ABSTRACT
The objective of this study was to analyze the influence of the variables that predict cocaine abstinence on an outpatient program for the treatment of addiction to this substance. Participants were 80 patients (85% men and 15% women) selected at random from those receiving treatment at a Spanish health service outpatient unit. For detecting the predictor variables the authors carried out a chi-square automatic interaction detection (CHAID) analysis. Logistic regression analysis and discriminant analysis were performed to estimate the probability of abstinence according to/using the predictor variables detected by CHAID analysis. Abstinence rate after six months of treatment was 37.5%. The variable that best predicted abstinence was number of urine tests carried out over the course of treatment. The rest of the variables used did not have statistically significant influence. The mathematical model used correctly classified 80% of cases. A total of 31 tests were necessary for a probability of over 0.75 of being abstinent at six months. Regular screening for abstinence by means of objective tests helps to improve abstinence rates on cocaine-addiction treatment programs.
Subject(s)
Cocaine-Related Disorders/rehabilitation , Cocaine/urine , Substance Abuse Detection/methods , Adult , Ambulatory Care/methods , Chi-Square Distribution , Female , Humans , Logistic Models , Male , Models, Theoretical , Secondary Prevention , Spain , Time FactorsABSTRACT
La alta tasa de abandonos de los programas de tratamiento es uno de los problemas más graves en el ámbito de las drogodependencias. La identificación temprana de predictores de riesgo de abandono puede proporcionar información útil sobre las necesidades específicas de tratamiento de este tipo de pacientes. El objetivo de este estudio fue identificar predictores de la finalización prematura de un programa de tratamiento ambulatorio para adictos a la cocaína. El estudio se realizó en varias unidades asistenciales públicas de una ciudad española. Los participantes fueron 91 adictos a la cocaína admitidos para ser tratados de su adicción, evaluados mediante entrevista y varias medidas de autoinforme. Para identificar las variables predictivas se utilizó un análisis factorial, un análisis cluster y un análisis CHAID. Las variables que obtuvieron capacidad predictiva fueron las puntuaciones en el MAST, y las puntuaciones compuestas de alcohol y drogas del Europ ASI. Estas tres variables quedaron agrupadas en un mismo factoral que se denominó gravedad adictiva. El análisis predictivo mostró que este factor tenía una cierta capacidad de predicción del abandono, pero que no era totalmente determinante. Los resultados apuntan hacia la conveniencia de detectar en la admisión a los pacientes que pudieran requerir una mayor preparación motivacional, mayor control e intensidad en el tratamiento, o la prestación de intervenciones coadyuvantes (AU)
The high rate of dropout from treatment programs is one of the most serious problems in the field of drug dependence. Early identification of predictors of dropout risk can provide useful information on the specific treatment needs of these types of patient. The aim of this study was to identify predictors of premature cessation of an outpatient treatment program for cocaine addicts. The study was carried out at public healthcare units in a Spanish city. Participants were 91 cocaine addicts admitted for treatment for their addiction, assessed by means of interview and various self-report measures. For identifying predictive variables the researchers used a factor analysis, a cluster analysis and a CHAID analysis. The variables that obtained predictive capacity were the MAST scores and the combined alcohol and drugs scores on the Europ ASI. These three variables were grouped in a single factor which was called addictive severity. The predictive analysis showed that this factor had some degree of capacity for the prediction of dropout, but that it was not completely determinant. The results suggest the advantageousness of detecting at the admission stage those patients who might require more attention to their motivational aspects, greater treatment control and intensity, or the provision of complementary interventions (AU)
Subject(s)
Humans , Male , Female , Cocaine-Related Disorders/epidemiology , Risk Factors , Patient Dropouts/psychology , Codependency, Psychological , Factor Analysis, Statistical , Patient Dropouts/classification , Patient Dropouts/statistics & numerical data , Diagnostic and Statistical Manual of Mental Disorders , Surveys and Questionnaires , Substance Withdrawal Syndrome/diagnosis , Substance Withdrawal Syndrome/psychologyABSTRACT
En los últimos años los Centros de Drogodependencias y Adicciones tienen una nueva demanda de tratamiento, la de las personas con dependencia de la nicotina. En este artículo se presentan tres experiencias prácticas del trabajo que estamos realizando con fumadores en el Centro de Atención a las Drogodependencias de Zaragoza, en la Unidad de Drogodependencias y Adicciones de Córdoba y en la Unidad de Conductas Adictivas, Area 2, de Castellón. Los tratamientos los llevamos a cabo tanto en personas que son usuarias de dichos centros (personas con dependencia del alcohol, heroína, cocaína, marihuana, etc.), como con personas que son remitidas a dichos centros, o bien otras experiencias en donde acudimos a Centros de Atención Primaria para llevar en los mismos el tratamiento de los fumadores. Los tratamientos que estamos llevando a cabo se basan en protocolos de tratamiento eficaces, tenemos una importante demanda de tratamientos para dejar de fumar y los resultados son adecuados. Si sigue la tendencia actual, en los próximos años continuará incrementándose la demanda de este tipo de tratamiento (AU)
In the last years the Centers of Drug Abuse and Addictions in Spain have a new treatment demand, people with nicotine dependence. In this article three practical experiences are presented that are carrying out with smokers in the Centro de Atención a las Drogodependencias of Zaragoza, Unidad de Drogodependencias y Adicciones of Córdoba, and Unidad de Conductas Adictivas, Area 2, of Castellón, in Spain. The treatments was applied in patients of this centers (persons with alcohol dependence, heroine dependence, cocaine dependence, marijuana, etc.), like with people that are derived at our centers. In other cases we go to the Centers of Primary Care to apply in this centers the treatment to the patients smokers. The treatments that we are carrying out are based on effective treatment protocols. We have an important demand of treatments to stop smoke and the results are good. If it follows the current tendency, in the next years it will continue increasing the demand of this treatment type (AU)
