Past-year gambling behaviour among patients receiving opioid substitution treatment

Substance Abuse Treatment, Prevention, and Policy

Kaarlo Simojoki¹  Tuuli Lahti³  Hannu Alho²  Anne H Salonen²  Sari Castrén² 

[1] A-clinic Foundation, Maistraatinportti 2, 00240 Helsinki, Finland;University of Helsinki, Internal Medicine, Helsinki, Finland;Faculty of Social Sciences, Department of Behavioural Sciences and Philosophy, University of Turku, Turku, Finland

关键词: Substance abuse;    Methadone;    Buprenorphine-naloxone;    Opioid substitution treatment;    Gambling;   

Others  :  1131516
DOI  :  10.1186/1747-597X-10-4

 received in 2014-09-29, accepted in 2015-01-19,  发布年份 2015

【 摘 要 】

Background

Substance abuse and gambling problems are associated, however, studies on gambling problems among opioid substitution treatment (OST) patients are scarce. The aims of this study are to explore the association of gender, age, treatment medication and treatment program with gambling behaviour, including gambling participation and gambling problems, among OST patients.

Findings

All OST patients (n = 244) in three Finnish outpatient clinics were recruited in March - April 2014. The response rate was 64.3%. OST programs included two choices of orientation (rehabilitative/harm reduction) and two choices for treatment medication (methadone/buprenorphine-naloxone). Of 144 respondents, 70.1% had gambled during the past year and 12.5% were identified as potential past-year problem gamblers. Gambling was statistically significant more commonly among males (79.8%) compared with females (53.7%). Similarly patients in the rehabilitative program gambled (75.9%) more than those in the harm reduction program (50.0%). Gender, age, treatment medication or treatment program was not associated with past-year gambling problems.

Conclusions

Gambling participation of the OST patients seemed to be somewhat similar compared with the Finnish general population, but gambling problems were more common among OST patients. Gender and age may not be very strong indicators of risk while screening problem gamblers among OST patients. Institution of a problem gambling screening program is recommended, and additional intervention for gambling problems should be implemented for that need as a part of OST.

【 授权许可】

   
2015 Castrén et al.; licensee BioMed Central.

【 参考文献 】

• [1]American Psychiatric Association: Diagnostic and Statistical manual of mental Disorders, Fith Edition. Arlington, VA: American Psychiatric Association; 2013.
• [2]UNODC: World Drug Report United Nations Publication. Vienna, Austria: United Nation Office on Drug and Crime; 2013.
• [3]Williams RJ, Volberg RA, Stevens RMG: The population prevalence of problem gambling: Methodological Influences, Standardized Rates, Jurisdictional differences, and Worldwide Trends. 2012. [Report Prepared for the Ontario Problem Gambling Research Centre & Ontario Ministry of Health and Long Term Care]
• [4]Petry NM, Stinson FS, Grant BF: Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 2005, 66(5):564-74. PubMed: 15889941
• [5]Peles E, Schreiber S, Linzy S, Adelson M: Pathological gambling in Methadone Maintenance Clinics Where Gambling is Legal Versus Illegal. Am J Orthopsychiatry 2010, 80(3):311-6.
• [6]Hodgins DC, Stea JN, Grant JE: Gambling disorders. Lancet 2011, 378:1874-84.
• [7]Shaffer HJ, Martin R: Disordered gambling: etiology, trajectory, and clinical considerations. Annu Rev Clin Psychol 2011, 7:483-510.
• [8]Castrén S, Basnet S, Salonen AH, Pankakoski M, Ronkainen J-E, Alho H, Lahti T: Factors associated with disordered gambling in Finland. Subst Abuse Treat Prev Pol 2013, 8:24. BioMed Central Full Text
• [9]Carpentier PJ, Knapen LJM, van Gogh MT, Buitelaar JK, De Jong CAJ: Addiction in developmental perspective: Influence of conduct disorder severity, subtype, and attention-deficit hyperactivity disorder on problem severity with opioid dependence. J Addict Dis 2012, 31:45-59. doi:10.1080/10550887.2011.642756
• [10]Lieb M, Wittchen H-U, Palm U, Apelt SM, Siegert J, Soyka M: Psychiatric comorbidity in substitution treatment of opioid-dependent patients in primary care: Prevalence and impact of clinical features. Heroin Addiction and Related Clinical Problems 2010, 12:5-16.
• [11]Strain EC: Assessment and treatment of comorbid psychiatric disorders in opioid-dependent patients. Clin J Pain 2002, 18:14-27. doi:10.1097/00002508-200207001-00003
• [12]Lorains F, Colishaw S, Thomas SA: Prevalence of comorbid disorders in problem and pathological gambling: systematic reveiew and meta-analysis of population surveys. Addiction 2011, 106:490-8.
• [13]Cunningham-Williams RM, Cottler LB, Compton WM, Spitznagel EL, Ben-Addallah A: Problem Gambling and Comorbid Psychiatric and Substance Use Disorders Among Drug Users Recruited from Drug Treatment and Community Settings. J Gambl Stud 2000, 16(4):347-75.
• [14]Weinstock J, Blanco C, Petry NM: Health Correlates of Pathological Gambling in a Methadone Maintenance Clinic. Exp Clin Psychopharmacol 2006, 14(1):87-93.
• [15]Kauch O: Patterns of substance abuse among treatment-seeking pathological gamblers. J Subst Abuse Treat 2003, 25:263-70.
• [16]Ledgerwood DM, Downey KK: Relationship between problem gambling and substance use in a methadone maintenance population. Addict Behav 2002, 27:483-91.
• [17]Simojoki K: Improving maintenance treatment of opiate addiction: Clinical aspects. 2013. [Academic dissertation, University of Helsinki]
• [18]Gebauer L, LaBrie R, Shaffer HJ: Optimizing DSM-IV_TR Classification Accuracy: A Brief Biosocial Screen for Detecting Current Gambling Disorders Among Gamblers in the General Household Population. Can J Psychiatry 2010, 55(2):82-90.
• [19]Vorma H, Sokero P, Turtiainen S, Katila H: Opioidiriippuvuuden korvaushoito HYKS:n päihdepsykiatrian yksikössä 2003–2005. [Opioid substitution treatment in HUCH Psychiatric Unit for Drug Dependence in 2003–2005]. Suom Laakaril 2009, 64(2):1853-7.
• [20]Aalto M, Visapää J-P, Halme J, Fabritius C, Salaspuro M: Effectiveness of buprenorphine maintenance treatment as compared to a syringe exchange program among buprenorphine mis-using opioid-dependent patients. Nord J Psychiatry 2010, 65(3):238-43.
• [21]Turja T, Halme J, Mervola M, Jarvinen-Tassopoulous J, Ronkainen J-E: Suomalaisten rahapelaaminen 2011 [Finnish Gambling 2011]. Helsinki: National Institute for Health and Welfare (THL); 2012. Report 14
• [22]PGRTC, Problem Gambling Research and Treatment centre: Guideline for screening, assessment and treatment in problem gambling. Clayton: Monash University 2011. Productivity Commission. Gambling. Final report. Australia, Canberra. 2010.
• [23]El-Guebaly N, Mudry T, Zohar J, Tavares H, Potenza MN: Compulsive features in behavioural addictions: the case of pathological gambling. Addiction 2011, 107:1726-34.
• [24]Grant JE, Potenza MN, Weinstein A, Gorelick DA: Introduction to Behavioral Addiction. Am J Drug Alcohol Abuse 2010, 36(5):233-41. doi:10.3109/00952990.2010.491884
• [25]Stinchfield R, Kushner MG, Winters KC: Alcohol use and prior substance abuse treatment in relation to gambling problem severity and gambling treatment outcome. J Gambl Stud 2005, 21:273-97.
• [26]Duhig AM, Maciejewski PK, Desai RA, Krishnan-Sarin S, Potenza MN: Characteristics of adolescent past year gamblers and non-gamblers in relation to alcohol drinking. Addict Behav 2007, 32:80-9.
• [27]Potenza MN, Steinberg MA, Mc Laughlin SD, Wu R, Rousaville BJ, Krishnan-Sarin S, Gerge TP, O’Malley SS: Characteristics of tobacco-smoking problem gamblers calling help-line. Am J Addict 2004, 13:471-93.
• [28]Peles E, Schreiber S, Adelson M: Pathological Gambling and Obsessive Compulsive Disorder Among Methadone Maintenance Treatment Patients. J Addict Dis 2009, 28(3):199-207.
• [29]Vanyukov MM, Tarter RE, Kirillova GP, Kirisci L, Reynolds MD, Kreek MJ, Conway KP, Maher BS, Iacano WG, Bierut L, Neale MC, Clark DB, Ridenour TA: Common liability to addiction and “gateway hypothesis”: Theorethical, empirical and evolutionary perspective. Drug Alcohol Depend 2012, 123:5-17.
• [30]Grant JE, Chamberlain SR: Impulsive action and impulsive choice across substance and behavioural addictions: Cause or consequence? Addict Behav 2014, 39:1632-9.
• [31]Kim SW, Grant JE, Adson DE, Shin YC: Double-blind naltrexone and placebo comparison study in the treatment of pathological gambling. Biol Psychiatry 2001, 49:914-21.
• [32]Grant JE, Potenza MN, Hollander C, Cunningham-Williams R, Nurminen T, Smits G, et al.: Multicenter investigation of the opioid antagonist nalmefene in the treatment of pathological gambling. Am J Psychiatry 2006, 163:303-12.
• [33]Ma Y, Zaller ND, Green TC, Rich JD: Buprenorphine and Buprenorphine/Naloxone Diversion, Misuse, and Illicit Use: An International Review. Curr Drug Abuse Rev 2001, 4(1):28-41.
• [34]WHO: Guidelines for the psychosocially Assisted Pharmacological Treatment of Opioid Dependence. Geneva: World Health Organisation Press; 2009.