Assessment of the efficacy of an integrated rehabilitation program in relapse prevention among opioid use disorder patients in psychiatry and neurology center, Tanta university
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Background
Relapse remains a major challenge in substance use disorder (SUD) Cognitive-behavioral therapy (CBT) and mindfulness-based cognitive therapy (MBCT) are effective in reducing relapse and improving quality of life (QoL) for individuals with SUD. This study aimed to develop, culturally adapt, and evaluate the feasibility and preliminary efficacy of an integrated psychotherapeutic program for individuals with opioid use disorder (OUD) in Egypt, and to identify predictors of relapse.
Methods
A quasi-experimental study was conducted to compare the effectiveness of either an integrated intervention combining CBT-based relapse prevention, MI, MBCT, family psychoeducation, peer support, and twelve-step facilitation, or treatment-as-usual (TAU). Feasibility outcomes included recruitment, retention, and adherence. Clinical outcomes relapse rates, Addiction Severity Index (ASI) scores, and WHOQOL-BREF scores were assessed at baseline, 3 months, and 6 months. Predictors of relapse were examined using Cox regression.
Results
The integrated program showed high feasibility, with 90% retention and strong adherence, and demonstrated clear superiority over TAU. Relapse rates were significantly lower at 3 and 6 months (33.3% vs. 66.7% and 44.4% vs. 77.8%; p = 0.001). Participants exhibited significant reductions in all ASI domains and all WHOQOL-BREF dimensions. Survival analysis confirmed a substantially lower relapse hazard, while multivariate modelling identified unemployment, illiteracy, unmarried status, higher opioid dose, repeated detoxification attempts, and poor adherence as independent predictors of relapse.
Conclusions
The culturally adapted, integrated psychotherapeutic program is a feasible and promising intervention, associated with reduced relapse rates, significant improvements in addiction severity, and enhanced quality of life over six months. These findings support the implementation of culturally tailored, multimodal psychological interventions for OUD in low- and middle-income countries like Egypt.
