Diagnosis And Classification Of Substance Use Disorders

1312 WordsApr 30, 20176 Pages
Overview This thesis describes Phase IV Randomised Clinical Trial performed with the objective of personalising treatment for patients receiving Suboxone® (Buprenorphine/Naloxone) for their Opioid Use Disorders (OUD). The trial is given an acronym of S.T.A.R.T standing for “Suboxone Treatment and Recovery Trial”. The trial attempts to study the impact of integrating therapeutic drug monitoring of Buprenorphine/Naloxone (BNX) with psychosocial concepts in patient management during the outpatient phase. S.T.A.R.T composes of several domains taking into account clinical intervention, and health economics and return on investment of treatment. This thesis details the components of the clinical commencing with an initial 4-week inpatient…show more content…
2. ‘Moderate’, being associated with the presence of at least 4-5 symptoms. 3. ‘Severe’, being associated with the presence of 6 or more symptoms. This alternation in the DSM-5 might contribute to extending treatment to patients diagnosed with SUD and not limit treatment to those with higher severity i.e. ‘Substance Dependence’ described under DSM-IV TR. In this context, identifying recovery and treatment outcomes i.e. what treatment is trying to achieve may contribute to strengthening the response to SUD. In fact, ‘recovery’ from SUD is a challenging concept to define, and limiting recovery to abstinence was described as a ‘false debate’ by Boardman and Slade (2008). A comprehensive understanding of what is expected from treatment has led to an operational definition of recovery to “voluntary abstinence” from substance use with psychiatric, psychological, social and spiritual health along with maintaining “good citizenship” [Betty Ford Consensus Panel, 2007]. It is important to note that maintaining and sustaining recovery outcomes are the most challenging. Patients who do not meet any of the diagnostic criteria, with the exception of “strong urge to use or craving” for at-least 3 months, are considered to be in early remission. If this period extends to 12 months, patients are considered in sustained remission. In this connection, it is important to identify the type and level of care the patient is receiving, i.e. whether the
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