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Outcome of inpatient opiate detoxification treatment in immigrants as compared to native Germans

Published online by Cambridge University Press:  16 April 2020

M. Specka ,
A. Buchholz ,
T. Kuhlmann ,
C. Haasen  and
N. Scherbaum
M. Specka
Affiliation:
Addiction Research Group at the Department of Psychiatry and Psychotherapy, Rhine State Hospital Essen, University of Duisburg-Essen, Virchowstr. 174, 45147Essen, Germany
A. Buchholz
Affiliation:
Department for Psychology, Psychotherapy and Psychological Diagnostics, Institute of Psychology I, Westphalian Wilhelms-University Muenster, Schlossplatz, 2, 48149Muenster, Germany
T. Kuhlmann
Affiliation:
Association of Detoxification Units in North Rhine Westphalia, Hospital of Psychosomatic Medicine, Bergisch-Gladbach, Schlodderdicher Weg 23a, 51469Bergisch Gladbach, Germany
C. Haasen
Affiliation:
Department of Psychiatry, University Medical Center Eppendorf, Martinistraße, 52, 20246Hamburg, Germany
N. Scherbaum*
Affiliation:
Addiction Research Group at the Department of Psychiatry and Psychotherapy, Rhine State Hospital Essen, University of Duisburg-Essen, Virchowstr. 174, 45147Essen, Germany
*
*Corresponding author. E-mail address: [email protected] (N. Scherbaum).
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Abstract

Background

Immigration is a factor with effects on the course of substance abuse and treatment response, however there is little consistent data regarding outcome of inpatient opiate detoxification treatment in immigrants as compared to native patients.

Methods

Patient history and the success of current detoxification treatment were systematically documented in a multicenter study in Germany which included 10 psychiatric hospitals with specialized detoxification wards.

Results

Out of 893 patients, 240 (27%) had a migration history. We further analyzed the three main groups (German, n = 653; Turkish, n = 58; Russian origin, n = 103). There were significant differences between groups regarding sociodemographic data, drug history, treatment experience and success of current treatment. However, considering the younger age of patients with Russian origin, analysis of younger patients (< 31 years) detected only minor group differences. In multiple logistic regressions age and center showed statistically significant associations with all outcome variables (early dropout, achievement of drug-free urine screen, regular completion of detoxification treatment, and referral to further treatment), while (Russian) origin was associated only with premature termination of treatment.

Conclusion

Young men were the main problem group regardless of origin. Significant center effects raise doubts regarding results from monocenter research.

Keywords

Opiate addictionDetoxificationMigration
Type
Original article
Information
European Psychiatry , Volume 25 , Issue 4 , May 2010 , pp. 242 - 248
Copyright
Copyright © Elsevier Masson SAS 2010

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References

Aparicio, L.M., Doering, A., Mielck, A., Holle, R.the KORA Study Group. Unterschiede zwischen Aussiedlern und der übrigen deutschen Bevölke rung bezüglich Gesundheit, Gesundheitsversorgung und Gesundheitsver halten [Differences between Eastern European immigrants of German origin and the rest of the German population in health status, health care use and health behaviour]. Soz Praventivmed 2005; 50: 107–118.CrossRefGoogle Scholar
Backmund, M., Meyer, K., Eichenlaub, D., Schütz, C.G.Predictors for completing an inpatient withdrawal program among intravenous heroin users, methadone substituted and codeine substituted patients. Drug Alcohol Depend 2001; 64: 173–180.CrossRefGoogle Scholar
Baron-Epel, O., Kaplan, G.Self-reported health status of immigrants from the former Soviet Union in Israel. Isr Med Assoc J 2001; 3: 940–946.Google ScholarPubMed
Bätz, B.Praxis der Behandlung abhängigkeitskranker Migranten in der WKPP Warstein: Qualifizierter Drogenentzug [Treatment of immigrants with addictive disorders in Warstein State Hospital: Detoxification treatment of drug addicts]. In: Sucht und Migration-Konzepte und Praxis vor Ort erleben und erfahren-Fachtagung “on tour” – 26/27 June 2001. Forum Sucht 2002; 29: 71–79.Google Scholar
Bätz, B.Qualifizierte stationäre Akutbehandlung drogenabhängiger Migranten–erste Erfahrungen und Daten über ein neues bedarfsorientiertes Behandlungsangebot. [Qualified acute inpatient treatment of drug dependent immigrants – first experiences and data about a new need-oriented treatment supply]. BINAD-Info 1998; 12: 17–22.Google Scholar
Boos-Nünning, U, Siefen, RG, Kirkcaldy, B, Otyakmaz, BÖ, Surall, D.Migration und Sucht. Expertise im Auftrag des Bundesministeriums für Gesundheit [Migration and Addiction. Report on behalf of the German Federal Ministry of Health]. Schriftenreihe des Bundesministeriums für Gesundheit, Nomos, 2002.Google Scholar
Compton, W.M., Thomas, Y.F., Stinson, F.S., Grant, B.F.Prevalence, correlates, disability, and comorbidity of DSM-IV drug abuse and dependence in the United States: results from the national epidemiologic survey on alcohol and related conditions. Arch Gen Psychiatry 2007; 64: 566–576.CrossRefGoogle ScholarPubMed
Deutsche Gesellschaft für Suchtforschung und Therapie [German Society of Addiction Research and Treatment] (Hrsg.). Dokumentationsstandards [Standards of Documentation] III für die Evaluation der Behandlung von Abhängigen. Sucht 2001;47 (Suppl. 2):3–94.CrossRefGoogle Scholar
Gaenslen, OM. Migration und Sucht: Retrospektive Analyse von Behandlungsverläufen Opiatabhängiger an der psychiatrischen Universitätsklinik Tübingen [Migration and addiction: course of opiate addicts in inpatient treatment at the psychiatric department, University Hospital Tübingen]. Thesis at the Medical Faculty, University Tübingen, 2006.Google Scholar
German Drug Commissioner. Drug and Addiction Report 2007. Available at: http://www.bmg.bund.de/cln_040/nn_604820/SharedDocs/Download/DE/Themenschwerpunkte/Drogen-und-Sucht/DrogenSuchtbericht-2007,templateId=raw,property=publicationFile.pdf/DrogenSuchtbericht-2007.pdf.(Accessed April 23, 2008).Google Scholar
Gossop, M., Johns, A., Green, L.Opiate withdrawal: inpatient versus outpatient programmes and preferred versus random assignment to treatment. Br Med J 1986; 293: 103–104.CrossRefGoogle ScholarPubMed
Gruesser, S.M., Wolfling, K., Morsen, C.P., Albrecht, U., Heinz, A.Immigration-associated variables and substance dependence. J Stud Alcohol 2005; 66: 98–104.CrossRefGoogle Scholar
Haasen, C., Blätter, A., Gharaei, D., Toprak, M.A., Haferkorn, J., Reimer, J.Psychosocial aspects of opiate dependence among Turkish immigrants in Germany. J Ethn Subst Abuse 2004; 3: 1–10.CrossRefGoogle Scholar
Haasen, C., Demiralay, C., Reimer, J.Acculturation and mental distress among Russian and Iranian immigrants in Germany. Eur Psychiatry 2008; 23: 10–13.CrossRefGoogle Scholar
Haasen, C., Toprak, M.A., Yagdiran, O., Kleinemeier, E.Psychosoziale Aspekte der Sucht bei Migranten [Psyhosocial aspects of addictive disorders in immigrants]. Suchttherapie 2001; 2: 161–166.CrossRefGoogle Scholar
Haasen, C., Yagdiran, O., Toprak, M.A.Negative outcome factors for addicted migrants. Eur Addict Res 2001; 7: 202–204.CrossRefGoogle ScholarPubMed
Hasin, D.S., Stinson, F.S., Ogburn, E., Grant, B.F.Prevalence, correlates, disability, and comorbidity of DSM-IV alcohol abuse and dependence in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry 2007; 64: 830–842.CrossRefGoogle ScholarPubMed
Johnson, T.P., VanGeest, J.B., Cho, Y.I.Migration and substance use: evidence from the U.S. National Health Interview Survey. Subst Use Misuse 2002; 37: 941–972.CrossRefGoogle ScholarPubMed
Kuhlmann, T., Hasse, H.E., Sawalies, D.Qualified inpatient acute treatment of drug dependent patients in North Rhine Westfalia. Psychiatr Prax 1994; 21: 13–18.[Article in German]Google Scholar
Lawental, E.Ultra rapid opiate detoxification as compared to 30-day inpatient detoxification program-a retrospective follow-up study. J Subst Abuse Treat 2000; 11: 173–181.CrossRefGoogle ScholarPubMed
McCambrigde, J., Gossop, M., Bewsick, T., Best, D., Bearn, J., Rees, S.et al.In-patient detoxification procedures, treatment retention, and post-treatment opiate use: comparison of lofexidine + naloxone, lofexidine + placebo, and methadone. Drug Alcohol Depend 2007; 88: 91–95.CrossRefGoogle Scholar
Murphy, P.N., Bentall, R.P.Opiate withdrawal outcome: the predictive ability of admission measures of motivation, self-efficacy, and lifestyle stability. Subst Use Misuse 1997; 32: 1587–1597.CrossRefGoogle ScholarPubMed
Muennig, P., Fahs, M.Health status and hospital utilization of recent immigrants to New York City. Prev Med 2002; 35: 225–231.CrossRefGoogle ScholarPubMed
Prager-Andresen, A.Langzeittherapie für Alkohol- und Medikamentenabhängige aus den ehemaligen Ostblockstaaten- Ein Erfahrungsbericht [Long-term treatment for patients with addictive disorders from the former Eastern bloc. A report]. In: Sucht und Migration- Konzepte und Praxis vor Ort erleben und erfahren- Fachtagung “on tour” – 26/27 June 2001. Forum Sucht 2002; 29: 93–105.Google Scholar
Reed, L.J., Glasper, A., de Wet, C.J., Bearn, J., Gossop, M.Comparison of buprenorphine and methadone in the treatment of opiate withdrawal: possible advantages of buprenorphine for the treatment of opiate-benzodiazepine codependent patients?. J Clin Psychopharmacol 2007; 27: 188–192.CrossRefGoogle ScholarPubMed
Reimer, J., Lorenzen, J., Baetz, B., Fischer, B., Rehm, J., Backmund, M.et al.Injection drug use, multiple hepatitis virus infections, and migration: a German study. Subst Use Misuse 2007; 42: 1353–1365.CrossRefGoogle ScholarPubMed
San, L., Camí, J., Peri, J.M., Mata, R., Porta, M.Success and failure at inpatient heroin detoxification. Br J Addict 1989; 84: 81–87.CrossRefGoogle ScholarPubMed
Scherbaum, N., Heppekausen, K., Rist, F.Is premature termination of opiate detoxification due to intensive withdrawal or craving?. Fortschr Neurol Psychiatr 2004; 72: 14–20. [Article in German]Google ScholarPubMed
Singh, S.P., Croudace, T., Beck, A., Harrison, G.Perceived ethnicity and the risk of compulsory admission. Soc Psychiatry Psychiatr Epidemiol 1998; 33: 39–44.CrossRefGoogle ScholarPubMed
Smyth, B.P., Barry, J., Lane, A., Cotter, M., O’Neill, M., Quinn, C.et al.In-patient treatment of opiate dependence: medium-term follow-up outcomes. Br J Psychiatry 2005; 187: 360–365.CrossRefGoogle ScholarPubMed
Statistisches Bundesamt [Federal Office for Statistics]. Fachserie 1 Reihe 2.2. Bevölkerung und Erwerbstätigkeit. Bevölkerung mit Migrationshintergrund – Ergebnisse des Mikrozensus 2005. Wiesbaden, Statistisches Bundesamt 2007.Google Scholar
Strang, J., Marks, I., Dawe, S., Powell, J., Gossop, M., Richards, D.et al.Type of hospital setting and treatment outcome with heroin addicts: Results from a randomised trial. Br J Psychiatry 1997; 171: 335–339.CrossRefGoogle ScholarPubMed
Strang, J., McCambridge, J., Best, J., Beswick, T., Bearn, J., Rees, S.et al.Loss of tolerance and overdose mortality after inpatient opiate detoxification: follow up study. BMJ 2003; 326: 959–960.CrossRefGoogle ScholarPubMed
Wong, F.Y., Huang, Z.J., Thompson, E.E., DeLeon, J.M., Shah, M.S., Park, R.J.et al.Substance use among a sample of foreign- and U.S.-born southeast Asians in an urban setting. J Ethn Subst Abuse 2007; 6: 45–66.CrossRefGoogle Scholar
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