Narcology and drug addiction. Some aspects of replacement therapy

Abstract

Introduction: Despite of the fact that patients join the Methadone program voluntarily and on their own initiative, often are facts of taking various substances (including narcotic, psychotropic, hypnotic, antiparkinsonian, antiepileptic drugs, etc.) and alcohol together with the already prescribed medication. This leads to hospitalization and re-hospitalization with the diagnosis of acute poisoning, which requires proper diagnosis and additional treatment in emergency, toxicology, intensive care or resuscitation departments and can be complicated in the form of the development of a new somatic pathology or exacerbation of a concomitant chronic disease.

Our study is important in terms of assessing (i) the frequency of acute poisoning of patients involved in the replacement treatment program, (ii) the type of xenobiotics, (iii) the delay of hospitalization and (iv) the rate of expenses incurred by the state.

Methods: Based on the Aims and Objectives the research process uses the methods of searching, collection, systematization, description, comparison and analysis. Public information (anonymized data) was requested from The National Health Agency and Center for Mental Health and Prevention of Addiction. The study included all the patients hospitalized with acute poisoning in 2017-2020. and who were on substitution therapy in 2019.

Results: 12,925 beneficiaries received substitution therapy under the state program "Treatment of drug addicts" in 2019. In Total 1,562 cases of hospitalization of 1,059 people were recorded during 2017-2020; government expenditures went up to 252 730.27 Georgian Lari Out of the 1562 cases, 993 were associated with alcohol intoxication, 267 with drugs and psychodyslexic drugs, 99 with the toxic effects of an unspecified substance, 72 intoxications with psychotropic substances. Duration of stay in hospital averaged 5.1 hours in outpatient cases, 2.8 hours in the day hospital and 37.6 hours in the hospital. As of to the frequency of hospitalizations in 2017-20 818 people from 1059 were hospitalized once due to acute intoxication; 143 persons twice, 46 three times; also, there was a case of 12 times hospitalization of one person in different years with the various (T51.9, T42.4, T42.6, T43.9) diagnosis.

Conclusion:

Based on the data obtained as a result of the study, it can be said with certainty that persons on substitution therapy under the state program "Treatment of patients suffering from drug addiction" are additionally receiving alcohol and xenobiotics. Further research should be initiated to determine the reason for the use of these substances and develop recommendations, the implementation of which will further reduce acute poisoning of patients involved in the substitution therapy program, complications of acute poisoning and, accordingly, additional payments from the state.