is a great barrier to improving the effectiveness of methadone maintenance treatment (MMT). Participants with different treatment durations could vary in their compliance with MMT, which may lead to different levels of relapse risk. This study aims to identify the risk factors for relapse and assess the relapse risk of MMT participants of different treatment durations. Method This retrospective study used data collected from seven MMT clinics in Guangdong Province, China, from January 2010 to April 2017. Newly enrolled participants who received 6 (n = 903) and 12 (n = 710) months of consecutive treatment with complete data were included. We selected significant risk factors for relapse through the group lasso regression and then incorporated them into Bayesian networks to reveal relationships between factors and predict the relapse risk. Results The results showed that participants who received 6-month treatment had a lower relapse rate (32.0%) than those of 12-month treatment (39.0%, P < 0.05). Factors including personal living status and daily methadone dose were only influential to those who received the 6-month treatment. However, age, age at the initial drug use, HIV infection status, sexual behaviors, and continuous treatment days were common factors of both durations. The highest relapse risk for those after the 6-month treatment was inferred as 66.7% while that of the 12-month treatment was 83.3%. Farmers and those who have high accessibility to MMT services may require additional attention. Conclusion It is necessary to implement targeted interventions and education based on the treatment durations of participants to decrease the relapse rate. Meanwhile, those about HIV/sexually transmitted infection prevention and anti-narcotics should be held in the whole process.
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Affiliation(s)
- Xijia Tang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Chaonan Fan
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Chijie Wang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Wenjuan Wang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zouxiang Chen
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Chaofan Xu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Li Ling
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China,Clinical Research Design Division, Clinical Research Center, Sun-Yat sen Memorial Hospital, Sun Yat-sen University, Guangdong, China,*Correspondence: Li Ling ✉
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3
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Analysis of Psychological Shaping Function of Music Education under the Background of Artificial Intelligence. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:7162069. [PMID: 36120157 PMCID: PMC9481338 DOI: 10.1155/2022/7162069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/12/2022] [Accepted: 08/22/2022] [Indexed: 11/18/2022]
Abstract
In order to solve the problem of integrating intelligent technology into music teaching, this paper puts forward the methods of using intelligent technology to optimize the music teaching system; to enhance the effectiveness of music psychological guidance, music intelligent creation, the development of Yi Guzheng platform, the integration of online sparring technology, and the rational use of Mu class platform, and to ensure the construction of loop curriculum system with “intelligent piano.” RBF algorithm has strong data processing ability, which can ensure the operation quality of music score, music score and performance learning modules, and effectively strengthen the training effect of music psychological function. The artificial intelligence platform is more progressive in evaluation. It can use emotion to evaluate courses, grasp the course direction in advance, ensure the construction quality of psychological function, and improve the effect of music teaching; take 100 people as the basis of students, and measure the time proportion of students' music learning in the intelligent system. cjσj refers to the learning situation of music courses within the learning time X of students with excellent psychological quality of music. This result is parallel. Y represents the best score of music output by each algorithm. 2024 music intelligent platforms have collected various course resources with difficulty coefficients of 1 to 5, and the course resources of pictures and videos are sufficient. It can provide students with comprehensive music psychological education and give full play to the teaching advantages of intelligent technology. It can be seen from the data: the operation of music score, music score and performance module viewed in March 2021, with high transportation times and resource download times, indicating that the operation is in good condition; The error correction accuracy of the system is greater than 99%, indicating that the system has strong error correction ability.
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Ezati E, Baghcheghi N, Araban M, Karimy M, Koohestani HR, Zabeti A, Hosseinzadeh H. Assessing drug use relapse rate and its associated factors among Iranian users. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2114387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Elahe Ezati
- Department of Public Health, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nayereh Baghcheghi
- Department of Nursing, Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Marzieh Araban
- Department of Health Education and Promotion, Social Determinants of Health Research Center, Public Health School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahmood Karimy
- Department of Public Health, Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Hamid Reza Koohestani
- Department of Medical Education, Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Arezo Zabeti
- Department of Public Health, Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Hassan Hosseinzadeh
- School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
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MacNeil A, Fuller-Thomson E. Factors Associated with Recovery and Flourishing Mental Health in a National Sample of Canadians with a History of Illicit Drug Dependence. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-021-00579-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Rentala S, Ng SM, Chan CLW, Bevoor P, Nayak RB, Desai M. Effect of holistic relapse prevention intervention among individuals with alcohol dependence: a prospective study at a mental health care setting in India. J Ethn Subst Abuse 2020; 21:687-707. [DOI: 10.1080/15332640.2020.1793867] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Sreevani Rentala
- Department of Psychiatric Nursing, Dharwad Institute of Mental health and Neuroscience, Dharwad, Karnataka, India
| | - Siu-Man Ng
- Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong, Hong Kong
| | - Cecilia L. W. Chan
- Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong, Hong Kong
| | - Prasanth Bevoor
- Department of Nursing, Dharwad Institute of Mental health and Neuroscience, Dharwad, Karnataka, India
| | | | - Mahesh Desai
- Department of Psychiatry, Dharwad Institute of Mental health and Neuroscience, Dharwad, Karnataka, India
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Allan J, Collings S, Munro A. The process of change for people with cognitive impairment in a residential rehabilitation program for substance problems: a phenomenographical analysis. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2019; 14:13. [PMID: 30925888 PMCID: PMC6441186 DOI: 10.1186/s13011-019-0200-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 03/19/2019] [Indexed: 11/10/2022]
Abstract
Cognitive impairment is prevalent among people with substance problems and a factor affecting retention in treatment. Empirical phenomenography was used to systematically explore how people with cognitive impairment viewed a novel residential rehabilitation program - Project RE PIN - designed with cognitive compensatory behaviour change activities and from a strengths-based approach. Twelve participants took part in semi-structured interviews and cross-case analysis identified the overarching theme of change. Key program elements were the safe environment, structured routines, modified psycho-educational material and staff support. Critical changes that participants attributed to the program were in dealing with their own and others' emotions, experiencing daily life without drugs or alcohol and reframing their self-view. Fear and anxiety about relapse were common and few participants had strategies or support to cope in the future. This study demonstrates that program activities changed participants' thoughts, feelings and behaviours about themselves and their substance use. The results indicate that RE-PIN's modified content and processes can benefit people with cognitive impairments in treatment. The study highlights that some treatment users may be vulnerable to resumption of drug use despite gains made during a residential program and their desire to remain substance-free.
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Affiliation(s)
- Julaine Allan
- Lives Lived Well, 91 Dalton st, Orange, NSW, 2800, Australia.
| | - Susan Collings
- School of Education, University of Sydney, Sydney, Australia
| | - Alice Munro
- Lives Lived Well, 91 Dalton st, Orange, NSW, 2800, Australia.,Western Local Health District, Orange, NSW, Australia
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Kakko J, Alho H, Baldacchino A, Molina R, Nava FA, Shaya G. Craving in Opioid Use Disorder: From Neurobiology to Clinical Practice. Front Psychiatry 2019; 10:592. [PMID: 31543832 PMCID: PMC6728888 DOI: 10.3389/fpsyt.2019.00592] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 07/26/2019] [Indexed: 12/21/2022] Open
Abstract
Opioid use disorder (OUD) is a major public health issue that has reached epidemic levels in some parts of the world. It is a chronic and complex neurobiological disease associated with frequent relapse to drug taking. Craving, defined as an overwhelmingly strong desire or need to use a drug, is a central component of OUD and other substance use disorders. In this review, we describe the neurobiological and neuroendocrine pathways that underpin craving in OUD and also focus on the importance of assessing and treating craving in clinical practice. Craving is strongly associated with patients returning to opioid misuse and is therefore an important treatment target to reduce the risk of relapse and improve patients' quality of life. Opioid agonist therapies (OAT), such as buprenorphine and methadone, can significantly reduce craving and relapse risk, and it is essential that patients are treated optimally with these therapies. There is also evidence to support the benefits of non-pharmacological approaches, such as cognitive behavioral therapy and mindfulness-based interventions, as supplementary treatments to opioid agonist therapies. However, despite the positive impact of these treatments on craving, many OUD patients continue to suffer with negative affect and dysphoria. There is a clear need for further studies to progress our understanding of the neurobiological basis of craving and addiction and to identify novel therapeutic strategies as well as to optimize the use of existing treatments to improve outcomes for the growing numbers of patients affected by OUD.
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Affiliation(s)
- Johan Kakko
- Department of Clinical Sciences, Psychiatry, Umeå University, Umeå, Sweden
| | - Hannu Alho
- Department of Public Health Solutions, The Alcohol, Drugs and Addictions Unit, National Institute of Health and Welfare, Helsinki, Finland
| | - Alexander Baldacchino
- Division of Population and Behavioural Science, School of Medicine, University of St Andrews, St Andrews, United Kingdom
| | - Rocío Molina
- Centro de Atencion a las Adicciones de Arganzuela, Madrid Salud, Ayuntamiento de Madrid, Madrid, Spain
| | - Felice Alfonso Nava
- Director Penitentiary Medicine and Drug Abuse Unit, Health Care Unit Padua, Padua, Italy
| | - Gabriel Shaya
- Medical Affairs, Indivior UK Ltd, Slough, United Kingdom
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Smyth BP, Ducray K, Cullen W. Changes in psychological well-being among heroin-dependent adolescents during psychologically supported opiate substitution treatment. Early Interv Psychiatry 2018; 12:417-425. [PMID: 26800851 DOI: 10.1111/eip.12318] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 12/15/2015] [Indexed: 12/01/2022]
Abstract
AIM Heroin-dependent adolescents demonstrate high rates of comorbid psychological problems. Among heroin-dependent adults, opiate substitution treatment (OST) programmes appear to reduce mental health problems. We sought to examine the impact of OST on psychological well-being in adolescents, as this is unknown. METHODS We conducted a prospective study examining psychological well-being in heroin dependent adolescents, aged 18 years or younger, engaged in outpatient psychologically supported OST. Patients were treated with either methadone or buprenorphine. This was complimented with individual key working, counselling (motivational interviewing and cognitive behavioral therapy) and group work focusing on life skills. The Beck Youth Inventory was used to measure psychological well-being at treatment entry and repeated after 4 months of treatment. RESULTS Among 55 consecutive treatment episodes, we examined the 32 episodes where the patient persisted with the OST programme. Polysubstance use was the norm at treatment entry. At follow-up, the median doses of methadone and buprenorphine were 50 mgs and 8 mgs, respectively. Only three patients were treated with antidepressant medication. There was significant improvement in the mean depression (65.0 to 57.9, P = 0.001), anxiety (61.7 to 57.0, P = 0.006) and anger (57.8 to 54.6, P = 0.009) subscale scores. The self-concept and disruptive behaviour subscale scores did not improve significantly. CONCLUSION In this relatively short-term follow-up, psychosocially assisted OST appears to be associated with improved psychological well-being in heroin-dependent adolescents, especially in the area of depressive and anxiety symptoms.
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Affiliation(s)
- Bobby P Smyth
- Department of Public Health & Primary Care, Trinity College Dublin, Dublin, Ireland.,The National Drug Treatment Centre, Dublin, Ireland.,Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Kevin Ducray
- The National Drug Treatment Centre, Dublin, Ireland
| | - Walter Cullen
- Academic General Practice, School of Medicine, University College Dublin, Dublin, Ireland
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Appiah R, Boakye KE, Ndaa P, Aziato L. “Tougher than ever”: An exploration of relapse prevention strategies among patients recovering from poly-substance use disorders in Ghana. DRUGS: EDUCATION, PREVENTION AND POLICY 2017. [DOI: 10.1080/09687637.2017.1337080] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Richard Appiah
- Africa Unit for Transdisciplinary Health Research, North-West University, Potchefstroom, South Africa,
- Department of Occupational Therapy, University of Ghana, Accra, Ghana, and
| | - Kofi E. Boakye
- Institute of Criminology, University of Cambridge, Cambridge, United Kingdom of Great Britain and Northern Ireland,
| | - Peter Ndaa
- Department of Occupational Therapy, University of Ghana, Accra, Ghana, and
| | - Lydia Aziato
- Department of Adult Health, School of Nursing, University of Ghana, Accra, Ghana
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Young people in drug treatment in Ireland: their views on substance use aetiology, trajectory, parents' role in substance use and coping skills. Ir J Psychol Med 2015; 32:247-258. [PMID: 30185264 DOI: 10.1017/ipm.2014.77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The aim of the current study was to gain insight into the process of initiation and progression to problematic use among young people who reach clinically significant levels of substance use requiring treatment. METHOD Twenty young people, aged between 15 and 19 years from two different drug treatment centres in Ireland were interviewed regarding their views on their pathway into substance use, their progress to more problematic use, their perception of their parents' role, if any, in their trajectory and their typical coping style before treatment. Content analysis was conducted on the resulting narratives. RESULTS The use of substances to cope with life stressors emerged as a prominent theme at initial and problematic stages of use. Multiple maladaptive coping approaches were reported. Both direct and indirect influences from parents in their substance use problem were cited. However, some participants reported that parents had no causal role in their substance use trajectory, in particular regarding mothers. CONCLUSIONS The current findings suggest that substance misuse is a multi-determined problem and a number of intervention strategies are suggested to delay onset and related harms associated with adolescent substance use.
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