Very Integrated Program (VIP): Health promotion for patients with alcohol and drug use disorders

Treatment of patients with alcohol or drug use disorders is a complex multistage process addressing the substance addiction and co-morbidities. The risky lifestyles, including tobacco smoking, insufficient physical activity and unhealthy diet, which can aggravate health condition as well as addiction treatment itself, are very common among these patients.

The purpose of this project was to evaluate the effect of integrating health promotion activities and rehabilitation in the treatment of alcohol and drug addiction on the outcome for alcohol and drug abusers compared to the usual intervention alone. Very Integrated Program (VIP) identified the presence of health and comorbidity for men and women, and evaluated the effect of health activities on living habits and effect of addiction treatment in a randomized controlled trial.

PhD Thesis

The PhD thesis linked to this project aimed to explore the health status and lifestyle risk factors in patients with alcohol or drug use disorders in Sweden (study 1), to investigate the effect of the VIP in patients with alcohol or drug use disorders (study 2). In addition, the thesis aimed to explore the factors of interest associated with this intervention, such as the compliance of these patients to the VIP (study 3) and the characteristics of the patients that were successful in changing their lifestyle (study 4). The thesis consists of a comprehensive survey (study 1), two quantitative studies (studies 2 and 4), and a mix methods study (study 3).

The screening of the patients with alcohol or drug use disorders revealed that most of them had at least one lifestyle risk factor (93%) and suffer from at least one chronic disease (70%). The VIP intervention garnered no significant effect on harm reduction among these patients, their health status or quality of life (QoL), as well as on the addiction treatment outcomes, such as days in treatment or time to relapse. Surprisingly, the patients that did not receive the program had significantly more substance-free days after 12 months. The patients with higher education, better QoL, and several lifestyle risk factors had higher chances of changing their lifestyle. The patients’ higher self-efficacy was positively associated with their compliance with the health promotion program. The patients displayed willingness for a change but also showed strong emotions associated with the process of change.

The purpose of this study was to evaluate the effect of adding the Health Promotion activities and rehabilitation to the usual alcohol and drug interventions on the outcome for alcohol and drug abusers compared to the usual intervention alone.