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Buprenorphine/naloxone maintenance for “poppy husk” dependence: A retrospective study
Author(s) -
Tikka Sai Krishna,
Singh Lokesh Kumar,
Mamidipalli Spoorthy Sai,
Purushotham Ashwathnarayan,
Suchandra K. Hari Hara
Publication year - 2019
Publication title -
asia‐pacific psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.654
H-Index - 21
eISSN - 1758-5872
pISSN - 1758-5864
DOI - 10.1111/appy.12358
Subject(s) - poppy , husk , medicine , retrospective cohort study , buprenorphine , (+) naloxone , cohort , opioid , biology , botany , receptor
Abstract Introduction Despite a significant number of patients dependent on “poppy husk” in India, they are poorly characterized. Moreover, scarce data is available with respect to their treatment. Methods A cohort of 148 patients with “poppy husk” dependence receiving substitution treatment with buprenorphine/naloxone were followed up for 4 years, using a retrospective chart‐based assessment. Baseline demographic and substance‐related characteristics were described. Retention rates (operationally redefined as “6 months of uninterrupted contact anytime during their visits”) over the next 4 years and their predictors were assessed. Results Mean age of onset of “poppy husk” use was found to be 27.51 years, and mean duration of dependence was 18.25 years. Mean amount of poppy husk consumed per month was 3.7 kg. Commonest reasons for initiating and quitting its use were enhancing work efficiency and lack of availability, respectively. Retention rates were 25%. Significant predictors of retention were age more than 40 years (OR = 2.295; 95%CI = 1.015‐5.19) and uninterrupted treatment duration for at least 1 month from first contact (for 1 month (OR = 5.625; 95%CI = 2.28‐13.89), for 3 months (OR = 10.96; 95%CI = 4.65‐25.85), and for 6 months (OR = 52.8; 95%CI:14.08‐197.98). Discussion Factors associated with occupation such as enhancing work efficiency and overcoming fatigue are related to use of “poppy husk.” While the amount of intake is considerably large among treatment seekers who are dependent on it, their dependence duration is longer and retention rates lower than those reported for patients with prescription and injectable opioid dependence. Specific strategies to tap patients less than 40 years and to target uninterrupted contact in initial phases of maintenance should be developed.