Developing substance misuse services in United Arab Emirates: the National Rehabilitation Centre experience

Ghaferi, Hamad Al; Ali, Ahmed Yousif; Gawad, Tarek; Wanigaratne, Shamil

doi:10.1192/s2056474000002105

Cited by 13 publications

(9 citation statements)

References 11 publications

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“…The United Nations World Drug Report 2019 suggests that the use of drugs is significant in the Middle East ( wdr.unodc.org ). Although the National Rehabilitation Centre in Abu Dhabi City is available for substance use disorders in the region, 12 it is located far from Al Ain Hospital, explaining the number of cases admitted locally. Many expatriates originate from countries affected by political unrest, poverty, ethnic/racial discrimination and military conflicts.…”

Section: Discussionmentioning

confidence: 99%

Pattern of psychiatric in-patient admissions in Al Ain, United Arab Emirates

et al. 2020

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An understanding of the current state of mental health services in the United Arab Emirates (UAE) from a clinical perspective is an important step in advising government and stakeholders on addressing the mental health needs of the fast-growing population. We conducted a retrospective study of data on all patients admitted to a regional psychiatric in-patient unit between June 2012 and May 2015. More Emiratis (UAE nationals) were admitted compared with expatriates. Emiratis were diagnosed more frequently with substance use disorders and expatriates with stress-related conditions. Psychotic and bipolar disorders were the most common causes for admission and had the longest in-patient stays; advancing age was associated with longer duration of in-patient stay.

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Section: Discussionmentioning

confidence: 99%

Pattern of psychiatric in-patient admissions in Al Ain, United Arab Emirates

et al. 2020

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“…This pattern of prescription opioid use in the young (below the age of 30 years old) users from the UAE was recently described in Alblooshi et al (2016) [12]. The use of prescription opioids such as Tramadol rose by an estimated 67.2% in users below 30 years of age [12,13]. This cohort was used in this study.…”

Section: Introductionmentioning

confidence: 67%

Stratified analyses of genome wide association study data reveal haplotypes for a candidate gene on chromosome 2 (KIAA1211L) is associated with opioid use in patients of Arabian descent

et al. 2020

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Background: Genome Wide Association Studies (GWAS) have been conducted to identify genes and pathways involved in development of opioid use disorder. This study extends the first GWAS of substance use disorder (SUD) patients from the United Arab Emirates (UAE) by stratifying the study group based on opioid use, which is the most common substance of use in this cohort. Methods: The GWAS cohort consisted of 512 (262 case, 250 controls) male participants from the UAE. The samples were genotyped using the Illumina Omni5 Exome system. Data was stratified according to opioid use using PLINK. Haplotype analysis was conducted using Haploview 4.2. Results: Two main associations were identified in this study. Firstly, two SNPs on chromosome 7 were associated with opioid use disorder, rs118129027 (p-value = 1.23 × 10 − 8) and rs74477937 (p-value = 1.48 × 10 − 8). This has been reported in Alblooshi et al. (Am J Med Genet B Neuropsychiatr Genet 180(1):68-79, 2019). Secondly, haplotypes on chromosome 2 which mapped to the KIAA1211L locus were identified in association with opioid use. Five SNPs in high linkage disequilibrium (LD) (rs2280142, rs6542837, rs12712037, rs10175560, rs11900524) were arranged into haplotypes. Two haplotypes GAGCG and AGTTA were associated with opioid use disorders (p-value 3.26 × 10 − 8 and 7.16 × 10 − 7 , respectively). Conclusion: This is the first GWAS to identify candidate genes associated with opioid use disorder in participants from the UAE. The lack of other genetic data of Arabian descent opioid use patients has hindered replication of the findings. Nevertheless, the outcomes implicate new pathways in opioid use disorder that requires further research to assess the role of the identified genes in the development of opioid use disorder.

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“…The study took longer to complete than we envisaged because of a lower rate of recruitment. During the recruitment phase there was a reduction in opioid use in the UAE and an increase in amphetamine‐type stimulant use [30]. This may have reduced OUD treatment demand.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of incentivised adherence and abstinence monitoring in buprenorphine maintenance: a pragmatic, randomised controlled trial

et al. 2021

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Background and Aim Buprenorphine (BUP) maintenance treatment for opioid use disorder (OUD) begins with supervised daily dosing. We estimated the clinical effectiveness of a novel incentivised medication adherence and abstinence monitoring protocol in BUP maintenance to enable contingent access to increasing take-home medication supplies.Design Two-arm, single-centre, pragmatic, randomised controlled trial of outpatient BUP maintenance, with during-treatment follow-ups at 4 weeks, 8 weeks, 12 weeks and 16 weeks. Setting Inpatient and outpatient addictions treatment centre in the United Arab Emirates. Participants Adults with OUD, voluntarily seeking treatment. Interventions The experimental condition was 16 weeks BUP maintenance with incentivised adherence and abstinence monitoring (I-AAM) giving contingent access to 7-day, then 14-day, then 21-day and 28-day medication supply. The control, treatment-as-usual (TAU) was 16 weeks BUP maintenance, with contingent access to 7-day then 14-day supply.Measurements The primary outcome was number of negative urine drug screens (UDS) for opioids, with non-attendance or otherwise missed UDS, imputed as positive for opioids. The secondary outcome was retention in treatment (continuous enrolment to the 16-week endpoint). Findings Of 182 patients screened, 171 were enrolled and 141 were randomly assigned to I-AAM (70 [49.6%]) and to TAU (71 [50.4%]. Follow-up rates at 4 weeks, 8 weeks, 12 weeks and 16 weeks were 91.4%, 85.7%, 71.0%, 60.0% respectively in I-AAM and 84.5%, 83.1%, 69.0%, 56.3% in TAU. By intention-to-treat, the absolute difference in percentage negative UDS for opioids was 76.7% (SD = 25.0%) in I-AAM versus 63.5% (SD = 34.7%) in TAU (mean difference = 13.3%; 95% CI = 3.2%-23.3%; Cohen's d = 0.44; 95% CI = 0.10-0.87). In I-AAM, 40 participants (57.1%) were retained versus 33 (46.4%) in TAU (odds ratio = 1.54; 95% CI = 0.79-2.98). Conclusions Buprenorphine maintenance with incentivised therapeutic drug monitoring to enable contingent access to increasing take-home medication supplies increased abstinence from opioids compared with buprenorphine maintenance treatment-as-usual, but it did not appear to increase treatment retention.

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Developing substance misuse services in United Arab Emirates: the National Rehabilitation Centre experience

Cited by 13 publications

References 11 publications

Pattern of psychiatric in-patient admissions in Al Ain, United Arab Emirates

Pattern of psychiatric in-patient admissions in Al Ain, United Arab Emirates

Stratified analyses of genome wide association study data reveal haplotypes for a candidate gene on chromosome 2 (KIAA1211L) is associated with opioid use in patients of Arabian descent

Effectiveness of incentivised adherence and abstinence monitoring in buprenorphine maintenance: a pragmatic, randomised controlled trial

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