Long-term outcome of in-patients with substance use disorders: A study from North India

Research into substance use disorders (SUD) has been unable to unequivocally demonstrate effectiveness of treatment modalities. The aim of the study was to study the long-term outcome after in-patient treatment in a cohort of patients admitted for SUD in a deaddiction unit of a hospital in North India. The case notes of all in-patients with a primary diagnosis of alcohol and/or opioid dependence syndrome (F10.24 and F11.24) in the calendar year 2006 were examined. All patients without any physical or mental comorbidity other than comorbid SUD were included in the study. They were contacted telephonically or their case notes examined in September, 2007. Status regarding abstinence or relapse was determined and data was analyzed. Independent samples t-test and chi-square test were used for determining significance of difference between continuous and categorical variables respectively. Kaplan-Meier analysis was applied to find the survival times of different groups with the duration to relapse as variable of interest. Log rank test was applied to find the significance of differences in various groups. Cox's Regression analysis was applied to find the hazard ratio. Data for 59.22% of patients included in the study were available for analysis. Mean survival time was 36.35 weeks (28.74-43.95, 95% CI) for patients across different groups, 36.71 weeks (26.24-47.18, 95% CI) for the alcohol group, 34.00 weeks (8.37-59.36, 95% CI) for natural opioids group, 37.53 weeks (26.33-48.73, 95% CI) for semi/synthetic opioids group and 17.00 weeks (3.39-30.60, 95% CI) for the mixed group. Kaplan-Meier analysis revealed that those who were following-up at time of evaluation had significantly longer durations to relapse. Deaddiction services should stress on keeping patients on follow-up as a means to better outcomes.