Integrated Detoxification in Inpatient Substance Use Disorder Treatment: A Way to Prevent Dropouts and Overdoses

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Abstract
This study aimed to understand patients' experience of lapse in substance use in inpatient substance use disorder (SUD) treatment. By applying mixed methods design, the study could understand lapses and the influence detoxification treatment has on the potential severity of the lapse of using substances. Patients were recruited from an internal detoxification unit from an NGO in Norway. They answered a questionnaire (N = 46), with questions about background, lapses into substance use, craving to use substances, and psychological distress. Twelve patients were interviewed about lapses to substances and detoxification treatment. Lapses to substance use ranged from 1 to 10 days (M = 3.93), and the number of substances used ranged from one to seven (M = 2.48). During a lapse, seven (15.2%) patients had/unsure if they had one or more overdoses (ranging from one to five). Eight (17.4%) patients had lapses still unknown to the center. Some patients were scared by the power and danger of using substances. Almost 80% (n = 36) of the patients had high psychological distress, and some had high craving for substances. After a period of soberness, many perceived an increased struggle with mental health, and they tried to cope with it and decrease the pain by using substances. SUD treatment could reduce the severity of lapses to substance use. Quick access to detoxification and continuing treatment could be crucial, and a way to prevent dropout and overdoses.

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