Effect of Cognitive Behavioural Interventions on the Quality of Life in Chinese Heroin-Dependent Individuals in Detoxification: A Randomised Controlled Trial.

Effect of cognitive behavioural interventions on the quality of life in Chinese heroin-dependent individuals in detoxification: a randomised controlled trial.

J Clin Nurs. 2013 Jul 12;
Zhuang SM, An SH, Zhao Y

To determine whether cognitive behavioural interventions would improve the quality of life in Chinese heroin addicts.Drug dependence is one of the most serious health problems in the world, representing a real menace to mental and somatic health. However, effects of cognitive behavioural interventions on quality of life in Chinese heroin addicts are unclear.This randomised controlled study was conducted at a Drug-withdrawal Rehabilitation Center in China.Following ethics approval and heroin addicts’ consent, 240 heroin addicts were randomly assigned to two groups. The experimental group (n = 120) received a six-month cognitive behavioural intervention comprising education intervention and behavioural intervention developed by the investigators. The control group (n = 120) received the hospital’s routine care. The effects of the interventions on patients’ quality of life were evaluated at baseline and six months and were compared. A Chinese version of Quality of Life in Drug Addiction Questionnaire was used in this study. Usefulness of the intervention and usual community services was evaluated at six months.The quality of life of participants with heroin addiction with physical and psychological disorders is poor. The experimental group showed a significant improvement in quality of life after nurse-managed cognitive behavioural intervention.The quality of life and the health status of Chinese heroin addicts were improved after they received a nurse-managed cognitive behavioural intervention.Appropriate nurse-managed cognitive behavioural intervention for heroin addicts can improve their quality of life and promote their health. It is important for clinical nurses to understand cognitive behavioural therapy, appraisal and coping to apply knowledge in practice when dealing with a client who has heroin addiction. HubMed – addiction


Subst Abus. 2013 July-September; 34(3): 321-322

HubMed – addiction

Topical Review on the Abuse and Misuse Potential of Tramadol and Tilidine in Germany.

Subst Abus. 2013 July-September; 34(3): 313-320
Radbruch L, Glaeske G, Grond S, Münchberg F, Scherbaum N, Storz E, Tholen K, Zagermann-Muncke P, Zieglgänsberger W, Hoffmann-Menzel H, Greve H, Cremer-Schaeffer P

ABSTRACT. Background: Tramadol and tilidine (in combination with naloxone) are used as weak opioid analgesics in Germany. Tramadol is not scheduled in the German Narcotic Drugs Act. Tilidine is scheduled, whereas Tilidine in fixed combinations with naloxone is exempt from some of the provisions of the Narcotic Drugs Act. Recent reports on misuse of both substances led to an evaluation of their potential for misuse, abuse, and dependency by the expert advisory committee established by the German Federal Government, resident at the Federal Institute for Drugs and Medical Devices. Methods: A subcommittee formulated key questions and identified available data sources for each of these questions. Additional information was solicited where necessary, including a survey among a panel of pharmacists, a survey in an addiction clinic, analysis of prescription patterns, and information from the boards of pharmacists of the federal states and the Federal Bureau of Criminal Investigation. Results: Analgesic efficiency in the treatment of acute and chronic pain has been proven for both tramadol and tilidine/naloxone. For tramadol, high evidence has been confirmed in systematic reviews, and tramadol is listed in national and international guidelines on acute and chronic pain management. Animal and human studies found a low potential for misuse, abuse, and dependency for both substances. Information from 2 tramadol safety databases allowed calculation of the incidence of abuse or dependency as 0.21 and 0.12 cases per million defined daily dosages (DDDs), with lower incidences in recent years. For tilidine/naloxone, the incidence was calculated as 0.43 cases per million DDDs for oral solution and 0.18 for slow-release tablets. In an online survey among German pharmacies as well as in the reports from state pharmacy boards, fraud attempts were repeated more frequently with tilidine/naloxone than with tramadol in the last 2 years. The Federal Bureau of Criminal Investigations reported prescription fraud only with tilidine/naloxone and predominantly in the region of Berlin. Dependency on tramadol or tilidine/naloxone is reported only rarely from addiction counseling centers. One third of the patients surveyed in an addiction clinic reported experiences with tramadol or tilidine/naloxone, but mostly with duration of less than 4 weeks and with a medical prescription based on a reasonable indication. Also, occasional illegal use of opioid analgesics as a substitute of heroin was reported. An evaluation of pooled data from statutory health insurance companies found 2.5% of persons receiving at least 1 prescription of tramadol or the combination of tilidine and naloxone in 2009 (1.6% with tramadol and 1.0% with tilidine/naloxone). High usage with more than 180 DDDs per year was found in 8.6% of patients treated with tramadol and 17.2% of patients with tilidine/naloxone. Conclusions: In conclusion, the subcommittee of the expert advisory committee found a low potential for misuse, abuse, and dependency for tramadol, and a low prevalence in clinical practice. Considerable less information is available for the combination of tilidine and naloxone. However, the cumulation of evidence indicated a higher risk of misuse, abuse, and dependency for tilidine/naloxone solution, but not for slow-release tablets. HubMed – addiction

Distress Tolerance and Perceived Barriers to Smoking Cessation.

Subst Abus. 2013 July-September; 34(3): 277-282
Kraemer KM, McLeish AC, Jeffries ER, Avallone KM, Luberto CM

ABSTRACT.  Background: The present study examined the role of emotional distress tolerance (DT) in predicting barriers to smoking cessation and number of quit attempts. Methods: The sample consisted of regular daily smokers (N = 126; 37 females; M age = 36.51, SD = 13.05) who completed self-report measures on affect and smoking. Results: After controlling for daily smoking rate and anxiety sensitivity, emotional DT significantly predicted internal barriers to cessation (6.9% unique variance) but not external or addiction-related barriers to cessation. Inconsistent with prediction, emotional DT did not significantly predict number of quit attempts. Conclusions: These results suggest that individuals who are low in emotional DT believe that quitting smoking will be difficult because it takes away an important affect regulation strategy, and there may be utility in targeting emotional DT in smoking cessation interventions. HubMed – addiction