Lapse and craving prevention in methadone maintenance treatment, applying continuous care model: a randomized clinical trial.

Objective: Although, the lapse and relapse are synonymous with the return to substance use disorder but they have different meanings. Lapse is suddenly return to substance use but relapse is reuse of substance after substance use quitting. Lapse does not have to lead to relapse. Lapse is one of the major challenges in methadone maintenance treatment (MMT). Lapse is the stage that occurs before relapse. Craving is the most important factor for lapse after the treatment periods, too. The aim of this study was to determine the effectiveness of applying continuous care model on lapse and craving prevention in patients on MMT. Methods: This parallel randomized controlled trial was conducted on 95 patients who were selected through the convenience sampling and randomly assigned to intervention (n=48) and control (n=47) groups. Continuous care model which consisted of four stages (orientation, sensitization, control and evaluation) was conducted on intervention group over a period of 3 months. At the end, two groups were compared. Craving Questionnaire and Lapse-and-Absence Check List were used to collect data. Results: At the end of third month, the mean of the lapse in the experimental group decreased to 1.57±1.1 times (from 2.07±0.89 times) and the mean of craving score decreased to 50.47±15.1 (from 53.73±13.58) that showed a significant difference comparing to the control group. Discussion: Continuous care model is effective to reduce lapse and craving in male patients on MMT. Therefore, it is suggested that this model should be implemented along with a medical treatment to prevent lapse and craving in male substance abuse disorder. [ABSTRACT FROM AUTHOR]