J Ayub Med Coll Abbottabad. 2024 Oct-Dec;36(4):749-754. doi: 10.55519/JAMC-04-14131.
ABSTRACT
BACKGROUND: Amphetamine use disorder (AUD) is a public health concern on a global scale and is a rising epidemic in Pakistan. Cognitive Behavioural Therapy (CBT) is a well-established treatment for substance use disorders, but its efficacy may be dependent on what is known as socio demographic and behavioural variables. The aims of this study are to provide evaluation of efficacy of CBT for AUD in Pakistani population and to find whether the presence of factors like education, job, duration of addiction, residence, age, family support, smoking and alcohol intake may affect treatment outcomes.
METHODS: A quasi-experimental design was applied with 100 participants recruited from outpatient treatment centers and rehabilitation centers in Pakistan. A culturally adapted CBT program was delivered to 50 participants along with treatment as usual and standard treatment as usual (TAU) was given to control group with 50 participants. Addiction Severity, anxiety, depression, psychological wellbeing, quality of life, as well as relapse rates were measured using pre-test and post-test assessments. Descriptive statistics, paired t-tests, ANOVA, multiple regression and survival analysis were completed to analyze the data.
RESULTS: The frequency of amphetamine use from pre to post change from 5.8 to 2.3 days per week (p<0.001) and ASI, addiction severity index scores from pre to post change from 30.2 to 18.7 (p<0.001) was significant in the CBT group. On the behavioural as well as on the psychological measures, improvements were observed, as evidenced by a decrease in the BDI from 22.4 to 14.1 (p<0.001) and a decrease in the GAD-7 from 18.5 to 11.3 (p<0.001). Significantly higher Quality of Life (WHOQOL-BREF) scores improved from 45.3 to 62.0 (p<0.001). But the TAU group also got better, just not as much as the CBT group. Positive associations were found with socio-demographic factors (such as higher education, stable employment and strong family support) and negative associations with unemployment, longer duration of addiction and regular alcohol intake.
CONCLUSIONS: Both the effectiveness of CBT and its suitability to reduce amphetamine use, enhance psychological wellbeing, and improve quality of life among individuals with AUD in Pakistan were demonstrated. The significance of incorporating social demographic factors, and behavioural factors in the development of CBT interventions to ensure maximal treatment effect is underscored.
PMID:40121636 | DOI:10.55519/JAMC-04-14131
