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Situational and psycho-social factors associated with relapse following residential detoxification in a population of Irish opioid dependent patients

Published online by Cambridge University Press:  13 June 2014

Kevin Ducray ,
Catherine Darker  and
Bobby P Smyth
Kevin Ducray*
Affiliation:
The Drug Treatment Centre Board, 30-31 Pearse Street, Dublin 2, Ireland
Catherine Darker
Affiliation:
Department of Public Health and Primary Care, Trinity College, Dublin 2, Ireland
Bobby P Smyth
Affiliation:
The Drug Treatment Centre Board, 30-31 Pearse Street, Dublin 2, Ireland Department of Public Health and Primary Care, Trinity College, Dublin 2, Ireland
*
*Correspondence E-mail: [email protected]
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Abstract

Aims: To identify and describe the context and factors involved in the opioid lapse process following discharge from an Irish inpatient opioid detoxification treatment programme.

Design, participants, setting: Prospective follow-up study of consecutive detoxified opioid dependent patients treated in a specialist inpatient drug dependency unit.

Measurements: The Maudsley Addiction Profile and a structured interview were administered to 109 patients, 18–36 months after discharge.

Findings: Of 109 people interviewed at follow-up, 102 (94%) reported at least one episode of opioid use after leaving the residential treatment programme. Eighty eight patients (86% of the lapsers) identified more than one major factor contributing to their recidivism. The median number of factors identified as having a major role in the lapse was four. The most frequently reported major contributors to lapse were low mood (62%), difficulties with craving (62%), ease of access to heroin (48%) and missing the support of the treatment centre (43%).

Conclusions: Early lapse was common following inpatient treatment of opioid dependence. Lapse tended to result from a number of common, identifiable, high-risk situations, feelings and cognitions which may assist clinicians and patients develop lapse prevention strategies to anticipate and interrupt this process.

Keywords

Lapserelapseopioidsheroinrelapse- preventionpsychologicaldrugaddictionabstinencesocial.
Type
Original Paper
Information
Irish Journal of Psychological Medicine , Volume 29 , Issue 2 , 2012 , pp. 72 - 79
Copyright
Copyright © Cambridge University Press 2012

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