Patterns of opioid use and treatment in a cohort of patients from the Anuradhapura district

• Main Author: A. Ellepola
• Format: Article
• Language: English
• Published: Sri Lanka College of Psychiatrists 2019-12-01
• Series: Sri Lanka Journal of Psychiatry
• Subjects: heroin, tramadol, opioid, withdrawal symptoms, dependence
• Online Access: https://sljpsyc.sljol.info/articles/8218

<p><strong>Background</strong></p><p>Opioid dependence is a major mental health problem in Sri Lanka. Anuradhapura is a district with a significant prevalence of opioid (especially heroin) dependence.</p><p><strong> </strong></p><p><strong>Aims</strong></p><p>To describe the socio-demographic features, patterns of use and types of treatment adopted by persons abusing opioids presenting to psychiatry services in Anuradhapura, Sri Lanka.</p><p><strong> </strong></p><p><strong>Methods</strong></p><p>This retrospective survey was conducted over three months using medical records of patients with opioid dependence who received treatment from psychiatry services in the government or private sector, in Anuradhapura.</p><p><strong> </strong></p><p><strong>Results</strong></p><p>Of the participants using opioids, most (n=56, 96%), had co morbid substance use, with nicotine, cannabis, or alcohol. Patients spent a significant proportion of their income on substances. All the patients received pharmacological treatment for opioid withdrawal symptoms. The most distressing withdrawal symptoms were insomnia and body aches. During the three-month study period, 38 out of 58 patients (65%) had defaulted follow-up treatment. Most who dropped out had reported severe withdrawal symptoms on presentation and had a low level of education. Sixteen patients (27%) remained abstinent for the over 3 months.</p><p><strong> </strong></p><p><strong>Conclusions</strong></p>Opioid dependence is a significant problem presenting to psychiatry services in the Anuradhapura district. Similar to international findings, long-term engagement of patients in care-programs is a challenge. More effective alternative measures should be explored to help this group of patients.