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Heroin Addiction and Related Clinical Problems: 2017, 19, N4 (pages: 13 - 24)

Novel Approach to Predicting the Likelihood of Sustained Abstinence in Heroin Addicts Treated with Naltrexone and Naltrexone-Behavioural Therapy

Knežević Tasić J., Karleuša Valkanou M., Đukanović B., Banković D., and Janjić V.

Summary: Background: Factors determining heroin addiction treatment outcome have not been studied extensively, despite their practical and theoretical significance. It is uncertain whether we are able to predict the odds of sustained heroin abstinence, or to influence the factors that increase the likelihood of recovery. This study has aimed to identify factors that either individually or in synergy support sustained multiannual abstinence. Methods: In this translational, ambidirectional cohort study, we have evaluated two groups of heroin addicts that underwent the same therapeutic procedures but with different outcomes (133 abstainers and 56 relapsers), using a non-standardized questionnaire to study: a) the history of addiction, b) motivation for the treatment, c) parental attitudes and control, d) job satisfaction, e) social and emotional relationships, f) alternative satisfactions, g) use of other substances during treatment and h) treatment characteristics. The chi square analysis was used to determine specific significant factors that act individually. Binary logistic regression provided a mathematical model of the synergistic effects of significant factors. Results: The study found a new variable, an ‘abstinence marker', which was defined by the synergistic effect of the following factors: a) use of tramadol before treatment (p = 0.011), b) non-use of benzodiazepines (p = 0.001), c) length of naltrexone use (p <0.0005), d) non-use of cannabis (p = 0.002), e) non-compulsive exercise (p = 0.009), and f) employment and job satisfaction (p <0.0005) during recovery. Conclusions: This study reports a mathematical model that predicts multiannual sustained abstinence as an outcome of heroin addiction treatment.