Predictors of Relapse after Inpatient Opioid Detoxification during 1-Year Follow-Up

Abstract

Introduction. Relapse rate after opioid detoxification is very high. We studied the possibility that predetoxification patient characteristics might predict relapse at follow-up and thus conducted this 1-year follow-up study to assess the predictors of relapse after inpatient opioid detoxification. Materials and Methods. We conducted this study in our tertiary care institute in India over two-year time period (1 Jan 2014 to 31 Dec 2015). Out of 581 patients admitted, 466 patients were considered for study. Results and Discussion. No significant difference was found between relapsed and nonrelapsed patients regarding sociodemographic profile; however substance abuse pattern and forensic history showed significant differences. Relapsed patients abused greater amount and used injections more commonly, as compared to nonrelapsed group. Longer duration of abuse was also a significant risk factor. Patients with past attempt of opioid detoxification and family history (parental or first degree) of alcohol abuse had decreased possibility of maintaining remission during 1-year follow-up. Relapsed patients were found to abuse their spouse or parents. Conclusion. Our study compared profiles of relapsed and nonrelapsed patients after inpatient detoxification and concluded predictors of relapse during 1-year follow-up period. Early identification of predictors of relapse and hence high risk patients might be helpful in designing more effective and focused treatment plan.

Multifunctional opioid receptor agonism and antagonism by a novel macrocyclic tetrapeptide prevents reinstatement of morphine‐seeking behaviour

“…Still, the unmet medical need is clear. While medications exist to manage opioid misuse, the relapse rate after opioid detoxification and in individuals undergoing substance use disorder treatment is reportedly as high as 60%–80% (Chalana, Kundal, Gupta, & Malhari, 2016; McLellan, Lewis, O'Brien, & Kleber, 2000; Viswanathan et al, 2012), emphasizing the need for additional therapeutic options throughout the recovery process. The favourable antinociceptive potency of cyclo [Pro‐Sar‐Phe‐ d ‐Phe] in the warm‐water tail‐withdrawal assay and its ability to prevent relapse to morphine‐seeking behaviour after both stress‐ and drug‐induced reinstatement paradigms suggests that this macrocyclic tetrapeptide could have therapeutic potential for the treatment of both pain and opioid abuse, specifically for preventing relapse.…”

Impact of reported NSAID “allergies” on opioid use disorder in back pain

“…However, even for patients with previously diagnosed OUD who have undergone treatment with detoxification, relapse rates are high and range from 32% to 88% after 12 to 36 months. 41 The prevalence of stable abstinence from opioid use after 10 to 30 years is less than 30%. 42 Management of chronic and acute (eg, perioperative) pain can be particularly challenging in this population, because poorly controlled pain can lead to cravings and relapse.…”

Treating Opioid Withdrawal With Buprenorphine in a Community Hospital Emergency Department: An Outreach Program

“…1 Medication-assisted treatment decreases relapse frequency, reduces morbidity, decreases the likelihood of overdose, and allows many individuals to regain a productive life. [2][3][4] Such treatment uses the long-acting opioid antagonist naltrexone, the opioid agonist methadone, or the partial agonist buprenorphine. 5,6 Each medication has advantages and disadvantages.…”