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Prediction of Abstinence in Opioid-Dependent Patients

Dijkstra, Boukje A. G. MSc*†; De Jong, Cor A. J. MD, PhD*†§; Krabbe, Paul F. M. PhD; van der Staak, Cees P. F. PhD§

Journal of Addiction Medicine: December 2008 - Volume 2 - Issue 4 - p 194-201
doi: 10.1097/ADM.0b013e31818a6596
Original Article
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Objectives: Opioid detoxification with subsequent naltrexone is found to be an effective method as the first step in an abstinence-oriented approach. The aim of this study is to investigate the predictive value of variables for abstinence in opioid-dependent patients.

Methods: Opioid-dependent patients were followed up to 1 month after detoxification. Predictor variables were assessed at baseline, during detoxification, and at discharge. Primary outcome was abstinence assessed by analyzing urine samples and self-reports. Logistic regression was used to identify predictors of abstinence.

Results: Of 272 participants, 211 could be rated as abstinent (59.2%) or nonabstinent (40.8%) at 1 month follow-up. Significant baseline predictors were severity score of justice/police (ASI) and physical quality of life (SF-36); discharge predictors were general quality of health (SF-36) and sleeping problems (SCL-90); change in sleeping problems (SCL-90) during detoxification was also a predictor. The explained variance of these predictors was very low and clinical significance was limited.

Conclusions: Considering the results it seems not possible to predict who will be abstinent or not 1 month after detoxification. Because rapid detoxification is found to be an effective detoxification method in selected patients, it seems warranted to recommend that patients with similar characteristics (ie, patients motivated for an abstinence-based treatment and low non–drug-related severity scores on the ASI) should be regarded as eligible for rapid detoxification.

From the *Novadic-Kentron, Network for Addiction Treatment Services, Vught, The Netherlands; †Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Radboud University Nijmegen, Nijmegen, The Netherlands; ‡Department of Epidemiology, Biostatistics and Health Technology Assessment, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; and §Department of Clinical Psychology, Radboud University Nijmegen, Nijmegen, The Netherlands.

Received for publication May 20, 2008; accepted Aug 13, 2008.

Send correspondence and reprint requests to Boukje A. G. Dijkstra, NISPA, P.O. Box 9104, 6500 HE, Nijmegen, The Netherlands. e-mail: boukje.dijkstra@novadic-kentron.nl.

© 2008 American Society of Addiction Medicine