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High numbers of patients lapse within one month of discharge

Most residential treatment rehab programmes will be abstinence based. However, some international studies have found that the majority of patients lapse within one month of discharge. A lapse is defined as a one-time return to addictive behaviour, and a relapse is defined as a return to an addictive lifestyle. A study conducted by The Department of Public Health and Primary Care in conjunction with local addiction services aimed to identify factors that were associated with early lapse or relapse.  

The study looked at patients who were admitted to a residential heroin detox facility. Within one week of discharge, 72 (66%) had lapsed and 64 (59%) had relapsed. Within one month these proportions had risen to 80% and 71% respectively. This supports the view that there is a critical period very shortly after discharge when patients are particularly susceptible to using opiates. This indicates the importance therefore of pre-discharge planning and prompt introduction of aftercare support during this high-risk period.

When analysing pre-treatment characteristics, earlier relapse was found to be significantly associated with a history of injecting, previous detoxification treatments and a history of imprisonment. Earlier relapse was significantly predicted by younger age, greater heroin use prior to treatment, history of injecting, and a failure to enter aftercare. Unexpectedly, those who were in a relationship with an opiate user had significantly delayed relapse. Those who completed the entire six-week inpatient treatment programme also had a significantly delayed relapse.

In order to reduce relapse and the associated increased risk of fatal overdose, services providing residential opiate detoxification should prepare people for admission, strive to retain them in treatment for the full admission period and actively support their entry into planned aftercare in order to improve outcome.

References

Smyth, B.P., Barry, J., Kennan, E., & Ducray, K. (2010). Lapse and Relapse Following Inpatient Treatment of Opiate Dependence. Department of Public Health and Primary Care.

Published by on 06/12/2020.

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