A real-world study on clinical predictors of relapse after hospitalized detoxification in a Chinese cohort with alcohol dependence.

BACKGROUND: The relapse rate of alcohol dependence (AD) after detoxification is high, but few studies have investigated the clinical predictors of relapse after hospitalized detoxification in real-world clinical practice, especially among Chinese patients. METHODS: This longitudinal cohort study followed up 122 AD patients who were discharged from January 1, 2016 to January 30, 2018 from their most recent hospitalization for detoxification. These patients were interviewed by telephone from May 20, 2017, to June 30, 2018, at least 6 months after discharge. During the interview, the relapse were assessed by using a revised Chinese version of the Alcohol Use Disorder Identification Test. Candidate predictors, such as therapeutic modalities during hospitalization and at discharge, medical history data related to alcohol use, and demographic information, were obtained from the medical records in the hospital information system. RESULTS: During the 6-24 months (with a median of 9 months) follow-up period, the relapse rate was 53.3%. Individuals with a college education level and those who had not been treated with the brief comprehensive cognitive-motivational-behavioural intervention (CCMBI) were more likely than their counterparts to relapse after hospitalized detoxification, and their adjusted HRs (95% CIs) were 1.85 (1.09, 3.16) and 2.00 (1.16, 3.46), respectively. The CCMBI use predicted a reduction in the relapse rate by approximately one-fifth. CONCLUSION: Undergoing the CCMBI during detoxification hospitalization and having less than a college-level education could predict a reduced risk of AD relapse. These findings provide useful information both for further clinical research and for real-world practice.

[Determinants of Drinking Relapse after Treatments in Patients with Alcohol Dependence in Sichuan Province].

OBJECTIVE: To identify factors that influent drinking relapse after treatments in patients with alcohol dependence in Sichuan province. METHODS: Data were collected in 10 cities of Sichuan province from September 2014 to June 2015,involving 599 patients who received treatments for alcohol dependence. A questionnaire survey was administered on these patients one year after discharge through face to face interviews,collecting data in relation to their demographic characteristics,drinking over the past year,smoking,mood and level of stress. Ordinal polytomous logistic regression analyses were performed to determine the association of these factors with drinking relapse. RESULTS: All of the 599 patients started drinking again after treatments: 18 having low-risk drinking,92 having hazardous drinking,103 having harmful drinking,and 386 having alcohol dependence. Younger patients [odds ratio (OR)=0.978,P=0.009],those who experienced less positive events (OR=0.978,P<0.001) or more negative events (OR=1.014,P=0.003),and those with depression (OR=1.121,P=0.001) were more likely to resume a higher level of alcohol drinking than their counterparts. CONCLUSION: High relapse with alcohol dependence is evident. So does hazardous and harmful drinking. Negative life events and depression are risk factors of drinking relapse,while older age and positive life events are protective factors.

Association of testosterone levels and heroin usage characteristics in male heroin users.

BACKGROUND: Previous studies have shown that heroin abuse can alter the gonadal functions. Few studies examined the association between testosterone levels and heroin use in the existing literature. We aimed to determine the association between gonadal hormones and heroin usage characteristics over 12 weeks of abstinence in heroin users. METHODS: We collected data on patient demographics and heroin use patterns for 65 men aged 18 to 45 and for 29 age-matched healthy controls. Serum levels of total testosterone, estradiol, and prolactin were assessed at 5 time points. RESULTS: Testosterone levels gradually increased and prolactin levels decreased in heroin users in this study. In heroin users, a significant positive correlation was observed between the way of using drug and the testosterone levels, the way of using drug and the estradiol levels, between the duration of heroin dependence and the testosterone levels, between the duration of heroin dependence and the estradiol levels on D0, and between relapse time and testosterone levels on D84. CONCLUSIONS: Our data reveal testosterone might promote injection drug use and repeated relapse in male heroin users.