Relationship Between Resilience and Treatment Continuity in Opioid Use Disorder Patients

Abstract

Objective: Opioid addiction is a disease with low remission rates that is difficult to treat in our country and in the World. One of the main reasons for the low remission rates is the difficulties in maintaining the continuation of the treatment. Resilience is one of the factors that determine people's reactions in difficult situations. In our study, we aimed to examine the relationship between psychological resilience and some sociodemographic characteristics with treatment continuation in patients with opioid use disorder. Method: A sociodemographic data form and a psychological resilience scale for adults were given to 260 patients who were admitted to Ankara Alcohol Substance Treatment and Education Center (AMATEM) for the first time whose urine analysis results were positive. The patients included in the study were followed up for 6 months by urinalysis and psychiatric interviews. Results: A total of 260 patients, 243 men and 17 women, were included in the study. While 61 patients did not come after the first application, 70 patients came to regular follow-up for 6 months. Psychological resilience was found significantly lower in patients who received disciplinary punishment at school, who did not work, who were previously in prison, who has family history about alcohol or drug use. Psychological resilience of the patients who continued follow-up was found higher. Conclusion: Treatment continuation of is one of the important factors affecting remission in opioid addiction. Factors such as family history, prison history, unemployment, resilience, and social resources can affect the continuation of treatment.

Keywords

• opioid
• resilience
• addiction

Opioid Kullanım Bozukluğu Olan Hastalarda Psikolojik Dayanıklılığın Tedavi Devamlılığı İle İlişkisi

Öz

Amaç: Opioid bağımlılığı ülkemizde ve dünyada tedavisi güç, remisyon oranları düşük bir hastalıktır. Remisyon oranlarının düşük olmasındaki ana nedenlerden biri de hastaların tedaviye devamının sağlanmasında yaşanan güçlüklerdir. Psikolojik dayanıklılık kişilerin güç durumlardaki verdikleri tepkileri belirleyen etmenlerden biridir. Çalışmamızda, opioid kullanım bozukluklu hastalarda psikolojik dayanıklılığın ve bazı sosyodemografik özelliklerin tedaviye devam etme ile ilişkisini incelemeyi amaçladık. Yöntem: Ankara Alkol Madde Tedavi ve Eğitim Merkezine (AMATEM) opioid kullanım bozukluğu tedavisi için ilk defa başvuran, idrar analiz sonucu pozitif çıkan 260 hastaya sosyodemografik veri formu, erişkinler için psikolojik dayanıklılık ölçeği verildi. Çalışmaya dahil edilen hastalar 6 ay boyunca idrar analizi ve psikiyatri görüşmesi yapılarak takip edildi. Bulgular: Çalışmaya 243 erkek 17 kadın toplam 260 hasta dahil edildi. 61 hasta ilk başvurudan sonra bir daha takibe gelmezken 70 hasta 6 ay boyunca düzenli takiplerine gelmiştir. Okulda disiplin cezası alan, çalışmayan, daha önce cezaevinde kalan, ailede alkol veya madde kullanımı olan hastalarda psikolojik dayanıklılık anlamlı derecede düşük bulunmuştur. Takibe devam eden hastaların psikolojik dayanıklılığı yüksek bulunmuş, sosyal kaynaklar gibi alt ölçekler anlamlı derece yüksek bulunmuştur. Sonuç: Opioid bağımlılığında tedaviye devam remisyonu etkileyen önemli faktörlerden biridir. Aile öyküsü, cezaevi öyküsü işsizlik, psikolojik dayanıklılık, sosyal kaynaklar gibi faktörler tedaviye devamı etkileyebilmektedir.

Anahtar Kelimeler

• opioid
• psikolojik dayanıklılık
• bağımlılık

Kaynakça

1. Ling W, Nadipelli VR, Ronquest N, et al. Remission from chronic opioid use—Studying environmental and socio-economic factors on recovery (Recover): Study design and participant characteristics. Contemp Clin Trials 2019; 76: 93-103.
2. Kadam M, SinhaA, Nimkar S, et al. A comparative study of factors associated with relapse in alcohol dependence and opioid dependence. Indian J Psychol Med 2017; 39(5): 627-633.
3. Kimmel SD, Gaeta JM, Hadland S, et al. Principles of harm reduction for young people who use drugs. Pediatrics 2021; 147 (Suppl 2): S240-S248.
4. Newman Russ. APA's resilience initiative. Professional psychology: research and practice 2005; 36 (3): 227-229.
5. Asan Ö, Tıkır B, Okay İT, ve ark. Bir AMATEM birimine başvuran alkol ve madde kullanım bozukluğu olan hastaların sosyodemografik ve klinik özellikleri. Bağımlılık Dergisi 2015; 16 (1): 1-8.
6. Wang L, Xu B, Gu Y, et al. The mediating and moderating effects of resilience on the relationship between perceived stress and depression in heroin addicts. J Community Psycho 2019; 47 (3): 495-503.
7. Cadet JL. Epigenetics of stress, addiction, and resilience: therapeutic implications. Mol Neurobiol 2016; 53 (1): 545-560.
8. Gökçen G. Madde Kullanan ve Kullanmayan Üniversite Öğrencilerinin Psikolojik Dayanıklılık Düzeylerinin İncelenmesi. Yüksek lisans tezi. Antalya. T.C. Akdeniz Üniversitesi Eğitim Bilimleri Enstitüsü 2015.

9. Yen JY, Lin HC, Chou WP, et al. Associations among resilience, stress, depression, and internet gaming disorder in young adults. Int J Environ Res Public Health 2019; 16 (17): 3181.
10. Horton-Eddıson M, Shortis P, Aldridge J, et al. Drug Cryptomarkets in the 2020s: Policy, Enforcement, Harm, And Resilience. Global Drug Policy Observatory 2021. Erişim tarihi: Temmuz 2021
11. Goodman DJ, Saunders EC, Wolff BW. In their own words: A qualitative study of factors promoting resilience and recovery among postpartum women with opioid use disorders. BMC Pregnancy Childbirth 2020; 20(1): 178.
12. Friborg O, Hjemdal O, Rosenvinge JH, Martinussen M. A new rating scale for adult resilience: what are the central protective resources behind healthy adjustment?. Int J Methods Psychiatr Res 2003; 12 (2): 65–76.
13. Basım HN, Çetin F. Yetişkinler için psikolojik dayanıklılık ölçeği’nin güvenilirlik ve geçerlilik çalışması. Türk Psikiyatri Dergisi 2011; 22 (2): 104-114.
14. Applewhite SR, Mendez-Luck CA, Kao D, et al. The Perceived Role of Family in Heroin Use Behaviors of Mexican-American Men. J Immigr Minor Health 2017; 19 (5) :1207-1215.
15. Luthar SS, Glick M, Zigler E. Social competence among cocaine abusers: Moderating effects of comorbid diagnoses and gender. Am J Drug Alcohol Abuse 1993; 19(3): 283-298.
16. Evren EC, Er FO, Erkıran M ve ark. Tedavi arayışında olan eroin bağımlılarında I. eksen psikiyatrik komorbidite: sosyodemografik ve madde kullanım özellikleri ile ilişkisi. Klinik Psikiyatri Dergisi 2002; (2): 92-104.
17. R Glavak, Jagodic GK, Sakoman S. Perceived parental acceptance-rejection, family-related factors, and socio-economic status of families of adolescent heroin addicts. Croat Med J 2003; 44 (2):199-206.
18. Woodcock EA, Lundahl LH, Stoltman JJ, Greenwald MK. Progression to regular heroin use: examination of patterns, predictors, and consequences. Addict Behav 2015; 45: 287-293.
19. Taha S, Broker B. Best practices across the continuum of care for the treatment of opioid use disorder. Canadian Centre on Substance Use and Addiction 2018:1-31.
20. Jiao M, Gu J, Xu H, et al. Resilience associated with mental health problems among methadone maintenance treatment patients in Guangzhou, China. AIDS Care 2017; 29 (5): 660-665.
21. Ali MM, Dwyer DS, Vanner EA, et al. Adolescent propensity to engage in health risky behaviors: The role of individual resilience. Int J Environ Res Public Health 2010; 7 (5): 2161-2176.
22. Schwinn TM, Schinke SP, Keller B, et al. Two-and three-year follow-up from a gender-specific, web-based drug abuse prevention program for adolescent girls. Addict Behav 2019; 93: 86-92
23. Frıesen EL, Kurdyak P. The impact of psychiatric comorbidity on treatment discontinuation among individuals receiving medications for opioid use disorder. Drug Alcohol Depend 2020; 216: 108244.
24. Kelly JF, Fallah-Sohy N, Cristello J, et al. Coping with the enduring unpredictability of opioid addiction: An investigation of a novel family-focused peer-support organization. J Subst Abuse Treat 2017; 77:193-200.