Buprenorphine/naloxone maintenance for “poppy husk” dependence: A retrospective study

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; ). 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.

Nondisrupted, safety ensured, opioid substitution clinic in a COVID‐19 designated hospital of a resource‐limited state in India

“…Like most departments, psychiatry services too were affected. The opioid substitution (OS) clinic, a special care delivery service (see Tikka, Singh, Mamidipalli, Purushotham, & Suchandra, 2019 for details of clinic's setting and management procedures), which the department has been successfully providing for the last 6 years, was going to be the worst hit.…”