Patterns of opioid use and treatment in a cohort of patients from the Anuradhapura district

Abstract

BackgroundOpioid dependence is a major mental health problem in Sri Lanka. Anuradhapura is a district with a significant prevalence of opioid (especially heroin) dependence. AimsTo describe the socio-demographic features, patterns of use and types of treatment adopted by persons abusing opioids presenting to psychiatry services in Anuradhapura, Sri Lanka. MethodsThis retrospective survey was conducted over three months using medical records of patients with opioid dependence who received treatment from psychiatry services in the government or private sector, in Anuradhapura. ResultsOf the participants using opioids, most (n=56, 96%), had co morbid substance use, with nicotine, cannabis, or alcohol. Patients spent a significant proportion of their income on substances. All the patients received pharmacological treatment for opioid withdrawal symptoms. The most distressing withdrawal symptoms were insomnia and body aches. During the three-month study period, 38 out of 58 patients (65%) had defaulted follow-up treatment. Most who dropped out had reported severe withdrawal symptoms on presentation and had a low level of education. Sixteen patients (27%) remained abstinent for the over 3 months. ConclusionsOpioid dependence is a significant problem presenting to psychiatry services in the Anuradhapura district. Similar to international findings, long-term engagement of patients in care-programs is a challenge. More effective alternative measures should be explored to help this group of patients.