Heroin addiction is a serious problem,but the psychological therapies as a treatment for addiction is still in its infancy in China.The aim of this study is to develop and evaluate the effects of an integrated psychological intervention (IPI) on the risk of relapse in a cohort of heroin addicts during 5 years of follow-up.In a prospective cluster-randomized controlled trial and follow-up from October 2003 to November 2009,129 heroin addicts (65 in the intervention group and 64 in the control group) were recruited from Wuhan Compulsive Rehabilitation Center.The intervention group (IG) received the IPI and regular education (RE) in the rehabilitation center,the control group (CG) received (RE) only.Follow-ups were conducted monthly in the first year and 4 times per year over the subsequent years after discharge for both groups.Sixteen sessions,over 8 weeks,of a manualized group intervention,emphasizing enhancing knowledge,confidence for abstinence,and coping skills training were implemented by experienced and trained interventionists in the rehabilitation center.Patients and their family in IG were offered psychoeducation and counseling as the follow-up intervention after release.Opioid urine test for every half a year.Five-year cumulative abstinence rate was 15.2% in IG,while nobody was abstinent in CG.Moreover,when adjusted for other predictors of relapse,the intervention decreased the odds of relapse into heroin use (OR=0.52,95% CI,0.29 to 0.68).In addition,unemployment (hazard ratio (HR) = 2.43,95% CI: 1.39 to 4.26),less family support (HR= 3.09,95% CI: 2.04 to 4.68) were significantly associated with risk of relapse after adjustment for confounders.This study provides evidence that the integrated psychological intervention results in significant and sustained effects on heroin relapse prevention.
CHEN Dingyan WANG Zengzhen HE Wulong CUI Yiwei LIANG Xunchang WANG Huaiji YANG Can YAN Yaqiong HE Qian SHI Qijia
Department of Epidemiology and Biostatistics,School of Public Health,Tongji Medical College,Huazhong Department of Epidemiology and Biostatistics,School of Public Health,Tongji Medical College,Huazhong Compulsory Residential Drug Abstinence Institution,Wuhan Public Security Bureau,Wuhan 430040,China Mental Health Center,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 4300 Department of Neurobiology,Tongji Medical College,Huazhong University of Science and Technology,Wuha Department of Epidemiology and Biostatistics,School of Public Health,Tongji Medical College,Huazhong Mental Health Center,People”s Hospital,Wuhan University,Wuhan 430060 Wuhan Hospital for Psychotherapy,Wuhan 430015,China