February 23, 2018

Long-Term Recovery Increases Quality of Life

Receiving successful treatment for an alcohol and drug problem can result in steep increases in physical, psychological, and social well-being, according to the Research Society on Alcoholism.

Alcohol and other drug (AOD) treatment and recovery research typically focuses on outcomes such as 'days abstinent.' Yet the degree to which individuals may be functioning better physically, socially and psychologically, how happy they may be, and their levels of self-esteem may be equally important as measures of progress.

Little is known about whether such changes occur, when they may occur, and for whom, as people progress in recovery. This study sought to improve understanding of recovery milestones and points of vulnerability and growth.

Five Measures of Well-Being

Researchers analyzed a national, probability-based, cross-sectional sample of US adults who answered yes to the question "Did you used to have a problem with alcohol or drugs but no longer do?"

Of the original sample of 39,809, the final weighted sample responding positively was 2,002 (60% men, 40% women). Relationships between time in recovery and five measures of well-being quality of life, happiness, self-esteem, recovery capital, and psychological distress were examined for two temporal periods: the first 5 years, and the first 40 years, after resolving an AOD problem.

In general, recovery from AOD problems was associated with dynamic improvements in indices of well-being. This was the case during the first five-year span of time, with the exception of the first year, where self-esteem and happiness initially decreased before improving.

Steep Decline in Distress

Over the first six years, there were initially steep increases in indices of well-being as well as steep drops in distress followed by shallower increases later.

The authors noted that during early recovery, women, mixed race/Native American groups, and those suffering with opioid- and stimulant-related problems faced ongoing challenges in well-being that suggest a greater need for assistance.

Source: Kelly JF, et al "Beyond Abstinence: Changes in Indices of Quality of Life with Time in Recovery in a Nationally Representative Sample of U.S. Adults." Alcoholism: Clinical & Experimental Research Feb. 23, 2018.

Posted by Webmaster at 11:06 AM

February 10, 2018

Follow-Up Increases Naltrexone Compliance

Symptoms of alcoholism make it more difficult for some people to regularly take the prescription drug naltrexone, which could help treat their disease, a researcher at Oregon State University has found.

The finding helps researchers better understand how to intervene with patients to improve the effectiveness of the medication, said Sarah Dermody, an assistant professor in the School of Psychological Science in OSU's College of Liberal Arts.

"The assumption is the medication is prescribed, so it's going to work, but the patient has to take the medication in order for it to work," Dermody said. "This tells us we need to do more than write a prescription. Having some sort of reoccurring contact with the patient is really important."

The findings were published in the Annals of Behavioral Medicine.

Reduces the Desire to Drink

Dermody studies risky behaviors such as alcohol and nicotine use with the goal of better understanding factors that contribute to alcohol and nicotine use and how best to intervene with problematic use of these substances.

Naltrexone, which works at the receptor level in the brain to reduce a patient's desire to drink, is one of just three medications that is approved by the Food and Drug Administration to treat alcohol use disorder.

The drug is believed to be effective, but only if it is taken as prescribed. Studies show that adherence to the daily medication regimen is poor. The researchers' goal with the new study was to better understand medication usage and factors that influence it.

Adherence Decreases Over Time

They followed a group of 58 people who were prescribed to take naltrexone daily for eight weeks to either reduce or stop drinking. The researchers also studied the effectiveness of a mobile health intervention designed to help people adhere to the medication. In response to daily text messages, patients reported their previous day's alcohol use, cravings and any side effects from using naltrexone.

The researchers found that adherence to the drug decreased over time, with a drop from approximately eight in 10 patients taking the medication at week one to approximately four in 10 patients by week eight. On days when participants completed daily text message assessments, their odds of taking the medication increased by more than two-fold compared to days when the assessments were not completed.

They also found that they could predict who would stick with the medication and who wouldn't, and the factors that influence adherence to the drug included symptoms of the underlying disease. Patients were less likely to take their medication on days they after they drank heavily; on weekends; or when cravings were strong.

Avoidance When Needed Most

"Weekends are a huge part of people's drinking life. That is often when people drink more heavily and when their cravings are strongest," Dermody said. "But they also tend not to be taking naltrexone on the days when the medication is particularly needed."

More research is needed to understand how best to address symptoms that influence medication adherence, Dermody said. Promoting medication adherence after heavy drinking episodes or strong cravings is critical, Dermody said. Ongoing daily contact with the patient could also help.

"We found that some sort of daily contact with the patient is important. It does not have to be human to human," she said. "It could be a mobile phone app that tracks a patient's symptoms and tailors feedback to their needs."

Posted by Webmaster at 02:06 PM