| Background:Today, drug abuse [18] [39] [61] [102]has become a big medical and social problem, which brings severe damage to person,family and society. Addiction drugs include opium,heroin,morphine,marijuana,cocain,methamphetamine hydrochloride,dancing outreach and other narcotics which are controlled by government. These dopes can addict person strongly and make terrible ruin to the world as following.1. Hurting the health of person severely. Dopes can addict person, make him excite,calm or daydream mentally and comfort him physically. So once addicts are forced to throw off dopes, they will have strong and bad reactions such as restlessness,agrypnia,depression,diarrhea,emesis,hyposexuality and so on. Furthermore, profuse dopes can restrain nervous system, cause respiratory failure and death. some infectious diseases such as hepatitis,pneumonia,venerism,AIDS and so on can also be spreaded by injecting dopes.2. Neglecting student his studies. Dopes can make person depressed,lost memory and lazy by destroying his health and volition. So, once student becomes addicted to dopes, he will be absorbed in the illusions caused by dopes. Thus, he can not concentrate his energy to study and his future will be destroy thoroughly.3. Inducing person to commit. Dopes can not only hurt the health of person, but also deprivate his judgement and personalities, which induces him to commit at last. Dopes are usually so expensive that many addicts can not pay for them. So, in order to have much money to buy dopes , many addicts have to steal,rob,cheat,corrupt,murder, etc.Because of strong drug addiction,severe abstinent symptom [32] [109]and high relapse rate, it is difficult to cure drug abstinence. It was reported that relapse rate of addicts who were treated by cuting off dopes simply was beyond 95% at home and abroad. So far, the treatment of drug abstinence is still a difficult and complex problem because some drugs such as opiate are psychoactive substances. Even though physical dependence is disappeared, psychic dependence will exist for long time. Therefore, in order to increase absfinent rate, it is very urgent to investigate the reasons for relapse of addicts at present.The popular conservative treatment of drug abstinence [76] [117]at home and abroad includes substitution therapy,Cold-Turkey Withdrawal,subhibernation therapy , etc. But the conservative treatment can only make addicts throw off physical dependence, while psychic dependence still exist. So addicts still crave for dopes after treatment. That is the main reason for relapse. Therefore, throwing off psychic dependence is the key measure.The surgery of making a lesion in nuleus accumbens in order to cure drug dependence cerebropathia is operated lessly in other countries. We have been operating this surgery since July 2000. Absfinent rate could reach 84.2% after surgery. Though some patients relapsed after surgery because of different reasons, the interval time is longer and the dosage is less than ever. So, surgery is better than conservative treatment remarkably for curing drug abstinence, and will be a important method to overcome psychic dependence and relapse.Objective:To investigate into reasons of relapse in addicts after treatment by ablating the nucleus accumbens with stereotactic surgery and evaluate the efficacy of the surgery.Methods:A retrospective analysis was made of 43 relapse cases with postoperative observations longer than 2 years.Information including reasons of relapse, drug-free time, change in dose of importation before and after surgery, psychological craving for drug and subjective sensation was collected by investigation, using uniform questionnaires by face-to-face and telephone interview. Comparison of therapeutic effects between surgical and expectant treatment was made through subject contrast method.Results:Among the 43 cases,34 were successfully followed-up.Main reasons of relapse included temptation by drug surroundings(28 cases ,82.4%)and stress to negative incidents in life(6 cases ,17.6%).Compared with patients subjected to expectant treatment, drug-free time after treatment was significantly prolonged in patients undergoing stereotactic surgery and relapse dose decreased too. Postoperative drug-free time and relapse dose ,as reasons for relapse, were compared through t-test, which suggested no significant difference (P>0.05).Conclusions:Compared with expectant treatment, the treatment of ablating the nucleus accumbens with stereotactic surgery is advantageous in prolonged drug-free time,decreased relapse dose and alleviated psychological craving for drug. It was reported that temptation by drug surroundings and stress to negative incidents in life were main reasons of relapse. So we think that the complete treatment of drug abstinence should be a continuous process which includes getting rid of drug,rehabilitation management and returning society. Getting rid of drug can make physical dependence disappeared. Though stereotactic surgery can make psychic dependence relieved obviously or cured thoroughly, it is not all. In order to enhance surgery effect, we think rehabilitation management and returning society after surgery should be emphasized in addition. After addicts being treated by surgery, society and family should administer them synthetically such as taking good care of them, stopping them contacting other addicts, changing their bad living environments and styles, arranging them to do some works which they can do and treating them psychically. Only so, we can strengthen surgery effect and decrease relapse rate. |
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