Hopeless patients?: A study of illicit opiate users who drop out from in-patient detoxification

Hopeless patients? : A study of illicit opiate users who drop out from in-patient detoxification

Individual and treatment-related factors associated with early self-discharge were studied among illicit opiate users consecutively admitted for hospital detoxification (ITT=68, n=45). Only 20% of the drop-outs had a detailed treatment plan, 20% participated in their own treatment planning, and none were enrolled in a methadone/buprenorphine programme at admission (compared with 60, 80, and 66%, respectively, of those retained in treatment). Having a treatment plan at intake improved the odds for planned discharge by 13 and perceiving fewer positive aspects of drug use increased the odds for drop-out by 12.6. A configural frequency analysis (CFA) showed one significant type: patients with sketchy or no treatment planning at intake, no maintenance treatment, and a low score on positive aspects of drug use were 7.5 times more likely to drop out than expected. Lacking a close maternal relationship characterized patients in this type (83% compared with 31% of non-types). Drop-outs seem to have insecure attachment patterns, which make contact difficult with social services and substance abuse treatment providers. Future research should devise ways of establishing a working alliance with patients likely to drop out, as well as investigating management policies for this patient group.

Källmén, HåkanKarolinska Institutet,Uppsala universitet,Institutionen för psykologi (författare)
Barredal, E. (författare)
Lindqvist, P.Karolinska Institutet (författare)
Karolinska InstitutetInstitutionen för psykologi (creator_code:org_t)

Ingår i:Journal of Substance Use: Informa UK Limited13:2, s. 121-1301465-98911475-9942

Av författaren/redakt...: Berman, Anne H.; Källmén, Håkan; Barredal, E.; Lindqvist, P.

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