Long-term Outcome of Treated Addiction in Saudi Arabia : Predictors of Relapse in 10-year Follow-up

الملخص EN

AIM : To evaluate the long-term outcome of male patients who had com-plated their first detoxification / rehabilitation programme in a specialized public sector facility in Saudi Arabia.

Design : A case-series determination of the re-hospitalized 10-year relapse rate in a random sample of the first seven-year admissions (1986 – 1993) followed by a case-control comparison between the relapsing versus the non-relapsing subgroups.

Setting : The 210-bedded Dammam Amal Hospital is exclusively devoted for the treatment of male substance-abusers.

The management programme consists of a one-month detoxification / rehabilitation protocol followed by a variable period of aftercare group and support therapy using Twelve-Step Facilitation.

Participants : A sample of 504 male subjects randomly drawn from the first 3,877 consecutive new admissions.

Findings : The overall relapse rate was 59.7 percent.

Ninety percent of re-lapses occurred within the first 42 months of discharge.

The mean interval between discharge and relapse was 17 months, the median - 8 months and the mode - 2 months.

The number of rehospitalizations per patient over ten years ranged from 1 to 18, the mean being 3.4 relapses.

Logistic regression identified nine variables conjointly predicting relapse with a sensitivity of 78 percent, specificity of 66, and overall accuracy rate of 73 percent.

These were: heroin dependence, nearby residence, criminal record, unemployment, divorce, longer duration of abuse, family history of addiction, severe psychosocial stressors, and being a student.

Conclusions : Three fifths of treated substance abusers relapsed despite their completing the provided detoxification / rehabilitation programme.

More extended and intensified pro-grammes might be needed for subjects at predictably higher risk for relapse.