Cause of relapse for drug addiction after lesioning in bilateral nucleus accumbens with stereotactic surgery: One-year follow-up

Jiang Li, Guo Dong Gao*, Xue Lian Wang, Shi Ming He

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Aim: To investigate the relapse for drug addiction after lesioning in bilateral nucleus accumbens with stereotactic surgery, the causes for relapse and the addicted degree of the drug addicts, so as to provide evidence for the surgery and postoperative treatment. Methods: Forty-two opiate drug dependent volunteers, who had underwent lesioning in the bilateral nucleus accumbens by stereotactic surgery in the Institute of Functional Brain Disorders, the Fourth Military Medical University of Chinese PLA between July 2000 and November 2004, participated in the study, and they were randomly surveyed irregularly postoperatively. The concrete methods were that the Distinct kit was used to perform urine test for use of morphine and naloxone addition test, those who were positive in the above two test were considered to have contacted orphon drugs or other similar anesthetics recently (within one week) to have relapse for drug addiction. They were followed up for one year averagely. The patients with relapse for drug addiction were asked to fill in the causes of relapse for drug addiction questionnaire and drug-dependent degree questionnaire. The relapse for drug addiction, causes and the change of drug dependent degree of the patients after the lesioning in the bilateral nucleus accumbens by stereotactic surgery were mainly observed. The changes of the distribution of causes for the relapse for drug addiction before and after surgery were tested with the method of Fisher precise probability. Results: Forty-two subjects were involved, and 2 cases lost to the follow-up, the effective rate of follow-up was 95%. 1 Condition of the relapse for drug addiction: The 40 cases of opiate drug dependent volunteers were followed up for 1 year after the lesioning in the bilateral nucleus accumbens by stereotactic surgery, the relapse for drug addiction did not occur in 19 cases but occurred in 21 cases, and the average rate of relapse for drug addiction was 54.8%. 2 Comparative analysis of the causes for relapse before and after surgery: For the 21 cases who relapsed, the distribution of the causes had significant changes, changed from psychological factor followed by environmental factor and physical factor in order preoperatively, to environmental factor followed by psychological factor and physical factor in order postoperatively. 3 Comparison of drug dependent degree in the 21 cases who relapsed before and after surgery: The postoperative subjective feeling was weakened as compared with the preoperative one in 52% of the patients who relapsed, and there was no obvious change in the other patients. The postoperative drug amount was reduced in 80%, did not change in 10% and increased in 10% of the patients as compared with the preoperative ones. Conclusion: The lesioning in the bilateral nucleus accumbens by stereotactic surgery can obviously alleviate the degree of drug dependence in the opiate drug addicts. The causes of the relapse for drug addiction change from psychological factor followed by environmental factor and physical factor in order preoperatively, to environmental factor followed by psychological factor and physical factor in order postoperatively.

Original languageEnglish (US)
Pages (from-to)80-82
Number of pages3
JournalChinese Journal of Clinical Rehabilitation
Volume10
Issue number22
StatePublished - Jun 15 2006

ASJC Scopus subject areas

  • Rehabilitation

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