[Study on short-term therapeutic effect and its impact factors of stereotactic surgery for treating opiate users with opiate dependence in Sichuan].
OBJECTIVE
To investigate the common characteristics of the patients, relapse reasons of patients before and after surgery, evaluate the relapse rate and its impact factors, and therapeutic effect of patients accepted stereotactic surgery to treat opiate dependence in Sichuan.


METHODS
An investigation, using uniform questionnaires by face-to-face and telephone interview, and gaining data from medical records of patients, was conducted in Mar to Jun 2005, in Sichuan Province. 208 patients (total 212 patients participated in surgery) were invited to gather information about their common characteristics, drug-taking history and the surgery. Statistical methods including t-test, chi2 test and logistic regression were used to analyze the data.


RESULTS
(1) 181 male patients and 27 female patients participated in this study, and their mean age was (29.5 +/- 5.5) years. Most of the respondents were in Sichuan and some peripheral province, graduated from senior high school and over, and with various occupations. (2) All patients abused opiate before the surgery, and the average duration of drug-taking was (7.6 +/- 3.4) years. All patients were detoxified by unconstraint or compulsory abstinence before surgery, with mean drug abstinence of 13.9, but relapse occurred after each detoxification. (3) Suffering with no drugs and abstinence syndrome were the two main reasons of relapse before surgery. Compared with relapse before surgery, validating the effect of the surgery treating drug dependence and temptation by drug surroundings were the two main reasons of relapse after surgery. (4) The complication rate was 38.0% (79/208), no severe complications occurred in patients, and most of the complications disappeared or were healed before they were discharged from hospital. Relapse rate within 7 months after surgery was 22.1% (46/208). A significant decrease of relapse time, relapse dose, subjective feel on drugs and relapse euphoria appeared in patients who relapsed after surgery when compared with those before surgery. The univariate and multivariate analysis shows potential significant predictors of relapse rate after surgery to include education (OR = 3.259), operative time (OR = 2.451), social support (OR = 23.256) and doing simple work (OR = 3.328).


CONCLUSIONS
This investigation showed that the stereotactic surgery can eliminate psychological desire for drugs and abstinence syndrome among most of the patients. Satisfactorily short-term therapeutic effect and substantial decline in relapse rate as well as no severe complications were appeared in these patients. Relapse was greatly associated with education, operative time, neuropsychological factors, and social conditions of patients. Therefore, patients' family and the society should strengthen their care, comprehension as well as support, and create better living and working surroundings to facilitate the complete drug abstinence to occur in patients. average duration of drug-taking was (7.6 +/- 3.4) years. All patients were detoxified by unconstraint or compulsory abstinence before surgery, with mean drug abstinence of 13.9, but relapse occurred after each detoxification. (3) Suffering with no drugs and abstinence syndrome were the two main reasons of relapse before surgery. Compared with relapse before surgery, validating the effect of the surgery treating drug dependence and temptation by drug surroundings were the two main reasons of relapse after surgery. (4) The complication rate was 38.0% (79/208), no severe complications occurred in patients, and most of the complications disappeared or were healed before they were discharged from hospital. Relapse rate within 7 months after surgery was 22.1% (46/208). A significant decrease of relapse time, relapse dose, subjective feel on drugs and relapse euphoria appeared in patients who relapsed after surgery when compared with those before surgery. The univariate and multivariate analysis shows potential significant predictors of relapse rate after surgery to include education (OR = 3.259), operative time (OR = 2.451), social support (OR = 23.256) and doing simple work (OR = 3.328).


CONCLUSIONS
This investigation showed that the stereotactic surgery can eliminate psychological desire for drugs and abstinence syndrome among most of the patients. Satisfactorily short-term therapeutic effect and substantial decline in relapse rate as well as no severe complications were appeared in these patients. Relapse was greatly associated with education, operative time, neuropsycological factors, and social conditions of patients. Therefore, patients' family and the society should strengthen their care, comprehension as well as support, and create better living and working surroundings to facilitate the complete drug abstinence to occur in patients.
Zhang
Ben
B
West China School of Public Health, Sichuan University, Chengdu 610041, China.
Liao
Jing
J
Wang
Zheng-Rong
ZR
Chen
Yun
Y
Gu
Jian-wen
JW
Chen
Li-gang
LG
Fang
Jun
J
D000293:Adolescent; D000328:Adult; D002681:China; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000523:psychology / Q000601:surgery*; D012008:Recurrence; D013238:Stereotaxic Techniques; D011795:Surveys and Questionnaires; D016896:Treatment Outcome