Special Section on Relapse Prevention: Substance Abuse Relapse in a Ten-Year Prospective Follow-up of Clients With Mental and Substance Use Disorders

This chapter includes an overview of the use of IPT for patients with substance abuse (e.g., alcohol, opiates, cocaine, and nicotine) and addictive disorders. The available data do not allow us to recommend IPT as a treatment for patients with a substance use disorder. There have been several negative IPT trials in this population, and in this setting IPT has been found to be no better than a control condition. However, some small studies in process are more optimistic for its use in narrowly defined samples. Based on the published literature, approaches other than IPT that focus on sobriety or relapse prevention may be preferable for patients with substance use disorders. IPT has never been intended as a treatment for all patients with all conditions, and substance abuse may be an area where its application has limited utility.

Download Full-text

Reaching Out to Patients with Antisocial Personality Disorder with Brief Psychoeducation

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.227 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S70-S71

Author(s):

M. Hesse ◽

B. Thylstrup

Keyword(s):

Substance Abuse ◽

Substance Use ◽

Personality Disorder ◽

Substance Abuse Treatment ◽

Substance Use Disorders ◽

Antisocial Personality Disorder ◽

Antisocial Personality ◽

Treatment As Usual ◽

Abuse Treatment

IntroductionPatients with antisocial personality disorder incur high costs on society, and are at high risk of dropping out of treatment and are often excluded from treatment, yet very little research has been conducted on how to best help these patients.ObjectivesTo test a six-session psychoeducation program, Impulsive Lifestyle Counselling, in outpatients with substance use disorders and antisocial personality disorder.AimsTo test the efficacy of the intervention versus treatment as usual in community outpatient treatment for substance use disorders.MethodsPragmatic randomized trial in 13 outpatient community substance abuse treatment uptake areas. Patients were interviewed by blinded interviewers 3, 9 and 15 months post-randomization and tracked through a national substance abuse treatment register. Mixed effects regression were used to assess substance use and self-reported aggression and Cox regression was used to assess risk of dropout.ResultsA total of 175 patients was randomized. At 3-month follow-up, patients randomized to intervention reported more days abstinent and less drug use severity than patients randomized to treatment as usual. In addition, patients randomized to intervention were at lower risk of dropout after intervention. In addition, patients randomized to intervention were more likely to report having received help for antisocial personality disorder at follow-up interviews.ConclusionsA brief psychoeducational intervention may improve outcomes for outpatients with antisocial personality disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Download Full-text

Physician Impairment: Is Recovery Feasible?

January 2018 - Pain Physician ◽

10.36076/ppj.2009/12/487 ◽

2009 ◽

Vol 3;12 (3;5) ◽

pp. 487-491

Author(s):

Paul J. Christo

Keyword(s):

Public Health ◽

Substance Abuse ◽

Substance Use ◽

Substance Use Disorders ◽

Relapse Prevention ◽

Health Concern ◽

Public Health Issue ◽

Professional Judgment ◽

Prevention Strategies ◽

Physician Impairment

Background: Physician impairment is a serious public health issue affecting not only physicians, but also their families, colleagues, and patients. Physician impairment is used most often to refer to substance use disorders, which involve both substance abuse and substance dependence and/or addiction. Objective: This article aims to describe the problem of physician impairment within the context of substance use disorders. The concept of recovery and several strategies for effective recovery are explored. Discussion: Experts now define impairment as an enduring condition that if left untreated is not amenable to remission and cure. In terms of functional capacity, impairment renders the physician unable to provide competent medical services, with serious flaws in professional judgment. Herein, we define the scope of the problem, consider several theories to explain the reason physicians may be prone to develop substance use disorders, discuss diagnosis and reporting, as well as treatment and prognosis, and identify several relapse prevention strategies. Conclusion: Physician impairment is a real and significant public health concern; however, recovery is feasible and the data support favorable odds of recovery and a return to clinical practice among those seeking appropriate treatment, counseling, and relapse prevention strategies. Key words: Physician impairment, substance use disorder, prevention, relapse, recovery, dependence, substance abuse, Physician Health Programs (PHPs).

Download Full-text

Quality of life and its related factors in women with substance use disorders referring to substance abuse treatment centers

BMC Women s Health ◽

10.1186/s12905-020-01155-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Majid Barati ◽

Khadijeh Bandehelahi ◽

Tahereh Nopasandasil ◽

Hanieh Jormand ◽

Amir Keshavarzi

Keyword(s):

Quality Of Life ◽

Substance Abuse ◽

Substance Use ◽

Substance Abuse Treatment ◽

Substance Use Disorders ◽

Related Factors ◽

Substance Abuse Treatment Centers ◽

The Mean ◽

Abuse Treatment

Abstract Background Substance-Related Disorders are among the most common social problems caused by using legal and illegal substances. Therefore, this study aimed at determining the quality of life (QoL) and its related factors among women with substance use disorders referring to substance abuse treatment centers in Hamadan, west of Iran. Methods This cross-sectional study was carried out on 120 Iranian female substance users recruited through the census sampling method in 2018. Data collection tools consisted of demographic characteristics and QoL assessment (SF-36). Data were analyzed using SPSS-16 via one-way analysis of variance (ANOVA) and chi-square tests. Results The mean age of the participants was 33.2 ± 12.1 years and the mean score of their total QoL was 35.35 ± 13.5. The results of multiple linear regression analysis indicated that using methamphetamine (β = − 6.62) was the predictor of QoL in women. Moreover, there was a significant association between QoL and age (p < 0.001), educational level (p = 0.011), and age at first use (p < 0.001). Conclusion According to the results, the participants’ QoL was found to be at an unsatisfactory level. So, it is essential to implement educational help-seeking behavior for treatment and effectiveness educational, as well as holding mental health intervention, school-based substance abuse prevention, and harm reduction programs of substance use. This is especially important in adolescents, young, low-educated, early drug use, and methamphetamine user women, as it may increase the QoL

Download Full-text

Treatment retention and abstinence of patients with substance use disorders according to addiction severity and psychiatry comorbidity: A six-month follow-up study in an outpatient unit

Addictive Behaviors ◽

10.1016/j.addbeh.2021.106832 ◽

2021 ◽

Vol 117 ◽

pp. 106832

Author(s):

Constanza Daigre ◽

Laia Rodríguez ◽

Carlos Roncero ◽

Raul Felipe Palma-Álvarez ◽

Marta Perea-Ortueta ◽

...

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Treatment Retention ◽

Addiction Severity ◽

Follow Up Study ◽

Outpatient Unit

Download Full-text

Clinical trials and American Indians/Alaska Natives with substance use disorders: identifying potential strategies for a new cultural-based intervention

Journal of Public Mental Health ◽

10.1108/jpmh-01-2014-0003 ◽

2014 ◽

Vol 13 (4) ◽

pp. 175-178 ◽

Cited By ~ 1

Author(s):

Daniel L. Dickerson ◽

Kamilla L. Venner ◽

Bonnie Duran

Keyword(s):

Clinical Trial ◽

Substance Abuse ◽

Clinical Trials ◽

Substance Use ◽

Focus Groups ◽

Substance Use Disorders ◽

American Indians ◽

Alaska Natives ◽

Treatment Setting ◽

Content Type

Purpose – The purpose of this paper is to address a significant public mental health disparity affecting American Indians/Alaska Natives (AI/ANs): the shortage of clinical trials research analyzing the benefits of AI/AN traditional-based treatments, e.g. drumming. Design/methodology/approach – A total of four focus groups were conducted among outpatient and inpatient AI/AN substance abuse patients and providers serving AI/ANs. The purpose of these focus groups was to obtain insights relating to the recent challenges of conducting a clinical trial within the outpatient treatment setting seeking to analyze the benefits of a new substance abuse treatment intervention utilizing drumming for AI/ANs [Drum-assisted Recovery Therapy for Native Americans (DARTNA)] and to obtain recommendations to successfully conduct a similar study within an inpatient treatment setting. Findings – The most prevalent barriers to conducting a clinical trial within an outpatient setting were transportation and child care issues. Recommendations were obtained with regard to optimizing recruitment and retention for a future study within an inpatient setting. Originality/value – This research offers the field rare information that helps toward identifying strategies to successfully conduct clinical trials investigating the benefits of culturally-appropriate treatments for AI/ANs with substance use disorders.

Download Full-text

Standard EMDR Protocol for Alcohol and Substance Dependence Comorbid With Posttraumatic Stress Disorder: Four Cases With 12-Month Follow-Up

Journal of EMDR Practice and Research ◽

10.1891/1933-3196.10.1.33 ◽

2016 ◽

Vol 10 (1) ◽

pp. 33-46 ◽

Cited By ~ 9

Author(s):

Claire Kullack ◽

Jonathan Laugharne

Keyword(s):

Posttraumatic Stress Disorder ◽

Substance Use ◽

Alcohol Dependence ◽

Posttraumatic Stress ◽

Substance Use Disorders ◽

Substance Dependence ◽

Stress Disorder ◽

Case Series ◽

Post Traumatic Stress

This report begins with a summary of the literature regarding the theoretical models behind the comorbid relationship between posttraumatic stress disorder and substance use disorders and the various modified addiction protocols formulated to assist in treating these disorders. This case series outlines the effect that the standard eye movement desensitization and reprocessing (EMDR) protocol had on alcohol and substance dependence for 4 patients who attended our Post Traumatic Stress Clinic in Fremantle, Western Australia, primarily for treatment for posttraumatic stress disorder. Patients were assessed for substance use disorders using the Mini International Neuropsychiatric Interview Plus prior to, immediately after, and 12 months after completing EMDR therapy. Results indicate that the standard EMDR protocol was successful in reducing alcohol and substance use. Prior to treatment, 3 patients met criteria for alcohol dependence and 1 met criteria for substance dependence. At 12-month follow-up, 3 out of 4 clients did not meet the diagnostic criteria for current alcohol dependence or current substance dependence. The implications of these findings are discussed with reference to theories of comorbid posttraumatic stress disorder and substance use disorder and the modified EMDR protocols developed for patients with substance dependence.

Download Full-text