Reasons for leaving treatment among patients with opioid dependence: A 3-month prospective follow-up study

Virendra Vikram Singh, DM; Siddharth Sarkar, MD; Rakesh Kumar Chadda, MD; Ashwani Kumar Mishra, PhD; Anju Dhawan, MD

doi:10.5055/jom.2022.0739

Authors

Virendra Vikram Singh, DM https://orcid.org/0000-0002-9413-0855
Siddharth Sarkar, MD
Rakesh Kumar Chadda, MD
Ashwani Kumar Mishra, PhD
Anju Dhawan, MD

DOI:

https://doi.org/10.5055/jom.2022.0739

Keywords:

opioid dependence, reasons to leave treatment, buprenorphine, naltrexone

Abstract

Objective: This study aimed to ascertain the reasons why patients with opioid dependence leave treatment.

Design: Prospective follow-up observational study.

Setting: This study was carried out at a tertiary care substance use treatment facility in north India with both outpatient and inpatient services. The facility is a public-funded institution.

Participants: One hundred and twenty opioid-dependent male patients with age 18 years or more who were willing to provide a valid telephone number for follow-up and willing to consent for the study were included.

Main outcome measure(s): Enquiries were made using the Reasons to Leave Treatment Questionnaire (RLTQ) and an open-ended question about why the patient left treatment.

Results: As per the RLTQ, the most common reasons for patients with opioid dependence leaving treatment were in the domains of external influence, motivational inconsistencies, and problem severity. Logistic problem was another issue that was highlighted by the patients. On open-ended question, the most common reason for leaving treatment pertained to feeling that one has improved and does not need treatment. Baseline characteristics that predicted patients leaving treatment were not being prescribed buprenorphine at discharge, not being formally educated, and living alone or in a nuclear family.

Conclusion: Several factors may lead to patients with opioid dependence leaving treatment prematurely after receiving inpatient care. Addressing these reasons might help to better retain patients in treatment and improve their outcomes.

Author Biographies

Virendra Vikram Singh, DM

Assistant Professor, Army College of Medical Sciences, Delhi Cantt, New Delhi, India

Siddharth Sarkar, MD

Associate Professor, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India

Rakesh Kumar Chadda, MD

Professor and Chief, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India

Ashwani Kumar Mishra, PhD

Additional Professor, Biostatistics, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India

Anju Dhawan, MD

Professor, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India

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