Trajectories of psychological distress during recovery from polysubstance use disorder

Abstract

Introduction

Polysubstance use is a prevalent substance use pattern with adverse effects on psychological distress and diminished treatment outcomes. Although polysubstance use often dominates clinical practice, the trajectories of substance use and psychological distress in the initial phase of treatment have been subject to few empirical investigations.

Material and Methods

141 patients initiating inpatient or outpatient treatment for substance use disorder were followed for 12 months, using multiple assessments. We assessed psychological distress and substance use at baseline and at 3-, 6-, and 12-month follow-up visits. We implemented an SMS tracker of substance use during follow-up to reduce the impact of missing data.

Results

Stable abstinence was associated with a lower baseline SCL-90-R score, as well as a more rapid symptomatic decline during the first 3 months of abstinence. Unstable abstinence was associated with higher GSI scores at baseline, but also with a significant drop in scores across the follow-up period. Relapse was associated with an initial drop in GSI scores, but a subsequent increase in GSI scores at later follow-ups.

Conclusions

Most participants had a rapid reduction of psychological distress during the first 3 months of abstinence. Elevated levels of psychological distress may indicate an increased risk of drug use or relapse and should be monitored carefully. Our findings highlight the importance of early screening for psychological distress in SUD treatment, and advocate the use of tentative diagnostic procedures in the early phase of treatment of PSUD.

Keywords:

• Polysubstance abuse
• psychological distress
• addiction
• substance use disorder
• Treatment
• Recovery
• SCL-90-R

Acknowledgements

We extend our sincere gratitude to the participants in our study and the staff of the participating clinical services, the KORFOR staff, and in particular, Thomas Solgård Svendsen, Anne-Lill Mjølhus Njaa, and Janne Aarstad, who collected all the initial and follow-up data.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The Western Norway Regional Health Authority, Strategic Initiative for Substance Use Research [912003], and the Department of Research and Education, Division of Psychiatry, Stavanger University Hospital funded this research.