Expectations about alcohol, cocaine, and benzodiazepine abstinence following inpatient heroin withdrawal management.


Journal

The American journal on addictions
ISSN: 1521-0391
Titre abrégé: Am J Addict
Pays: England
ID NLM: 9208821

Informations de publication

Date de publication:
01 2019
Historique:
received: 08 06 2018
revised: 19 11 2018
accepted: 24 11 2018
pubmed: 15 12 2018
medline: 1 2 2020
entrez: 15 12 2018
Statut: ppublish

Résumé

Polysubstance use is associated with relapse and poor treatment outcomes among people dependent on heroin. Despite the high prevalence of polysubstance use among patients detoxifying from heroin, little is known about patients' expectations to abstain or use non-opiate substances. The current study examined factors associated with expectations about abstaining from alcohol, cocaine, and benzodiazepines (BZDs) following heroin withdrawal management. Between May and December of 2015, we surveyed 417 patients (71.9% male, 31.7 [±8.39] mean years old) initiating short-term inpatient heroin withdrawal management who reported alcohol, cocaine, or BZD use in the past 30 days. We used logistic regression to evaluate the adjusted associations of background characteristics with expectations about using each substance following discharge. Approximately half of respondents reported past month alcohol (52%), cocaine (47.0%), or BZD (47.0%) use, and 25.9% reported using all three substances. Approximately half of those reporting drinking, 6.6% reporting cocaine use, and 27% of reporting BZD use expected to abstain from using that substance following heroin withdrawal. Prior opioid withdrawal was associated with a lower likelihood of expecting to stop using alcohol and BZDs, and more days of BZD use was associated with a greater likelihood of expecting to abstain from BZDs following discharge. Persons with opioid use disorder often do not expect to stop using other substances following withdrawal management, with very few planning cocaine cessation. Inpatient heroin withdrawal programs need to address and educate patients about how polysubstance use complicates recovery from heroin use. (Am J Addict 2019;28:36-42).

Sections du résumé

BACKGROUND AND OBJECTIVES
Polysubstance use is associated with relapse and poor treatment outcomes among people dependent on heroin. Despite the high prevalence of polysubstance use among patients detoxifying from heroin, little is known about patients' expectations to abstain or use non-opiate substances. The current study examined factors associated with expectations about abstaining from alcohol, cocaine, and benzodiazepines (BZDs) following heroin withdrawal management.
METHODS
Between May and December of 2015, we surveyed 417 patients (71.9% male, 31.7 [±8.39] mean years old) initiating short-term inpatient heroin withdrawal management who reported alcohol, cocaine, or BZD use in the past 30 days. We used logistic regression to evaluate the adjusted associations of background characteristics with expectations about using each substance following discharge.
RESULTS
Approximately half of respondents reported past month alcohol (52%), cocaine (47.0%), or BZD (47.0%) use, and 25.9% reported using all three substances. Approximately half of those reporting drinking, 6.6% reporting cocaine use, and 27% of reporting BZD use expected to abstain from using that substance following heroin withdrawal. Prior opioid withdrawal was associated with a lower likelihood of expecting to stop using alcohol and BZDs, and more days of BZD use was associated with a greater likelihood of expecting to abstain from BZDs following discharge.
CONCLUSION
Persons with opioid use disorder often do not expect to stop using other substances following withdrawal management, with very few planning cocaine cessation.
SCIENTIFIC SIGNIFICANCE
Inpatient heroin withdrawal programs need to address and educate patients about how polysubstance use complicates recovery from heroin use. (Am J Addict 2019;28:36-42).

Identifiants

pubmed: 30548526
doi: 10.1111/ajad.12834
doi:

Substances chimiques

Benzodiazepines 12794-10-4
Cocaine I5Y540LHVR

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

36-42

Subventions

Organisme : NIDA NIH HHS
ID : R01 DA034261
Pays : United States

Informations de copyright

© 2018 American Academy of Addiction Psychiatry.

Auteurs

Shannon R Kenney (SR)

Behavioral Medicine Department, Butler Hospital, Providence 02906, Rhode Island.
Warren Alpert Medical School of Brown University, Providence 02912, Rhode Island.

Bradley J Anderson (BJ)

Behavioral Medicine Department, Butler Hospital, Providence 02906, Rhode Island.

Genie L Bailey (GL)

Warren Alpert Medical School of Brown University, Providence 02912, Rhode Island.
Stanley Street Treatment and Resources, Inc., Fall River 02720, Massachusetts.

Michael D Stein (MD)

Behavioral Medicine Department, Butler Hospital, Providence 02906, Rhode Island.
Boston University School of Public Health, Boston 02118, Massachusetts.

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Classifications MeSH