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Ecstasy consumption in opiate addicts: Personality disorders and severity of addiction
P5 Addiction
[m
Rapld psychiatric treatment of detoxification from opiates
S285
Ecstasy consumption in opiate addicts: Personality Ip.5.0141 disorders and severity of addiction
G.L. Conte, C. Taranto, G. Camardese, A. Buonamro, S. De Risio.
E. Gutierrez’, PA. S&z*, J.J. Femandez’, M.P. Gonzalez*, J. Babes*.
Department Italy
‘Mental Health Services of Asturias; 2Department of Psychiatry, Faculv of Medicine, University of Oviedo, Spain
of Psychiatry,
Catholic University of Sacred Heart, Rome,
The authors investigated the effectiveness of a rapid psychiatric protocol of detoxification from opiate in 100 heroin addicts. Preliminary results of 15 full cases (detoxification treatment and 6 month follow-up) are already available. The protocol develops in 7 days hospitalization, based on trazodone and naltrexone administration (trazodone was selected because of the adrenolytic side effect and the antidepressant efficacy), plus other symptomatic common therapy. Characteristic of the protocol is the invasive way (i.v.) of administration of drugs, part of a more general interest to the care of whole psychosomatic body of the patient. After recovery several and different psychosocial, psychiatric and psychodinamic treatments are offered by the same unit. Between the 15 full cases, 2 relapsed and eventually dropped out, 1 relapsed and was later reinstated in the protocol. References [1] Rawson R.A., Ling W.: Opioid addiction treatment modalities and some guidelines to their optimal use. J. of Psychoactive drugs, 23 (2): 1991, 15 1. [2] Fedeli S., Ferri EA., Fogari R.: Blockage of acute opiate withdrawal symptoms by Trazodone treatment. Boll. Chim. Farm. 1979, 118: 268.
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Quality of life, psychopathological status and drug use In a methadone maintenance treatment in Spain
J.J. Femandez-Miranda’, M.P GonzLlez2, PA. Saiz*, E. Gutierrez’, J. Babes*. ‘Mental Health Services OfAsturias; 2Department ofpsychiatv, Faculty of Medicine,
Univer,sity of Oviedo, Spain
To determine the relationship among psychopathological status, opiate dependence and quality of life in heroin addicts in a methadone maintenance treatment (MMT). Patients and Method: 50 heroin addicts undergoing MMT programme in Asturias (Spain) over a period of 4 years. Assessment: SF-36 Health Survey, Goldberg Anxiety/Depression Scales. Blood and urine analysis (for HIV and heroin and cocaine consumption monitoritation) were made. Results: Patients showed moderate quality of life levels. Mental domains were worse than physical ones [PF = 8 1.4 (SD 25.7); RP = 79.1 (SD 33.2); BP = 76.5 (SD 27.4); GH = 50.0 (SD 29.3); V = 43.8 (SD = 17.7); SF = 76.6 (SD 28.2); KE = 64.4 (SD 35.7); MH = 55.3 (20.5)]. In the 6 months prior to the 4-year follow-up, 37.8% had used heroin, 20% cocaine and 43.3% benzodiacepines. Heroin consumption was related with psychiatric comorbidity (p < .Ol), being HIV+ (p < .Ol) and using cocaine (p < .Ol). Low levels of quality of life were found in those HIV+ (p < .OOl), heroin users (p < ,001) and cocaine users (p < .05) users and those who had anxiety and/or depressive symptoms (p i .OOl). Conclusions: After 4 years in a MMT programme, patients had a moderate level of quality of life. Physical (HIV+) and psychiatric (anxiety and depression) comorbidity was related with lower quality of life and, also, with the use of heroin and other drugs. This group of patients needs more intensive and specific psychosocial support. Objectives:
References [I] Parrino MW. State methadone treatment guidelines. U S Department of Health and Human Services. Rockville, 1993. [2] Ware JE, Gandek B and the IQOLA Project Group. The SF-36 Health Survey: Development and use in mental health research. lot J Ment Health 1994; 23 (2): 49-73.
Objectives: The aim of this study is to establish the relationship between personality disorders (PD) and ecstasy consumption in a sample of opiate addicts and to determine the severity of addiction in such. Patients and Method: A sample of 135 patients [mean age 27.47 (5.85); 82.2% males] diagnosed as heroin dependent, and who requested treatment in a Detoxification Unit in Mieres (Asturias - Spain), between January and December 1997, were included. Inclusion criteria: Opiate dependence (DSM-IV), over 18 years of age, initiation/reinitiation treatment, informed consent. Exclusion criteria: Polyconsumers whose main drug was non-opiate, less than 18 years, presence of psychiatric disorder, lack of informed consent. Eualuation: International Personality Disorder Examination DSM-IV version (IPDE) (Loranger et al, 1994) and European version of Addiction Severity Index (EuropASI) (Kokkevi et al, 1995). Results: Lifetime prevalence of MDMA consumption was 43.7%, however, at the beginning of treatment only 10.4% of the total sample were actually consuming ecstasy. “Sometime” consumers of MDMASociodemographic and clinical data: 79.7% males, mean age = 24.64 (5.11) [mean age of “never’consumers = 29.67 (5.45), p = .OOO],mean age of first use of MDMA = 20.58 (4.89). Eighty three percent of consumers were single compared to 74.6% of “never” consumers (p = ,002) and living with their parents (64.4%), 72.9% had completed Spanish “primary” education (up to 14 years of age), mean age of first use of heroin = 18.20 (2.79) [versus 21.55 (5.31) in the “never” consumers, p = .OOO],57.6% had used intravenous route. Personality Disorders: The prevalence of different PD in the MDMA sample was 72.9% [mean number of PD = 1.373 (1.26)] and the most frequent PD was the antisocial type (33.4%) [no differences were found in terms of PD between “sometime” consumers and “never” consumers]. EuropASI: Higher scores were obtained in the drug area [mean score = 6.89 (0.78)] (no differences were found between “sometime” consumers and “never” consumers in the different areas of EuropASI). Conclusions: 1. There is a higher lifetime prevalence of ecstasy consumption between opiate addicts 2. The consumption of ecstasy in opiate addicts is more common in the younger age group 3. Ecstasy consumption in opiate addicts is no related to suffering from PD 4. Ecstasy consumption in opiate addicts is not related to a greater severity of addiction. References [l] De Jong CAJ, Van den Brink W, Harteveld FH et al (1993). Personality disorders in alcoholics and drug addicts. Comprehensive Psychiatry, 34 (2): 87-94. [2] Bobes J, Lorenzo P, S&z PA (1998). Extasis (MDMA): Un abordaje compreheosivo. Barcelona: Masson.
-1
Carbamaxepin in the treatment of the alcohol withdrawal syndrome
V Lazarova, M. Jakovcevska-KujundZiska, V Filovska. Psychiatric hospital Skopje, Macedonia
In the past, Carbamazepin was used mainly in the treatment of convulsive diseaeses. Now It is also used because of It’s psychotropic effect. Good results are succeed with the application of Carbamazepin in the treatment of the withdrawal syndromes. In this study we present our expiriences in the treatment of Alcohol withdrawal syndrome with Carbamazepin. Our research included a group of 35 patients, hospitalized in Psychiatric hospital Skopje, who manifested alcohol withdrawal without complications (They didn’t manifested clinical symptomes of Delirium
[m
Rapld psychiatric treatment of detoxification from opiates
S285
Ecstasy consumption in opiate addicts: Personality Ip.5.0141 disorders and severity of addiction
G.L. Conte, C. Taranto, G. Camardese, A. Buonamro, S. De Risio.
E. Gutierrez’, PA. S&z*, J.J. Femandez’, M.P. Gonzalez*, J. Babes*.
Department Italy
‘Mental Health Services of Asturias; 2Department of Psychiatry, Faculv of Medicine, University of Oviedo, Spain
of Psychiatry,
Catholic University of Sacred Heart, Rome,
The authors investigated the effectiveness of a rapid psychiatric protocol of detoxification from opiate in 100 heroin addicts. Preliminary results of 15 full cases (detoxification treatment and 6 month follow-up) are already available. The protocol develops in 7 days hospitalization, based on trazodone and naltrexone administration (trazodone was selected because of the adrenolytic side effect and the antidepressant efficacy), plus other symptomatic common therapy. Characteristic of the protocol is the invasive way (i.v.) of administration of drugs, part of a more general interest to the care of whole psychosomatic body of the patient. After recovery several and different psychosocial, psychiatric and psychodinamic treatments are offered by the same unit. Between the 15 full cases, 2 relapsed and eventually dropped out, 1 relapsed and was later reinstated in the protocol. References [1] Rawson R.A., Ling W.: Opioid addiction treatment modalities and some guidelines to their optimal use. J. of Psychoactive drugs, 23 (2): 1991, 15 1. [2] Fedeli S., Ferri EA., Fogari R.: Blockage of acute opiate withdrawal symptoms by Trazodone treatment. Boll. Chim. Farm. 1979, 118: 268.
m(
Quality of life, psychopathological status and drug use In a methadone maintenance treatment in Spain
J.J. Femandez-Miranda’, M.P GonzLlez2, PA. Saiz*, E. Gutierrez’, J. Babes*. ‘Mental Health Services OfAsturias; 2Department ofpsychiatv, Faculty of Medicine,
Univer,sity of Oviedo, Spain
To determine the relationship among psychopathological status, opiate dependence and quality of life in heroin addicts in a methadone maintenance treatment (MMT). Patients and Method: 50 heroin addicts undergoing MMT programme in Asturias (Spain) over a period of 4 years. Assessment: SF-36 Health Survey, Goldberg Anxiety/Depression Scales. Blood and urine analysis (for HIV and heroin and cocaine consumption monitoritation) were made. Results: Patients showed moderate quality of life levels. Mental domains were worse than physical ones [PF = 8 1.4 (SD 25.7); RP = 79.1 (SD 33.2); BP = 76.5 (SD 27.4); GH = 50.0 (SD 29.3); V = 43.8 (SD = 17.7); SF = 76.6 (SD 28.2); KE = 64.4 (SD 35.7); MH = 55.3 (20.5)]. In the 6 months prior to the 4-year follow-up, 37.8% had used heroin, 20% cocaine and 43.3% benzodiacepines. Heroin consumption was related with psychiatric comorbidity (p < .Ol), being HIV+ (p < .Ol) and using cocaine (p < .Ol). Low levels of quality of life were found in those HIV+ (p < .OOl), heroin users (p < ,001) and cocaine users (p < .05) users and those who had anxiety and/or depressive symptoms (p i .OOl). Conclusions: After 4 years in a MMT programme, patients had a moderate level of quality of life. Physical (HIV+) and psychiatric (anxiety and depression) comorbidity was related with lower quality of life and, also, with the use of heroin and other drugs. This group of patients needs more intensive and specific psychosocial support. Objectives:
References [I] Parrino MW. State methadone treatment guidelines. U S Department of Health and Human Services. Rockville, 1993. [2] Ware JE, Gandek B and the IQOLA Project Group. The SF-36 Health Survey: Development and use in mental health research. lot J Ment Health 1994; 23 (2): 49-73.
Objectives: The aim of this study is to establish the relationship between personality disorders (PD) and ecstasy consumption in a sample of opiate addicts and to determine the severity of addiction in such. Patients and Method: A sample of 135 patients [mean age 27.47 (5.85); 82.2% males] diagnosed as heroin dependent, and who requested treatment in a Detoxification Unit in Mieres (Asturias - Spain), between January and December 1997, were included. Inclusion criteria: Opiate dependence (DSM-IV), over 18 years of age, initiation/reinitiation treatment, informed consent. Exclusion criteria: Polyconsumers whose main drug was non-opiate, less than 18 years, presence of psychiatric disorder, lack of informed consent. Eualuation: International Personality Disorder Examination DSM-IV version (IPDE) (Loranger et al, 1994) and European version of Addiction Severity Index (EuropASI) (Kokkevi et al, 1995). Results: Lifetime prevalence of MDMA consumption was 43.7%, however, at the beginning of treatment only 10.4% of the total sample were actually consuming ecstasy. “Sometime” consumers of MDMASociodemographic and clinical data: 79.7% males, mean age = 24.64 (5.11) [mean age of “never’consumers = 29.67 (5.45), p = .OOO],mean age of first use of MDMA = 20.58 (4.89). Eighty three percent of consumers were single compared to 74.6% of “never” consumers (p = ,002) and living with their parents (64.4%), 72.9% had completed Spanish “primary” education (up to 14 years of age), mean age of first use of heroin = 18.20 (2.79) [versus 21.55 (5.31) in the “never” consumers, p = .OOO],57.6% had used intravenous route. Personality Disorders: The prevalence of different PD in the MDMA sample was 72.9% [mean number of PD = 1.373 (1.26)] and the most frequent PD was the antisocial type (33.4%) [no differences were found in terms of PD between “sometime” consumers and “never” consumers]. EuropASI: Higher scores were obtained in the drug area [mean score = 6.89 (0.78)] (no differences were found between “sometime” consumers and “never” consumers in the different areas of EuropASI). Conclusions: 1. There is a higher lifetime prevalence of ecstasy consumption between opiate addicts 2. The consumption of ecstasy in opiate addicts is more common in the younger age group 3. Ecstasy consumption in opiate addicts is no related to suffering from PD 4. Ecstasy consumption in opiate addicts is not related to a greater severity of addiction. References [l] De Jong CAJ, Van den Brink W, Harteveld FH et al (1993). Personality disorders in alcoholics and drug addicts. Comprehensive Psychiatry, 34 (2): 87-94. [2] Bobes J, Lorenzo P, S&z PA (1998). Extasis (MDMA): Un abordaje compreheosivo. Barcelona: Masson.
-1
Carbamaxepin in the treatment of the alcohol withdrawal syndrome
V Lazarova, M. Jakovcevska-KujundZiska, V Filovska. Psychiatric hospital Skopje, Macedonia
In the past, Carbamazepin was used mainly in the treatment of convulsive diseaeses. Now It is also used because of It’s psychotropic effect. Good results are succeed with the application of Carbamazepin in the treatment of the withdrawal syndromes. In this study we present our expiriences in the treatment of Alcohol withdrawal syndrome with Carbamazepin. Our research included a group of 35 patients, hospitalized in Psychiatric hospital Skopje, who manifested alcohol withdrawal without complications (They didn’t manifested clinical symptomes of Delirium