Historique
Article de Périodique
Hopeless patients? A study of illicit opiate users who drop out from in-patient detoxification (2008)
(Des patients sans espoir ? Une étude sur les usagers d'opiacés illicites qui ont décroché d'une désintoxication résidentielle.)
Auteur(s) :
A. H. BERMAN ;
KÄLLMÉN H. ;
E. BARREDAL ;
LINDQVIST P.
Article en page(s) :
121-130
Domaine :
Drogues illicites / Illicit drugs
Langue(s) :
Anglais
Thésaurus mots-clés
OBSERVANCE DU TRAITEMENT
;
DESINTOXICATION
;
OPIACES
;
CURE DE DESINTOXICATION
;
TRAITEMENT DE MAINTENANCE
Thésaurus géographique
SUEDE
Note générale :
Journal of Substance Use, 2008, 13, (2), 121-130
Résumé :
ENGLISH :
Individual and treatment-related factors associated with early self-discharge were studied among illicit opiate users consecutively admitted for hospital detoxification (ITT = 68, n = 45). Only 20% of the drop-outs had a detailed treatment plan, 20% participated in their own treatment planning, and none were enrolled in a methadone/buprenorphine programme at admission (compared with 60, 80, and 66%, respectively, of those retained in treatment). Having a treatment plan at intake improved the odds for planned discharge by 13 and perceiving fewer positive aspects of drug use increased the odds for drop-out by 12.6. A configural frequency analysis (CFA) showed one significant type: patients with sketchy or no treatment planning at intake, no maintenance treatment, and a low score on positive aspects of drug use were 7.5 times more likely to drop out than expected. Lacking a close maternal relationship characterized patients in this type (83% compared with 31% of non-types). Drop-outs seem to have insecure attachment patterns, which make contact difficult with social services and substance abuse treatment providers. Future research should devise ways of establishing a working alliance with patients likely to drop out, as well as investigating management policies for this patient group. (Author' s abstract)
ENGLISH :
Individual and treatment-related factors associated with early self-discharge were studied among illicit opiate users consecutively admitted for hospital detoxification (ITT = 68, n = 45). Only 20% of the drop-outs had a detailed treatment plan, 20% participated in their own treatment planning, and none were enrolled in a methadone/buprenorphine programme at admission (compared with 60, 80, and 66%, respectively, of those retained in treatment). Having a treatment plan at intake improved the odds for planned discharge by 13 and perceiving fewer positive aspects of drug use increased the odds for drop-out by 12.6. A configural frequency analysis (CFA) showed one significant type: patients with sketchy or no treatment planning at intake, no maintenance treatment, and a low score on positive aspects of drug use were 7.5 times more likely to drop out than expected. Lacking a close maternal relationship characterized patients in this type (83% compared with 31% of non-types). Drop-outs seem to have insecure attachment patterns, which make contact difficult with social services and substance abuse treatment providers. Future research should devise ways of establishing a working alliance with patients likely to drop out, as well as investigating management policies for this patient group. (Author' s abstract)
Affiliation :
Department of Clinical Neuroscience, Division of Forensic Psychiatry, Karolinska Institute, Stockholm
Suède. Sweden.
Suède. Sweden.