Background
Cannabis use is common among opioid-dependent individuals, but little is known about cannabis withdrawal in this population.
Method
Thirty inpatients (57% men) completed the Marijuana Quit Questionnaire (MJQQ) after completing acute heroin detoxification treatment in St. Petersburg, Russia. The MJQQ collected data on motivations for quitting, withdrawal symptoms, and coping strategies used to help maintain abstinence during their most “userious” (self-defined) quit attempt made without formal treatment outside a controlled environment.
Results
At the start of their quit attempt, 70% of participants smoked cannabis at least weekly (40% daily), averaging [SD] 2.73 [1.95] joints daily; 60% were heroin-dependent. Subjects with heroin dependence were significantly older at the start of their quit attempt (22.9 [3.6] years vs. 19.1 [2.9] years), were significantly less likely to report withdrawal irritability/anger/aggression (22% vs. 58%), restlessness (0% vs. 25%), or physical symptoms (6% vs. 33%), or to meet diagnostic criteria for DSM-5 cannabis withdrawal syndrome (6% vs. 33%), and had shorter duration of abstinence (29.6 [28.7] months vs. 73.7 [44.1] months) than those without heroin dependence.
Conclusion
Cannabis users with opioid dependence are less likely to experience cannabis withdrawal, suggesting that opiate use may prevent or mask the experience of cannabis withdrawal. Results should be considered preliminary due to small convenience sample and retrospective data.
Background. There is evidence that sleep disorders may be significantly linked to the development of the substance use disorders (SUD). However, data about the prevalence of the sleep disturbances among patients with SUD in Russia are relatively limited.Aim. To evaluate the frequency of the sleep disturbances among patients (n = 196) with alcohol (ÀD, n = 102), opioid (ÎD, n = 55) and polysubstance dependence (PD, n = 39) seeking addiction medical care.Materials and methods. We conduct a cross-sectional study of sleep disturbances among patients in St. Petersburg in 2017–2018. The modified Insomnia Severity Index (ISI) was administered to assess sleep during different periods of time: lifetime, the past 12 months, and the past 30 days.Results. All groups demonstrated relatively high presence of different sleep disorders (range: 49.0–76.5% among 196). The sleep disturbances over the past 30 days were more common in the AD group (60.8– 73.5% among 102) with the early morning awakening as the most frequent complaint. In the PD group the prevalence of lifetime sleep disturbances was high (94.9–100.0% among 39), whereas insomnia disorders were relatively rare over the past 30 days. However, it was sleep disturbances over the past 30 days that were statistically significantly more often (p < 0,05) observed in the group of patients who actively consume narcotic substances (40.2–87.2%), compared with the group of patients in remission (0–16.7%).Conclusion. The results demonstrated the high prevalence of insomnia among patients with SUD and suggested that the remission have a positive effect on the symptoms of sleep disorders. Further studies of the association between sleep disturbances and SUD progression are needed.
Introduction
Sleep problems are common in patients with substance use disorders (SUD) and have been related to poor treatment outcomes. Little is known about the sleep characteristics in patients with opioid and alcohol use disorders after detoxification program.
Objectives
To compare sleep quantitative and qualitative characteristics between patients with opioid and alcohol use disorders.
Methods
This is a secondary data analysis of the longitudinal data from the observational study in St. Petersburg, Russia. The sample included 75 patients (22.7% female) who received detoxification treatment for alcohol (n=49) or opioid (n=26) withdrawal. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and underwent daily wrist actigrahy.
Results
Good internal consistency was demonstrated for self-report and actigraphy data (r
=-0,405, p<0,01). Sleep duration and sleep onset latency were not different between alcohol and opioid groups (5.7 vs. 6.1 hours; 74 vs. 65 minutes, respectively) based on self-report data. The majority of the patients (57-100%) had sleep complaints and low quality of sleep after detoxification completion (at baseline). In both groups, the mean PSQI score had a tendency to decrease, representing better sleep quality, over the 1-week following detoxification program completion (from 12 at baseline to 10 at 1-week in alcohol group; from 13 to 12 in opioid group,
p<0,001).
Conclusions
The findings show that sleep characteristics are similar in patients with different SUD and insomnia symptoms are prevalent after detoxification, suggesting the rationale for sleep assessment before hospital discharge. Despite the positive changes in sleep quality over 1-week abstinence, patients might benefit from the therapeutic sleep interventions.
Disclosure
This work was financially supported by a research grant from Russian Foundation for Basic Research, 18-013-00481.
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