Inpatient Care for People with New Psychoactive Substance use Disorders: A Trend Study

Abstract

Introduction. The growing number of cases of use of new psychoactive substances (NPS) poses a significant problem for the entire public health of the country, as it requires improved clinical approaches to the treatment of such conditions. At the same time, there is a growing need to analyze the needs for such services.
Purpose of this study: was to determine the trend in the provision of inpatient drug treatment services to people with NPS addictions over a five-year period (2016-2020), as well as the dynamic characteristics of NPS drug use patterns over a three-year period (2018-2020).
Methods. A longitudinal observational study design was used, e.g. trend analysis for the period from 2016 to 2020. We analyzed exclusively cases of receiving inpatient drug treatment for the first time in each calendar year with diagnoses of synthetic cannabinoid and synthetic stimulant use disorders.
Results. A preliminary screening of medical records identified 344 cases in 2018, 614 in 2019, and 708 in 2020. Thus, in the country as a whole, there was a stable increase in the share of initial hospitalizations per year with diagnoses of NPS addiction: from 3.91% (3.2%; 4.7%) in 2016 to 23.91% (22.41%; 25.48%) in 2020. In all regions where patients with NPS addiction were identified, an upward trend was observed. The exception was the North Kazakhstan region and the city of Astana. When assessing the use of NPS, it was revealed that the prevalence of abuse of synthetic stimulants had an upward trend and made up the absolute majority of the observed cases.
Conclusions. This study demonstrated a stable exponential increase in the number of inpatients with NPS dependence, while remaining uneven in this indicator in different regions over the five-year period from 2016 to 2020. Over a three-year period, the absolute majority of synthetic stimulant use disorders has persisted among the entire class of NPS. The dynamics of NPS use patterns remain largely stable (methods of anesthesia, frequency and rhythm of NPS use per week and during the day). However, there has been an increase in the proportion of addicts combining NPS and alcohol, which requires further assessment and interpretation.