The functional outcome and recovery of patients admitted to an intensive care unit following drug overdose: a follow-up study.

Patients who have overdosed on drugs commonly present to emergency departments, with only the most severe cases requiring intensive care unit (ICU) admission. Such patients typically survive hospitalisation. We studied their longer term functional outcomes and recovery patterns which have not been well described. All patients admitted to the 18-bed ICU of a university-affiliated teaching hospital following drug overdoses between 1 January 2004 and 31 December 2006 were identified. With ethical approval, we evaluated the functional outcome and recovery patterns of the surviving patients 31 months after presentation, by telephone or personal interview. These were recorded as Glasgow outcome score, Karnofsky performance index and present work status. During the three years studied, 43 patients were identified as being admitted to our ICU because of an overdose. The average age was 34 years, 72% were male and the mean APACHE II score was 16.7. Of these, 32 were discharged from hospital alive. Follow-up data was attained on all of them. At a median of 31 months follow-up, a further eight had died. Of the 24 surviving there were 13 unemployed, seven employed and four in custody. The median Glasgow outcome score of survivors was 4.5, their Karnofsky score 80. Admission to ICU for treatment of overdose is associated with a very high risk of death in both the short- and long-term. While excellent functional recovery is achievable, 16% of survivors were held in custody and 54% unemployed.This resource was contributed by The National Documentation Centre on Drug Use.

Addiction and Change: How Aaddictions Develop and Addicted People Recover

Contents: 1. Models of addiction and change 2. The process of human intentional behavior change 3. The well maintained addiction : an ending and a beginning 4. Exploring precontemplation, contemplation, and preparation stages of becoming addicted 5. Repeated and regular use : moving from preparation to action on the road to addiction 6. Precontemplation for recovery : cultivating seeds for change 7. The decision to change : moving from the contemplation to the preparation stage of recovery 8. Preparing for action : creating a plan 9. Taking action to change an addiction 10. The long haul : well-maintained recovery 11. Prevention : interfering with the process of becoming addicted 12. Designing interventions for recovery 13. Research on addiction and change. "The stages-of-change model has become widely known as a framework for conceptualizing recovery. Less well known are the processes that drive movement through the stages or how the stages apply to becoming addicted. From Carlo DiClemente, codeveloper of the Transtheoretical Model, this book offers a panoramic view of the entire continuum of addictive behavior change. Illuminated is the common path that individuals travel as they establish and reinforce new patterns of behavior, whether they are developing an addiction or struggling to free themselves from one, and regardless of the specific addictive behavior. Presenting cutting-edge research with significant clinical implications, the book addresses crucial questions of why, when, and how to intervene to bolster recovery in those already addicted and reach out effectively to people at risk. It is essential reading for clinicians, prevention specialists, and policymakers." [from Book Jacket]This resource was contributed by The National Documentation Centre on Drug Use.