Background
The impact of opioid use
Maintenance to abstinence programs
Method
Research in context
Participants and data collection
Outcome measures
Statistical analyses
Results
Completion of program
Total | Completers | Non-completers | p value | ||
---|---|---|---|---|---|
N = 100 | N = 51 | N = 49 | |||
n | % | % | % | ||
Exit status | < 0.0013 | ||||
Voluntary | 85 | 85 | 51 | 34 | |
Program complete | 23 | 23 | 23 | 0 | |
Program incomplete | 15 | 15 | 0 | 15 | |
Progression to therapeutic community | 28 | 28 | 28 | 0 | |
Reduction complete | 19 | 19 | 0 | 19 | |
Involuntary | 15 | 15 | 0 | 15 | |
Reduction complete | 9 | 9 | 0 | 9 | |
Reduction incomplete | 6 | 6 | 0 | 6 | |
Length of stay (LOS) in daysa | < 0.001b | ||||
< 47 | 25 | 25 | 0 | 25 | |
47–82 | 23 | 23 | 3 | 20 | |
> 82 | 52 | 52 | 48 | 4 | |
Gender | |||||
Male | 56 | 56 | 53.1 | 58.8 | 0.562b |
Female | 44 | 44 | 46.9 | 41.2 | |
Age (years) | |||||
< 30 | 9 | 9 | 5.9 | 12.2 | |
30–39 | 43 | 43 | 39.2 | 46.9 | |
40–49 | 37 | 37 | 56.8 | 32.7 | |
> 50 | 11 | 11 | 13.7 | 8.2 | |
Mean age in years (sd) | 38.9 | (7.7) | 40.1 (7.7) | 37.6 (7.5) | 0.094c |
Rurality (n = 98) | 0.901c | ||||
MMM1 | 63 | 62 | 64.7 | 63.8 | |
MMM2 | 3 | 3 | 2.0 | 4.3 | |
MMM3 | 9 | 8 | 7.8 | 10.6 | |
MMM4 | 15 | 15 | 17.6 | 12.8 | |
MMM5 | 8 | 8 | 7.8 | 8.5 | |
Mean MMM score (sd) | 2.0 | (1.5) | 2.0 (1.5) | 2.0 (1.4) | 0.890c |
Primary substance | 0.781b | ||||
Analgesics | 80 | 80 | 82.4 | 77.6 | |
Sedatives and hypnotics | 12 | 12 | 9.8 | 14.3 | |
Stimulants and antipsychotics | 8 | 8 | 7.8 | 8.2 | |
Method of use | 0.773b | ||||
Inject | 65 | 65 | 70.6 | 59.2 | |
Ingest | 25 | 25 | 19.6 | 30.6 | |
Absorption | 2 | 2 | 2.0 | 2.0 | |
Smoke | 4 | 4 | 3.9 | 4.1 | |
Sniff (powder) | 1 | 1 | 2.0 | 0.0 | |
Other | 3 | 3 | 2.0 | 2.0 | |
Last injected (n = 99) | 0.614b | ||||
Within previous 3 months | 65 | 65 | 66.7 | 63.3 | |
More than 3, less than 12 months | 12 | 12 | 13.7 | 10.2 | |
More than 12 months ago | 11 | 11 | 11.8 | 10.2 | |
Never Injected | 12 | 12 | 7.8 | 16.3 |
Population sample and drug use behaviour
Total | Completers | Non-completers | p value | ||
---|---|---|---|---|---|
N = 100 | N = 51 | N = 49 | |||
n | % | % | % | ||
General groupings of self-reported problems | |||||
Any non-drug addictions | 12 | 12.0 | 11.8 | 12.2 | 0.941 |
Aggression | 33 | 33.0 | 31.4 | 34.7 | 0.724 |
Self-harm/suicidality | 52 | 52.0 | 47.1 | 57.1 | 0.313 |
Risk taking behaviours more than monthly | 59 | 59.0 | 62.7 | 55.1 | 0.437 |
Recent self harm and suicidality (in the last 4 weeks) | |||||
Thoughts of self-harm | 40 | 39.6 | 33.3 | 46.9 | 0.165 |
Thoughts of self-harm while intoxicated | 8 | 7.9 | 9.8 | 6.3 | 0.716 |
Suicidal thoughts | 42 | 41.6 | 39.2 | 44.9 | 0.565 |
Suicidal thoughts while intoxicated | 11 | 10.9 | 17.6 | 4.2 | 0.033 |
Self harm attempts | 18 | 17.8 | 15.7 | 20.4 | 0.539 |
Self harm attempts while intoxicated | 3 | 3.0 | 2.0 | 4.2 | 0.610 |
Suicide attempts | 19 | 18.8 | 18.0 | 21.3 | 0.684 |
Suicide attempts while intoxicated | 5 | 5.0 | 5.9 | 4.2 | 1.000 |
Current self harm and suicidality on entry | |||||
Current self harm behaviour | 1 | 1.0 | 0.0 | 2.0 | 0.490 |
Current suicide attempts | 1 | 1.0 | 0.0 | 2.0 | 0.490 |
Antisocial behaviour | |||||
Abusive language | 32 | 31.7 | 31.4 | 32.7 | 0.891 |
Abusive language while intoxicated | 5 | 5.0 | 3.9 | 6.3 | 0.672 |
Aggressive behaviour | 8 | 7.9 | 5.9 | 10.2 | 0.483 |
Aggressive behaviour while intoxicated | 2 | 2.0 | 0.0 | 4.1 | 0.238 |
Disciplinary action due to aggression behaviour | 1 | 1.0 | 2.0 | 0.0 | 1.00 |
Frequency of sharing needles | |||||
Monthly or more | 9 | 9.0 | 11.8 | 10.2 | 0.574 |
Less than monthly | 17 | 17.0 | 21.6 | 12.2 | |
Once | 25 | 25.0 | 21.6 | 28.6 | |
Never | 49 | 49.0 | 47.1 | 51.0 | |
Frequency of unsafe sex (n = 100) | |||||
Never | 72 | 72.0 | 64.7 | 79.6 | 0.097 |
Less than monthly/monthly/weekly or more | 28 | 28.0 | 35.3 | 20.4 |
Mental health and quality of life in participants
Total | Completers | Non completers | p valuea | ||
---|---|---|---|---|---|
N = 100 | N = 51 | N = 49 | |||
n | % | % | % | ||
Depression on entry (DASS) | 0.910 | ||||
Normal–mild | 24 | 24.0 | 23.5 | 24.5 | |
Moderate–very severe | 76 | 76.0 | 76.5 | 75.5 | |
Anxiety on entry (DASS) | 0.390 | ||||
Normal–mild | 22 | 22.0 | 25.5 | 18.4 | |
Moderate–very severe | 78 | 78.0 | 74.5 | 81.6 | |
Stress on entry (DASS) | 0.718 | ||||
Normal–mild | 37 | 37.0 | 35.3 | 38.8 | |
Moderate–very severe | 63 | 63.0 | 64.7 | 61.2 | |
Level of psychological distress (K10) on entryb | 0.372 | ||||
None | 13 | 13.5 | 14.3 | 12.8 | |
Mild | 16 | 16.7 | 18.4 | 14.9 | |
Moderate | 20 | 20.8 | 26.5 | 14.9 | |
Severe | 47 | 49.0 | 40.8 | 57.4 |
Total | Completers | Non-completers | p valuea | ||
---|---|---|---|---|---|
N = 100 | N = 51 | N = 49 | |||
n | % | % | % | ||
WHOQOL-8 on entry
| |||||
Overall perception of quality of life | |||||
Very poor | 12 | 12 | 5.9 | 18.4 | 0.131 |
Poor | 36 | 36 | 35.3 | 36.7 | |
Neither poor nor good | 31 | 31 | 39.2 | 22.4 | |
Good/very good | 21 | 21 | 19.6 | 22.4 | |
Overall perception of health | |||||
Very dissatisfied | 24 | 24 | 17.6 | 30.6 | 0.363 |
Dissatisfied | 40 | 40 | 43.1 | 36.7 | |
Neither satisfied nor dissatisfied | 24 | 24 | 23.5 | 24.5 | |
Satisfied/very satisfied | 12.0 | 12 | 15.7 | 8.2 | |
Enough energy for daily life | |||||
Not at all | 21 | 21 | 21.6 | 20.4 | 0.422 |
A little | 32 | 32 | 25.5 | 38.8 | |
Moderately | 29 | 29 | 35.3 | 22.4 | |
Mostly | 17 | 17 | 15.7 | 18.4 | |
Completely | 1 | 1 | 2.0 | 0.0 | |
Enough money for daily needs | |||||
Not at all | 20 | 20 | 15.7 | 24.5 | 0.260 |
A little | 37 | 37 | 39.2 | 34.7 | |
Moderately | 17 | 17 | 23.5 | 10.2 | |
Mostly | 21 | 21 | 15.7 | 26.5 | |
Completely | 5 | 5 | 5.9 | 4.1 | |
Daily living | |||||
Very dissatisfied | 21 | 21 | 15.7 | 26.5 | 0.251 |
Dissatisfied | 32 | 32 | 27.5 | 36.7 | |
Neither satisfied nor dissatisfied | 20 | 20 | 21.6 | 18.4 | |
Satisfied | 23 | 23 | 31.4 | 14.3 | |
Very satisfied | 4 | 4 | 3.9 | 4.1 | |
Self-satisfaction | |||||
Very dissatisfied | 25 | 25 | 23.5 | 26.5 | 0.556 |
Dissatisfied | 47 | 47 | 43.1 | 51.0 | |
Nether satisfied nor dissatisfied | 16 | 16 | 19.6 | 12.2 | |
Satisfied | 11 | 11 | 13.7 | 8.2 | |
Very satisfied | 1 | 1 | 0.0 | 2.0 | |
Relationships | |||||
Very dissatisfied | 21 | 21 | 11.8 | 30.6 | 0.044 |
Dissatisfied | 36 | 36 | 37.3 | 34.7 | |
Neither satisfied nor dissatisfied | 24 | 24 | 29.4 | 18.4 | |
Satisfied | 14 | 14 | 19.6 | 8.2 | |
Very satisfied | 5 | 5 | 2.0 | 8.2 | |
Living place | |||||
Very dissatisfied | 18 | 18 | 11.8 | 24.5 | 0.040 |
Dissatisfied | 23 | 23 | 25.5 | 20.4 | |
Neither satisfied nor dissatisfied | 22 | 22 | 25.5 | 18.4 | |
Satisfied | 26 | 26 | 33.3 | 18.4 | |
Very satisfied | 11 | 11 | 3.9 | 18.4 |
Completers | Non-completers | Time effect | Completion effect | Time * completion effect | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Entry | Exit | Entry | Exit | DF | F | P | DF | F | P | DF | F | P | |
Mean (SD) | Mean (SD) | Mean (SD) | Mean (SD) | ||||||||||
DASS | |||||||||||||
Depression | 20.5 (8.61) | 7.8 (6.30) | 20.2 (10.01) | 12.8 (10.42) | (1,90) | 82.37 | < 0.001 | (1,90) | 2.51 | 0.117 | (1,90) | 5.35 |
0.023
|
Anxiety | 16.5 (8.97) | 6.4 (5.49) | 16.9 (10.77) | 12.3 (9.94) | (1,90) | 51.64 | < 0.001 | (1,90) | 4.05 |
0.047
| (1,90) | 7.02 |
0.010
|
Stress | 20.8 (7.64) | 10.2 (6.91) | 21.5 (9.23) | 16.2 (9.92) | (1,90) | 54.66 | < 0.001 | (1,90) | 5.81 |
0.018
| (1,90) | 6.12 |
0.015
|
WHOQOL-8 | |||||||||||||
Total score | 20.8 (5.68) | 29.3 (5.69) | 19.2 (6.67) | 24.9 (8.57) | (1,91) | 80.42 | < 0.001 | (1.91) | 6.88 |
0.010
| (1,91) | 3.27 | 0.074 |
Quality | 1.7 (0.85) | 2.9 (0.84) | 1.6 (1.03) | 2.3 (1.16) | (1,90) | 55.87 | < 0.001 | (1.90) | 5.96 |
0.017
| (1,90) | 3.25 | 0.075 |
Health | 1.4 (0.96) | 2.6 (0.92) | 1.1 (0.95) | 2.1 (1.15) | (1,90) | 73.58 | < 0.001 | (1,90) | 5.35 |
0.023
| (1,90) | 1.10 | 0.298 |
Energy | 1.5 (1.07) | 2.4 (0.94) | 1.4 (1.05) | 1.9 (1.26) | (1,90) | 30.49 | < 0.001 | (1,90) | 3.08 | 0.083 | (1,90) | 2.49 | 0.118 |
Money | 1.6 (1.12) | 2.5 (1.15) | 1.5 (1.21) | 2.0 (1.33) | (1,90) | 26.15 | < 0.001 | (1,90) | 1.47 | 0.229 | (1,90) | 1.55 | 0.216 |
Daily living | 1.8 (1.17) | 2.7 (0.92) | 1.4 (1.14) | 2.3 (1.14) | (1,90) | 37.06 | < 0.001 | (1,90) | 5.84 |
0.018
| (1,90) | 0.01 | 0.935 |
Self-satisfaction | 1.2 (0.97) | 2.6 (0.98) | 1.1 (0.87) | 2.1 (1.28) | (1,90) | 81.20 | < 0.001 | (1,90) | 3.26 | 0.074 | (1,90) | 2.32 | 0.131 |
Relationships | 1.6 (1.00) | 2.6 (0.90) | 1.3 (1.21) | 2.2 (1.17) | (1,90) | 52.19 | < 0.001 | (1,90) | 3.94 |
0.050
| (1,90) | 0.16 | 0.692 |
Living place | 1.9 (1.11) | 3.0 (0.79) | 1.8 (1.50) | 2.6 (1.22) | (1,90) | 39.33 | < 0.001 | (1,90) | 1.71 | 0.194 | (1,90) | 1.12 | 0.292 |
K10a | |||||||||||||
Total score | 28.1 (8.00) | 19.3 (5.91) | 31.0 (8.43) | 23.7 (8.84) | (1,70) | 44.30 | < 0.001 | (1,70) | 6.03 |
0.017
| (1,70) | 0.41 | 0.525 |
Total sample | ||||
---|---|---|---|---|
Measure | % Reliably improved (n) | % Not improved (n) | % Reliably declined (n) | p value |
DASS-42 (N = 92) | 72.8 (67) | 19.6(18) | 7.6 (7) | |
WHOQOL-8 (N = 93) | 76.3 (71) | 12.9 (12) | 10.8(10) | |
K10 (N = 73) | 74.0 (54) | 13.7 (10) | 12.3 (9) | |
Length of stay (days) | ||||
DASS-42 (N = 92) | ||||
≤ 46 days | 71.4 (15) | 23.8(5) | 4.8 (1) | 0.088 |
47–82 | 52.6 (10) | 26.3 (5) | 21.1(4) | |
83+ | 80.8 (42) | 15.4 (8) | 3.8 (2) | |
WHOQOL-8 (N = 93) | ||||
≤ 46 days | 72.7 (16) | 13.6 (3) | 13.6 (3) | 0.937 |
47–82 | 73.7 (14) | 15.8 (3) | 10.5 (2) | |
83+ | 78.8 (41) | 11.5 (6) | 9.6 (5) | |
K10 Scores (N = 73) | ||||
≤ 46 days | 58.3 (7) | 33.3 (4) | 8.3 (1) | 0.158 |
47–82 | 66.7 (8) | 8.3 (1) | 25 (3) | |
83+ | 79.6 (39) | 10.2 (5) | 10.2 (5) |