Standardisert avrusning ved blandingsmisbruk

• DOI: 10.4045/tidsskr.16.0308
• Publication Date: 2016-10-28T07:23:33Z
• Authors: Frode Dunsæd; Øistein Kristensen; John-Kåre Vederhus; Thomas Clausen; Magnhild Mjåvatn ...
• Keywords: Adult; Male; Patient Dropouts; Adolescent; Norway; Substance-Related Disorders; Valproic Acid; Middle Aged; Clonidine; Substance Withdrawal Syndrome; 3. Good health; Cohort Studies; Young Adult; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Adrenergic alpha-2 Receptor Agonists; Humans; Anticonvulsants; Female; Aged; Program Evaluation; Socioenvironmental Therapy

In recent decades the pattern of substance use among patients admitted for detoxification has changed from predominantly single-substance use to simultaneous multi-substance use. The evidence base for pharmacological treatment of polydrug users remains inadequate.A non-experimental cohort study was conducted with 284 polydrug users in the Detoxification Unit of Sørlandet Hospital in 2013. The therapeutic approach was standardised, and was based on social therapy and symptomatic treatment of withdrawal symptoms with valproate and clonidine as key medications.Three quarters of the patients were male and they had used more than three different substances on average. The average age was 39 years. In total, 75 % of patients completed the detoxification programme, and for 95 % detoxification occurred without complications. In 89 % of cases, the standard treatment protocol was followed. There was a weak but significant correlation between treatment discontinuation and the number of substances used (OR = 1.42, p < 0.05). In terms of complications, 1.1 % experienced delirium tremens, 1.1 % epileptic seizures and 1.4 % substance-induced psychosis. Transfer to a somatic ward was necessary for 2.1 % of patients, and to a psychiatric ward for 1.4 %.The completion rate in this study was considerably higher than in previous detoxification studies, and the complication rate was lower. In view of the good results observed and the high degree of standardised treatment, the regimen can be considered a safe treatment option for other detoxification units.