Browsing by Author "Weich, Lize"
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- ItemThe effectiveness of a hospital-based intervention for patients with substance-use problems in the Western Cape(HMPG, 2012-06) Sorsdahl, Katherine; Stein, Dan J.; Weich, Lize; Fourie, David; Myers, BronwynENGLISH ABSTRACT: District hospitals regularly experience a high incidence of substanceuse disorders, but rarely provide interventions. We describe the effectiveness of an intervention developed and implemented by a Western Cape hospital. Patients with probable substance use were referred to an on-site social worker for an alcohol, smoking and substance involvement screening test (ASSIST), a brief motivational intervention and referral to specialist care. At the 3-month followup, the ASSIST was re-administered telephonically. An intervention was received by 127 patients. A significant reduction in substance use was reported in 92 patients who completed a 3-month followup evaluation (p<0.001). Of the 60 patients referred to further care, half entered treatment. We conclude that, with minimal resourcing, it is feasible to administer a brief substance-use intervention for patients attending district hospitals.
- ItemFrequency and correlates of co-morbid psychiatric illness in patients with heroin use disorder admitted to Stikland Opioid Detoxification Unit, South Africa(Health and Medical Publishing Group, 2014-08) Dannatt, Lisa Gwen; Weich, Lize; Cloete, Karen J.; Kidd, MartinBackground. There is a lack of studies addressing the frequency and correlates of co-morbidities among heroin users admitted for treatment in South Africa. Objective. To assess the frequency and correlates of psychiatric co-morbidity among patients with heroin use disorder admitted to the Opioid Detoxification Unit at Stikland Hospital, Western Cape, South Africa. Method. Participants (N = 141) were assessed for psychiatric illness (Mini International Neuropsychiatric Interview), co-morbid substance use disorders (World Health Organization’s Alcohol Smoking Substance Involvement Screening Tool), legal and social problems (Maudsley Addiction Profile). Demographic, personal, psychiatric and substance use history, in addition to mental state examination on admission, were collected from the case notes. Results. Most participants had never been abstinent from heroin (56; 40%), had been arrested for drug related activities (117; 83%), and had family conflicts related to use (135; 96%). Nicotine was the most common co-morbid substance of dependence (137; 97%) and methamphetamine was the most common co-morbid substance abused (73; 52%). The most common co-morbid psychiatric illness was previous substance induced psychosis (42; 30%) and current major depressive disorder (37; 26%). Current major depressive disorder was significantly associated with female gender (p = 0.03), intravenous drug use (p = 0.03), alcohol use (p = 0.02), and a higher number of previous rehabilitation attempts (p = 0.008). Conclusion. Patients with heroin use disorders present with high rates of psychiatric co-morbidities that underscore the need for substance treatment services with the capacity to diagnose and manage these co-morbidities.
- ItemMedical management of opioid dependence in South Africa(Health and Medical Publishing Group (HMPG), 2008) Weich, Lize; Perkel, Charles; Van Zyl, Nicolette; Rataemane, S. T.; Naidoo, LochanMedical practitioners in South Africa are increasingly confronted with requests to treat patients with opioid use disorders. Many do not possess the required knowledge and skills to deal with these patients effectively. This overview of the medical treatment of opioid dependence was compiled by an elected working group of doctors working in the field of substance dependence. Recommendations are based on current best practice derived from scientific evidence and consensus of the working group, but should never replace individual clinical judgement.
- ItemMethamphetamine-induced psychosis : clinical features, treatment modalities and outcomes(AOSIS Publishing, 2016) Thomas, Eileen; Lategan, Helena; Verster, Chris; Kidd, Martin; Weich, LizeObjective: To investigate the clinical features, prescribing patterns and outcomes of psychiatric inpatients admitted with methamphetamine-induced psychosis. Method: A cross-sectional, descriptive pilot study was conducted between March 2014 and August 2014 at three South African Mental Health Care Act designated hospitals prior to admission to a psychiatric hospital. Patients with methamphetamine-related psychotic symptoms according to the DSM-5 criteria were eligible. Structured face-to-face interviews were conducted and the Brief Psychiatric Rating Scale was employed as a measure of current psychopathology. Results: Fifty-six participants were included. Positive psychotic symptoms (e.g. hallucinations) were more prominent than negative symptoms (e.g. affective blunting). Almost half the participants (43%) had previous episodes of methamphetamine-induced psychosis. Within this group, all had defaulted on the prescribed treatment prior to admission. Only 29% of the participants had received prior formal substance-use rehabilitation as treatment for their disorder. High rates of comorbid cannabis and alcohol use (51%) were recorded. Most of the participants required transfer to specialist psychiatric hospitals. The amounts of methamphetamine used were not a predictor of the persistence of psychosis; however, the pattern of use was. Conclusion: Clinical features correspond with other international findings. The currently employed model of sequential, non-integrated psychiatric and substance use treatment in this setting appears ineffective.
- ItemOutcomes of adult heroin users v. abstinent users four years after presenting for heroin detoxification treatment(AOSIS Publishing, 2014-08) Khan, Zureida; Cloete, Karen Jacqueline; Harvey, Justin; Weich, LizeBackground. There are no studies in South Africa (SA) on the outcomes following detoxification and psychosocial rehabilitation of heroindependent patients. Objective. To compare the demographic, clinical, forensic and treatment data of active heroin users v. users who were abstinent at the time of interview 4 years after attending the Opioid Detoxification Unit at Stikland Hospital in the Western Cape Province, SA. Method. Participants included patients above the age of 16 years who had been admitted to the Opioid Detoxification Unit at Stikland Hospital for heroin detoxification between July 2006 and June 2007. Participants were individually interviewed (either in person or telephonically) using a structured self-report questionnaire to collect demographic, clinical, forensic and treatment data 4 years following heroin detoxification treatment at this unit. Results. Of the participants, 60% were abstinent and a large portion (34%) attributed this to social support. Furthermore, there was a significant (p=0.04) difference in the longest period of abstinence between the past user group and active users, with more participants in the past user group being abstinent for 18 months or longer (n=24, 57%) than in the active users group (n=8, 29%). Active users (n=18, 64%) had significantly (p=0.03) more legal problems than abstinent users (n=14, 33%). Most participants (n=38, 54%) relapsed within 3 months after index detoxification and rehabilitation. Conclusion. Active users had more legal problems than abstinent users, with social support structures playing a pivotal role in abstinence. Future research should assess the impact of interventions such as post-discharge social support programmes on criminality and heroin use in those that relapse following treatment.