Socio-Demographic, Clinical Correlates and Predictors of Adverse Outcome in Substance Use Disorder (Sud) Patients Attending the De-Addiction Clinic of a Tertiary Care Hospital in Eastern India

Abstract

Substance Use Disorder (SUD) is a serious public health problem in India. The present study was planned to study the socio-demographic, clinical correlates and predictors of adverse outcomes in all new patients attending the De-addiction clinic in a tertiary hospital in Eastern India. All new patients visiting the De-addiction clinic were assessed and interviewed. Four groups were made viz Alcohol, Opioid, Cannabinoid and Other SUDs. A total of 200 patients were included in the study, of whom majority were males. A positive family history of substance use was evident in 44.1% of the patients in the Cannabinoid group. The mean duration of use was 180.87 ± 95.64 for the alcohol group, 78.70 ± 66.41 for the opioid group, 94.0 ± 85.70 for the Cannabinoid group, 104.2 ± 79.37 for other SUDs. The most common substance used was alcohol (n=117). Our findings suggest that the initiation of substance use occurs during late teen age years and early 20s in case of Opioid and Cannabinoid group and in case of Alcohol group in their early 30s. In our study, poor social support correlated with family complications, marital complications and social complications. Motivation clearly and significantly correlated with financial, family, marital and social complications suggesting that motivation to leave alcohol/drugs is influenced by these factors. The motivation level influenced follow-up rates with poor to superficial motivation predicting poorer follow up rates. On the other hand good and fair motivation correlated with increased adherence to attending Group therapy. Motivation to leave drugs/alcohol correlated with drop-out & relapse rates with poorer outcomes in form of relapses and drop out related to poor motivation to leave drugs. Financial security in form of employment is critical for adherence to treatment and follow-up rates which in turn influences recovery and rehabilitation. Motivation is cornerstone to relapses and management of motivation enhancement and adherence to treatment can reduce relapses.