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Compulsivity and obsessionality in opioid addiction.

I Friedman1, R Dar, E Shilony

  • 1Department of Psychology, Tel Aviv University, Israel.

The Journal of Nervous and Mental Disease
|April 5, 2000
PubMed
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Opioid dependence shows high levels of compulsivity and obsessionality, similar to obsessive-compulsive disorder (OCD). Ritual importance impacts relapse, and many patients may meet OCD diagnostic criteria.

Area of Science:

  • Psychiatry
  • Addiction Medicine
  • Clinical Psychology

Background:

  • Opioid dependence is a complex condition characterized by compulsive drug seeking and use.
  • Ritualistic behaviors and obsessive-compulsive symptoms are frequently observed in substance use disorders.
  • Understanding the interplay between opioid use and obsessive-compulsive disorder (OCD) is crucial for effective treatment.

Purpose of the Study:

  • To assess the severity of compulsivity, obsessionality, and opioid-use rituals in individuals with opioid dependence.
  • To investigate the relationship between these factors and treatment outcomes (opioid lapses).
  • To estimate the prevalence of obsessive-compulsive disorder (OCD) symptoms within this population.

Main Methods:

  • Seventy-one individuals undergoing ambulatory treatment for opioid dependence were interviewed.

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  • Assessment included the importance of opioid-use rituals, compulsivity/obsessionality severity, and the number of obsessive-compulsive disorder (OCD) symptoms.
  • Statistical analyses examined correlations between ritual importance, compulsivity, obsessionality, and treatment lapses.

    • Main Results:

    • Compulsivity and obsessionality levels in opioid dependence were comparable to those in OCD and alcohol addiction.
    • The importance of opioid-use rituals was inversely related to opioid lapses during treatment.
    • A significant positive correlation was found between ritual importance and non-drug-related OCD symptoms.
    • An estimated 11.4% of the sample met diagnostic criteria for OCD, over four times the general population rate.

    Conclusions:

    • Opioid dependence shares significant phenomenological similarities with OCD and alcohol addiction, particularly regarding compulsivity and obsessionality.
    • Ritualistic behaviors in opioid dependence are linked to treatment outcomes, suggesting potential therapeutic targets.
    • The high estimated prevalence of OCD in opioid-dependent individuals underscores the need for integrated treatment approaches.