Patient characteristics and expected needs: an opioid substitution programme findings

Background. – Opioid substitution represents a safe and effective therapy for treating opioid dependence. Psychiatric comorbidities affect the adherence to the substitution programme and the overall prognosis. This study aims to describe the sociodemographic, clinical and psychiatric characteristics attending a public opioid substitution programme at Agualva-Cacém, Portugal.

Methods. – We conducted a cross-sectional study involving 236 patients treated in the public opioid substitution programme of Agualva-Cacém, Portugal.

Results. – The patient's majority (83.1%) attended the opioid substitution programme for at least two years. The main sociodemographic characteristics were: 91.1% male, with an average age of 46.7 years, and 67.3% not married. About 2/3 of the population had nine years or less of education and history of legal problems in the past. Currently, 33.9% were unemployed, and 25.8% lived alone. Regarding the clinical outcomes we highlight: 1) very high prevalence of Hepatitis C (53%; n=125); 2) severe ongoing consumption of psychoactive drugs (cannabinoids, cocaine, heroin, alcohol) in the last 30 days (73.7%; n=174); 3) high rate of psychiatric symptoms such as depression (62.3%), anxiety (63.6%), irritability and anger (29.2%), and suicidal thoughts (8.0%); and 4) high percentage of dual diagnosis (36.9%).

Conclusions. – Our results suggest that this population has a low sociodemographic background and a high prevalence of infectious diseases and psychiatric symptoms. We identify as critical necessities having a multidisciplinary approach with a focus on infectious diseases and mental health, to enhance the treatment effectivity and overall prognosis.