Cognizance about Substance Abuse Disorder among Attendees of Opioid Substitution Therapy Clinic: A Study of Related Clinicosocial Factors.

Background: Persons with substance use disorders (SUDs) who do not recognize their substance use as problematic are less likely to perceive needing treatment and less motivated to seek help. The factors that contribute to cognizance among persons with SUDs are poorly understood. The identification of factors of cognizance and using this to tailor motivational enhancement strategies may be beneficial toward minimum relapse and prolonged drug-free existence.

Objectives: To identify the social and clinical factors which are at play with cognizance of SUD among subjects attending opioid substitution clinic.

Materials and methods: A cross-sectional study of subjects registered more than 3 months who attended opioid substitution therapy were included with a sample size of 62. Pretested questionnaire was used to elicit the information from consenting eligible persons. A translated validated version of Scale of Change Readiness and Treatment Eagerness Scale in Bengali was applied scoring subjects with high or low recognition of SUD.

Results: On regression modeling, predictors which had positive odds of having good cognizance were subjects with family support (adjusted odds ratio [AOR]: 9.4, confidence interval [CI]: 1.77-81.9) and those subjects who were continuing the present spell of therapy for less than a year (AOR 4.03, CI 1.1-19.7). Subjects who were declared clean at least once in their life time had a less chance of being cognizant of their problems. (AOR 0.13 CI 0.03-0.55). Model had an accuracy of 74% and area under the curve as 0.8.

Conclusion: Identifying the factors associated with increased or decreased cognizance can be used while counseling or predicting follow-up treatment for SUD subjects.