[Opioid Maintenance for Patients in Inpatient Long-Term Rehabilitation Treatment - which Patients Benefit?]

Abstract:

OBJECTIVE:Patients from opioid maintenance treatment (OMT) may taper off from opioids during rehab treatment. It is investigated whether this option improves treatment outcomes in particular for those patients who are affected by psychiatric or somatic comorbidity, or by social problems. METHODS:Multicenter study with 4 rehab units. Patient characteristics and treatment outcomes were collected retrospectively. There were n = 227 patients who were admitted to treatment while still receiving OMT, and n = 156 who were opioid free. RESULTS:With regard to regular completion of rehab treatment, an interaction was observed between status at admission and diagnosis of affective, neurotic and anxiety disorders, and between status and previous rehab treatment experience. If admitted in an abstinent status, patients who had never entered rehab, and patients with affective or anxiety disorders showed decreased regular completion rates, while they showed increased completion rates if tapered off during treatment. There was no interaction between initial status and acute life crisis (release from prison, homelessness), somatic diagnoses, or number of stabilizing social factors. CONCLUSION:Admission while still receiving opiate maintenance could be helpful for patients with psychiatric comorbidity and for patients who had previously been reluctant to enter rehab treatment. :ZIEL: Es wird untersucht, ob opiatabhängige Patienten mit gesundheitlichen und sozialen Zusatzbelastungen von einer stationären Drogen-Reha davon profitieren, dass eine bestehende Substitution zunächst fortgeführt wird. METHODIK:Multizentrische Studie in 4 Fachkliniken mit 227 bei Aufnahme substituierten und 156 bei Aufnahme opioidfreien Patienten. ERGEBNISSE:Patienten ohne Reha-Erfahrung und solche mit affektiven und Angststörungen zeigten in der abstinenzbasierten Behandlung geminderte Erfolgsraten, in der initial substituierten Gruppe dagegen erhöhte. SCHLUSSFOLGERUNG:Für Patienten mit besonderen psychischen Belastungen bzw. für solche, die rein abstinenzbasierte Rehabilitationsbehandlungen nicht beginnen wollten, kann die Aufnahme unter Substitution ein Vorteil sein.

journal_name

Psychiatr Prax

journal_title

Psychiatrische Praxis

authors

Kuhlmann T,Specka M,Rhode A,Post Y,Pietras M,Funke W,Feugmann K,Scherbaum N

doi

10.1055/a-0883-2690

subject

Has Abstract

pub_date

2019-07-01 00:00:00

pages

281-286

issue

5

eissn

0303-4259

issn

1439-0876

journal_volume

46

pub_type

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