RESUMEN

PURPOSE: This study takes a systematic approach to investigate the effect of social work intervention aimed at increasing general health among opioid addicts in addiction treatment centers. PATIENTS AND METHODS: This is an experimental plan (pretest to posttest with a control group); the study sample included 60 patients with drug dependencies undergoing treatment in addiction treatment centers. These patients were randomly assigned as case (30) and control (30) groups. The case group was subjected to intervention over ten sessions, whereas the control group received no intervention. Both groups then passed through a posttest, while a follow-up was conducted after 4 months. Data were obtained via a General Health Questionnaire. RESULTS: A covariance analysis test and independent and dependent t-test results indicated that a social work intervention adopting systematic approach was effective in increasing the general health of drug-addicted patients under treatment. CONCLUSION: Thus, the nature of the presence of social workers in addiction treatment centers has been effective and can have a significant influence by reducing anxiety and insomnia and somatic symptoms, improving patients' self-understanding and self-recognition, and enhancing social functioning.

RESUMEN

In the current experiment, we used the saccadometric test to study the effect of a single therapeutic dose of methadone on the integrity of cortico-subcortical brain functioning. In this prospective study, we used the Saccadometer System (Advanced Clinical Instrumentation, Cambridge, UK). The saccadometric test was performed before and 1.5 hours after methadone dosing. We analyzed the following saccadic parameters: latency, duration, amplitude, average and peak velocity, and processing performance (promptness) as well as a number of different types of saccades (like correct/incorrect, under/overshoot, and left-sided/right-sided). The sample consists of 40 subjects with an average 18 years of opioid addiction. The mean age is 35.3 ± 7 (80% males and 20% females). The mean period of heroin dependence is 15.3 ± 6.3 years. The mean daily dose of methadone in substitution therapy is 90 ± 26.5 mg. After administration of a single therapeutic dose of methadone, there were statistically significant differences in the values of saccade duration and latency when compared to the values before the drug administration. Average duration of saccade was significantly longer [51.40 ± 8.75 ms versus 48.93 ± 6.91 ms, z = 2.53, p = .01] and average latency was significantly longer [198.85 ± 52.57 ms versus 183.05 ± 30.95 ms, z = 2.09 p < .03]. This is the first study to test the therapeutic effect of daily methadone dosing on the integrity of the cortico-subcortical brain functions as measured by the saccadometry. More research is needed to explore the effect of illicit opioid use on the integrity of brain structures and functions, and the protective effect of opioid agonist therapy on reversing the damaging effects of illicit opioid use.

Asunto(s)

Metadona/uso terapéutico , Narcóticos/uso terapéutico , Trastornos Relacionados con Opioides/tratamiento farmacológico , Movimientos Sacádicos/efectos de los fármacos , Adulto , Femenino , Humanos , Masculino , Estudios Prospectivos , Tiempo de Reacción

RESUMEN

The program of our Clinic includes, not only treatment of acute intoxication with opioids and other drugs, but also comprehends clinical investigations and treatment of the somatic complications of this population. For the first time in our country our Clinic offers to this population the alternative way of treatment with Buprenorfin. The Clinic started with this protocol on August 1, 2009. During a period of two years, the treatment with Buprenorfine has been initiated in 353 patients, of which 211 regularly attend the medical check ups. This model is used according to the national clinical guidelines and procedures for the use of buprenorfine in the treatment of opioid dependence The dose of this medicament depends on the evolution of the withdrawal symptoms. We have used the objective and subjective opioid withdrawal scale for the observation of these symptoms (OOWS ; SOWS - Handelsman et al 1987). This protocol starts with a complete clinical investigations, (i.e. where all patients undergo the inclusion and exclusion criteria with a written consent). Afterwards, the patients are hospitalized and start with a Buprenorfin teratment. After period of 7-10 days hospitalization they come to our Clinic, like outpatients for a regular controls. We have precise evidence for every patient who comes for control (e.g. medical record with all biochemical and toxicological screenings). All patients are recommended a tight cooperation with psychiatrists who are specialized to treat the problematic drug addictions.

RESUMEN

Objective We developed a scale on opioid addicts' sensitivity to drug-related environments for assessing addicts sensitivity and influential factors, which could provide evidence for psychological interventions on detoxification. Methods The survey on opioid addicts' sensitivity was administered to 1096 opioid addicts through stratified random cluster sampling in mandatory detoxification centers from 5 cities in China. Results Patients were more sensitive to environments directly related to drug abuse, social and family environments, especially in those cases that lack of love from family or watching drug use from others, with percentages of persons having strong response reaching 59.40% and 59.05%, respectively. The risk factors of patients' sensitivity to environments directly related to drug abuse would include long period of drug use, high frequency of drug abuse, drug abuse in family members and negative family attitudes ( F = 17.10, P＜ 0. 0001 ). Being female, younger of age, long period of drug use and negative family attitudes increased the extent of patients' sensitivity to social and family environments (F = 8.52, P＜0. 0001) while long period of drug use, high frequency of drug abuse, and negative family attitudes increased the extent of patients' sensitivity to environments indirectly related to drug abuse (F =10.08, P ＜ 0. 0001). Conclusion Patients were very sensitive to drug-related environments. The extent of patients' sensitivity was influenced by sex, age, years of drug use, the frequency of drug abuse, having drug user in family and the family attitudes towards them.