Authors (including presenting author) :
Lam WC, Chan SW, Chan KH, Fung KW, Tam HC
Affiliation :
Department of Psychiatry, United Christian Hospital (UCH), Kowloon East Cluster (KEC)
Introduction :
Overseas studies show that high frequency repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) is a safe treatment and improves outcomes of substance use disorder (SUD). The neuromodulation therapy team of department of psychiatry of UCH successfully applied Beat Drug Fund for a 3-year project starting in September 2022 to provide rTMS as a new therapy to SUD in KEC.
Objectives :
The rTMS treatment outcomes of SUD in the first two years of the newly funded project were reported and analyzed.
Methodology :
It is a single-group pretest-posttest design. The participants diagnosed SUD were referred from the Kowloon East Substance Abuse Clinic. The change in 4 areas before and 1 month after the treatment program of 10 rTMS therapy sessions were measured with Beat Drug Fund Evaluation Question sets (no. 5, no. 13 and no. 14) and Visual Analogue Scale: 1) Frequency of drug use in the past 1 month 2) Motivation to abstain 3) Risk of relapse 4) Craving intensity Paired Sample t Test was used in analysing the difference between pretest and posttest median total scores of each area. Satisfaction of the intervention was assessed after the treatment.
Result & Outcome :
133 individuals were referred in the period from 1 September 2022 to 31 August 2024. 113 patients (M:F = 81:32, Age = 17–64, all Chinese, duration of substance abuse = 1- 40 years) completed the 10-session treatment program. The primary drugs include cocaine, cannabis, heroin, ketamine, methamphetamine and hypnotic. Paired Samples t Test showed significant post-treatment change: • median score of “frequency of drug use in the past one month” was reduced from 34.733 to 14.891 (p < 0.0005), • median score of “motivation to abstain” was increased from 3.817 to 7.461 (p < 0.0005), • median score of “risk of relapse” was reduced from 6.486 to 9.725 (p < 0.0005), • median score of craving intensity was reduced from 6.475 to 4.262 (p < 0.0005). 90.3% of the participants (n = 113) were satisfied with the treatment. In conclusion, rTMS therapy improves clinical outcomes of SUD by decreasing the frequency of drug use, enhancing the motivation for abstinence, mitigating the risk of relapse and alleviating cravings.
