Substance use and psychiatric outcomes following substance use disorder treatment: An 18‐month prospective cohort study in Chile.

Background and aims: Evidence from high‐income countries has linked duration and compliance with treatment for substance use disorders (SUDs) with reductions in substance use and improvements in mental health. Generalizing these findings to other regions like South America, where opioid and injectio...

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Published in:Addiction Vol. 120; no. 4; pp. 756 - 770
Main Authors: Bórquez, Ignacio, Krawczyk, Noa, Matthay, Ellicott C., Charris, Rafael, Dupré, Sofía, Mateo, Mariel, Carvacho, Pablo, Cerdá, Magdalena, Castillo‐Carniglia, Álvaro, Valenzuela, Eduardo
Format: research tables/charts Journal Article
Published: Wiley-Blackwell Apr2025
Online Access:View this record in EBSCOhost
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      dt: Apr2025
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      pub: Wiley-Blackwell
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        atl: Substance use and psychiatric outcomes following substance use disorder treatment: An 18‐month prospective cohort study in Chile.
      aug:
        au:
          Bórquez, Ignacio
          Krawczyk, Noa
          Matthay, Ellicott C.
          Charris, Rafael
          Dupré, Sofía
          Mateo, Mariel
          Carvacho, Pablo
          Cerdá, Magdalena
          Castillo‐Carniglia, Álvaro
          Valenzuela, Eduardo
        affil: Center for Opioid Epidemiology and Policy (COEP), Division of Epidemiology, Department of Population Health, New York University Grossman School of Medicine, New York NY,, USA
      sug:
        subj:
          Substance Use Disorders Therapy
          Treatment Duration
          Patient Compliance
          Substance Use Disorders Prevention and Control
          Mental Disorders Prevention and Control
          Human
          Male
          Female
          Adult
          Middle Age
          Chile
          Prospective Studies
          Surveys
          Probability
          Outpatients
          Inpatients
          Psychiatric Patients
          Depression Prevention and Control
          Panic Disorder Prevention and Control
          Anxiety Prevention and Control
          Stress Disorders, Post-Traumatic Prevention and Control
          Alcoholic Beverages
          Cannabis
          Cocaine
          Descriptive Statistics
          Confidence Intervals
          Odds Ratio
          Funding Source
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Background and aims: Evidence from high‐income countries has linked duration and compliance with treatment for substance use disorders (SUDs) with reductions in substance use and improvements in mental health. Generalizing these findings to other regions like South America, where opioid and injection drug use is uncommon, is not straightforward. We examined if length of time in treatment and compliance with treatment reduced subsequent substance use and presence of psychiatric comorbidities. Design: Prospective cohort analysis (3 assessments, 18 months) using inverse probability weighting to account for confounding and loss to follow‐up. Settings Outpatient/inpatient programs in Región Metropolitana, Chile. Participants: Individuals initiating publicly funded treatment (n = 399). Measurements Exposures included length of time in (0–3, 4–7, 8 + months, currently in) and compliance with treatment (not completed, completed, currently in) measured in the intermediate assessment (12 months). Primary outcomes were past‐month use of primary substance (most problematic) and current psychiatric comorbidities (major depressive episode, panic, anxiety or post‐traumatic stress disorders) measured 6 months later (18 months). Secondary outcomes included past month use of alcohol, cannabis, cocaine powder and cocaine paste. Findings 18.3% [95% confidence interval (CI) = 14.7%–22.6%] of individuals participated for 3 or fewer months in treatment and 50.1% (95% CI = 45.2%–55.1%) did not complete their treatment plan at 12 months. Participating for 8 + months in treatment was associated with lower risk of past month use of primary substance at 18 months [vs. 0–3 months, risk ratio (RR) = 0.62, 95% CI = 0.38–1.00] and completion of treatment (vs. not completed, RR = 0.49, 95% CI = 0.30–0.80). Neither participating 8 + months (vs. 0–3 months, RR = 0.83, 95% CI = 0.57–1.22) nor treatment completion (vs. not completed, RR = 1.02, 95% CI = 0.72–1.46) were associated with lower risk of psychiatric comorbidity at 18 months. Conclusions: Longer time in treatment and compliance with treatment for substance use disorders in Chile appears to be associated with lower risk of substance use but not current comorbid psychiatric conditions 18 months after treatment initiation.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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