The long-term impact of a holistic inpatient treatment program for substance use disorders: 498 patients personally revisited after 5-10 years

Abstract

Background: Holistic treatment often better impacts recovery from substance use disorder (SUD) in terms of treatment retention and psychosocial improvement. Studies on the long-term outcome of such treatment programs are needed from India. Materials and Methods: We traced and interviewed 498 patients face to face after 5–10 years from their last inpatient treatment with holistic approach in a rural addiction treatment center in Punjab. We used a semi-structured questionnaire for the assessment of various clinical, social, and behavioral parameters. Patients were asked about their experience during inpatient treatment and treatment modalities, and qualitative assessment was performed by content analysis. Results: The mean age of onset was 21.1 ± 7 years, and the mean duration of dependence was around 10 years. At the final assessment, 33% of the patients had relapsed, 32% were abstinent, 27% were abstinent with intermittent lapses, and the rest of them died. Intergroup comparison revealed that with respect to the relapsed group, abstinent patients had more regular follow-up (χ2 = 52.8, P < 0.001), physical exercise (χ2 = 50.5, P < 0.001), social interaction (χ2 = 11.4, P = 0.02), better marital relationship (χ2 = 202.5, P < 0.001), participation in household works (χ2 = 159.5, P < 0.001), and more favorable rating of the treatment center (χ2 = 70.4, P < 0.001). The majority of satisfied patients felt that overall good facility and service during inpatient treatment helped in their recovery. Conclusion: There was an overall improvement in psychosocial functioning in the abstinent patients after the holistic treatment. The positive changes are persistent after an interval of around 5 to 10 years. The inadequate treatment utilization of the relapsed group requires attention and redressal.