A naturalistic longitudinal analysis of post-detoxification outcomes in opioid-dependent patients

Introduction and aims: To provide an assessment of outcomes in a cohort of opioid-dependent patients post-detoxification.

Design and methods: This study employed an observational longitudinal cohort design. Patients who completed detoxification in the three major Drug Dependency Units in Ireland during a 14-month period were included in the study (n = 143). Patients opting for one of the three pathways post-detoxification (inpatient aftercare, outpatient aftercare or no formal aftercare) were assessed in the final week of detoxification and followed up after 3, 6 and 9 months. The primary outcome was abstinence following detoxification.

Results: A Cox (adjusted) model indicated participants who opted for outpatient aftercare treatment lapsed/relapsed at a rate of 52% higher than the inpatient aftercare group (hazard ratio = 1.52, 95% confidence interval 0.75-3.08, P = 0.24). Moreover, time to lapse/relapse was considerably shorter for the no formal aftercare group (hazard ratio = 7.68, 95% confidence interval 4.30-13.73, P = 5.75 × 10^-12 ). Abstinence rates for outpatient aftercare and inpatient aftercare are about equal after 9 months.

Discussion and conclusion: Patients who opt for aftercare post-detoxification have significantly better outcomes at follow up when compared to no formal aftercare. In addition, patients' intention to attend aftercare affected their outcomes regardless of eventual treatment path.