Abandono del tratamiento en adictos a la cocaína

Abstract

The high rate of dropout from treatment programs is one of the most serious problems in the field of drug dependence. Early identification of predictors of dropout risk can provide useful information on the specific treatment needs of these types of patient. The aim of this study was to identify predictors of premature cessation of an outpatient treatment program for cocaine addicts. The study was carried out at public healthcare units in a Spanish city. Participants were 91 cocaine addicts admitted for treatment for their addiction, assessed by means of interview and various self-report measures. For identifying predictive variables the researchers used a factor analysis, a cluster analysis and a CHAID analysis.The variables that obtained predictive capacity were the MAST scores and the combined alcohol and drugs scores on the EuropASI. These three variables were grouped in a single factor which was called addictive severity. The predictive analysis showed that this factor had some degree of capacity for the prediction of dropout, but that it was not completely determinant. The results suggest the advantageousness of detecting at the admission stage those patients who might require more attention to their motivational aspects, greater treatment control and intensity, or the provision of complementary interventions.Key words: cocaine, treatment dropout, addiction severity RESUMEN ABSTRACTLa alta tasa de abandonos de los programas de tratamiento es uno de los problemas más graves en el ámbito de las drogodependencias. La identificación temprana de predictores de riesgo de abandono puede proporcionar información útil sobre las necesidades específicas de tratamiento de este tipo de pacientes. El objetivo de este estudio fue identificar predictores de la finalización prematura de un programa de tratamiento ambulatorio para adictos a la cocaína. El estudio se realizó en varias unidades asistenciales públicas de una ciudad española. Los participantes fueron 91 adictos a la cocaína admitidos para ser tratados de su adicción, evaluados mediante entrevista y varias medidas de autoinforme. Para identificar las variables predictivas se utilizó un análisis factorial, un análisis cluster y un análisis CHAID.Las variables que obtuvieron capacidad predictiva fueron las puntuaciones en el MAST, y las puntuaciones compuestas de alcohol y drogas del EuropASI. Estas tres variables quedaron agrupadas en un mismo factor al que se denominó gravedad adictiva. El análisis predictivo mostró que este factor tenía una cierta capacidad de predicción del abandono, pero que no era totalmente determinante. Los resultados apuntan hacia la conveniencia de detectar en la admisión a los pacientes que pudieran requerir una mayor preparación motivacional, mayor control e intensidad en el tratamiento, o la prestación de intervenciones coadyuvantes.Palabras clave: cocaína, abandono del tratamiento, gravedad adictiva.

Características clínico y sociodemográficas de los pacientes de un centro de rehabilitación para las adicciones

“…The sample has a demographic distribution similar to that previously described in studies performed in Lima (1) and studies in other countries, where the predominance of the male gender is similarly observed. (13)(14)(15) The average age was 31 years, which corresponds to young patients, mostly under 34 years of age, similarly to that found in other studies with national samples. (11,(16)(17) This is also comparable to the age observed in other populations such as the North American and European populations, which is around 30 years.…”

Profile of Addicted Patients who Reenter Treatment Programs

“…(20)(21)(22)(23) It is known, however, that one of the best predictors of success is the completion of an entire treatment program. Various studies have suggested that patients who abandon treatment prematurely (regardless of the treatment period in question) present with, among other factors, more anxiety problems, (24) more severe addictions, (6,25) greater cognitive deficits, (26,27) more personality disorders, (25.28) greater psychopathological problems, (29) less social or familial support, or different combinations of these factors. (4,30) The combination of withdrawal from a previous treatment program and the presence of a more severe addiction profile requires that the protocols that are used in the treatment of a readmitted patient have specific adaptations that are designed to make therapeutic interventions more efficient.…”

Factores de riesgo de recaída en pacientes drogodependientes tras desintoxicación hospitalaria

“…Los resultados también coinciden con los estudios de pacientes que realizaban seguimiento ambulatorio. En dependientes de cocaína que seguían tratamiento ambulatorio, el 50,5% había recaído a los 6 meses (Sánchez-Hervás et al, 2010). Goeb y cols.…”

“…El resultado del presente trabajo es coherente con que la adicción a heroína se ha considerado de mayor gravedad, debido a la problemática social, familiar y a las enfermedades médicas (sobre todo infecciosas) y psiquiátricas a las que se asocia (Maremmani et al, 2011;Sánchez-Hervás et al, 2010). Maremmani y cols.…”