The Long‑Term Impact of a Holistic Inpatient Treatment Program for Substance use Disorders: 498 Patients Personally Revisited after 5‑10 Years
Substance use disorders (SUDs) affect multiple facets of human life, posing a wide array of challenges. The tolerance, craving, and withdrawal from psychoactive substances often lead to salience to substance‑taking behavior and neglect of other responsibilities and alternate pleasrable activities.[1] Around 8% of the Indian population require help for their alcohol use, and around 1% require help for their opioid and cannabis use problems.[2] Although the quantum of work for SUD is quite high, there is a treatment gap, of up to 90% as per a nationwide survey.[3] Another challenge is frequent lapse, as around 60% of patients lapsed within 1 to 6 months of the inpatient treatment.[4,5] Hence, there is a need to shift the treatment goal from complete abstinence to a more realistic recovery. Recovery is defined as ‘a voluntarily maintained lifestyle characterized by sobriety, personal health, and citizenship’.[6] With proper intervention, around half of the patients achieve lasting recovery.[7] Instead of an unidimensional approach, a holistic treatment incorporating biopsychosocial, spiritual, and alternative treatment modalities may help to attain the treatment goal more effectively.[8] This field is still evolving, and the effectiveness of the holistic treatment approach is not yet widely tudied. The preliminary evidence shows that a multimodal treatment approach can reduce premature treatment ending, increase treatment retention, and lead to an overall improved abstinence rate.[9] The majority of the studies incorporate a relatively short‑term follow‑up. These studies reveal that a persistent positive change in social functioning, family functioning and daily routine, as well as regular treatment adherence is associated with the persistent recovery and fewer relapses.[10‑14] The poor utilization of treatment, pessimistic view, and stigma are the main barriers to recovery.[15] The enduring effect of the holistic treatment approach may be appreciated over a longer time interval and in a larger population. This study aims to assess the current psychosocial and behavioral aspects of the patients with SUD who were ted using the multimodal treatment approach after an interval of around 5 to 10 years. This study will further help us understand the various challenges that patients with SUD face during their recovery.