Cargando…

A preliminary evaluation of N-acetylcysteine's effects on patient adherence to treatment for cocaine use disorder

INTRODUCTION: Cocaine use disorder (CUD) is a disabling disease associated with high rates of relapse and intense cravings. Patients with CUD struggle to adhere to treatment, which contributes to relapse and frequent readmissions to residential rehab (RR) facilities. Preliminary studies suggest that...

Descripción completa

Detalles Bibliográficos
Autores principales: Schechter, Jake, Brown, Geoffrey W., Janda, Maria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Association of Psychiatric Pharmacists 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9987261/
https://www.ncbi.nlm.nih.gov/pubmed/36891481
http://dx.doi.org/10.9740/mhc.2023.02.004
_version_ 1784901345540571136
author Schechter, Jake
Brown, Geoffrey W.
Janda, Maria
author_facet Schechter, Jake
Brown, Geoffrey W.
Janda, Maria
author_sort Schechter, Jake
collection PubMed
description INTRODUCTION: Cocaine use disorder (CUD) is a disabling disease associated with high rates of relapse and intense cravings. Patients with CUD struggle to adhere to treatment, which contributes to relapse and frequent readmissions to residential rehab (RR) facilities. Preliminary studies suggest that N-acetylcysteine (NAC) attenuates cocaine-induced neuroplasticity and, therefore, may assist with cocaine abstinence and adherence to treatment. METHODS: This retrospective cohort study obtained data from 20 RR facilities across Western New York. Eligible subjects were 18 or older, diagnosed with CUD, and were divided based on their exposure to 1200 mg NAC twice daily during RR. The primary outcome was treatment adherence measured by outpatient treatment attendance rates (OTA). Secondary outcomes included length of stay (LOS) in RR and craving severity on a 1 to 100 visual analog scale. RESULTS: One hundred eighty-eight (N = 188) patients were included in this investigation: NAC, n = 90; control, n = 98. NAC did not significantly impact OTA (% appointments attended), NAC 68%; control 69%, (P = .89) or craving severity NAC 34 ± 26; control 30 ± 27, (P = .38). Subjects treated with NAC had a significantly longer average LOS in RR compared with controls, NAC 86 ± 30; control 78 ± 26, (P = .04). DISCUSSION: In this study, NAC did not impact treatment adherence but was associated with a significantly longer LOS in RR for patients with CUD. Owing to limitations, these results may not be applicable to the general population. More rigorous studies examining NAC's impact on treatment adherence in CUD are warranted.
format Online
Article
Text
id pubmed-9987261
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher American Association of Psychiatric Pharmacists
record_format MEDLINE/PubMed
spelling pubmed-99872612023-03-07 A preliminary evaluation of N-acetylcysteine's effects on patient adherence to treatment for cocaine use disorder Schechter, Jake Brown, Geoffrey W. Janda, Maria Ment Health Clin Original Research INTRODUCTION: Cocaine use disorder (CUD) is a disabling disease associated with high rates of relapse and intense cravings. Patients with CUD struggle to adhere to treatment, which contributes to relapse and frequent readmissions to residential rehab (RR) facilities. Preliminary studies suggest that N-acetylcysteine (NAC) attenuates cocaine-induced neuroplasticity and, therefore, may assist with cocaine abstinence and adherence to treatment. METHODS: This retrospective cohort study obtained data from 20 RR facilities across Western New York. Eligible subjects were 18 or older, diagnosed with CUD, and were divided based on their exposure to 1200 mg NAC twice daily during RR. The primary outcome was treatment adherence measured by outpatient treatment attendance rates (OTA). Secondary outcomes included length of stay (LOS) in RR and craving severity on a 1 to 100 visual analog scale. RESULTS: One hundred eighty-eight (N = 188) patients were included in this investigation: NAC, n = 90; control, n = 98. NAC did not significantly impact OTA (% appointments attended), NAC 68%; control 69%, (P = .89) or craving severity NAC 34 ± 26; control 30 ± 27, (P = .38). Subjects treated with NAC had a significantly longer average LOS in RR compared with controls, NAC 86 ± 30; control 78 ± 26, (P = .04). DISCUSSION: In this study, NAC did not impact treatment adherence but was associated with a significantly longer LOS in RR for patients with CUD. Owing to limitations, these results may not be applicable to the general population. More rigorous studies examining NAC's impact on treatment adherence in CUD are warranted. American Association of Psychiatric Pharmacists 2023-03-03 /pmc/articles/PMC9987261/ /pubmed/36891481 http://dx.doi.org/10.9740/mhc.2023.02.004 Text en © 2023 AAPP. The Mental Health Clinician is a publication of the American Association of Psychiatric Pharmacists. https://creativecommons.org/licenses/by-nc/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License, which permits non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Schechter, Jake
Brown, Geoffrey W.
Janda, Maria
A preliminary evaluation of N-acetylcysteine's effects on patient adherence to treatment for cocaine use disorder
title A preliminary evaluation of N-acetylcysteine's effects on patient adherence to treatment for cocaine use disorder
title_full A preliminary evaluation of N-acetylcysteine's effects on patient adherence to treatment for cocaine use disorder
title_fullStr A preliminary evaluation of N-acetylcysteine's effects on patient adherence to treatment for cocaine use disorder
title_full_unstemmed A preliminary evaluation of N-acetylcysteine's effects on patient adherence to treatment for cocaine use disorder
title_short A preliminary evaluation of N-acetylcysteine's effects on patient adherence to treatment for cocaine use disorder
title_sort preliminary evaluation of n-acetylcysteine's effects on patient adherence to treatment for cocaine use disorder
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9987261/
https://www.ncbi.nlm.nih.gov/pubmed/36891481
http://dx.doi.org/10.9740/mhc.2023.02.004
work_keys_str_mv AT schechterjake apreliminaryevaluationofnacetylcysteineseffectsonpatientadherencetotreatmentforcocaineusedisorder
AT browngeoffreyw apreliminaryevaluationofnacetylcysteineseffectsonpatientadherencetotreatmentforcocaineusedisorder
AT jandamaria apreliminaryevaluationofnacetylcysteineseffectsonpatientadherencetotreatmentforcocaineusedisorder
AT schechterjake preliminaryevaluationofnacetylcysteineseffectsonpatientadherencetotreatmentforcocaineusedisorder
AT browngeoffreyw preliminaryevaluationofnacetylcysteineseffectsonpatientadherencetotreatmentforcocaineusedisorder
AT jandamaria preliminaryevaluationofnacetylcysteineseffectsonpatientadherencetotreatmentforcocaineusedisorder