Significance of comorbidity for the long-term course of opiate dependence
Uwe Verthein1, Peter Degkwitz, Christian Haasen
1Centre for Interdisciplinary Addiction Research of Hamburg University (CIAR), Hamburg, Germany. verthein@sozialwiss.uni-hamburg.de
Objective:
Studies on drug dependence show a high prevalence of comorbidity with additional mental disorders. Comorbidity patients also show more poly-substance use and other psychosocial problems. This study analyzed the importance of comorbidity for the long-term course of opiate dependence.
Method:
350 opiate-dependent patients were examined at yearly follow-ups over 4 years using the EuropASI for the assessment of drug-related problems and the CIDI for diagnostic of psychiatric disorders. 196 patients were reached at final follow up (56%).
Results:
Of the patients reached at final follow-up, 30% had severe, 29% mild and 41% no clinically relevant disorders at baseline. However, the linear relationship at baseline--the more severe the disorder, the greater the impairment through drug-related problems--was not present at final follow-up. The results show that lifetime diagnosis of mental disorder had no prognostic relevance for the long-term course of drug dependency.
Conclusion:
The assumption that opiate users with an additional mental disorder are more vulnerable in their course of addiction could not be confirmed.
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