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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805

S355

complex, with many alkaloids involved. The subjective effects in

humans are very peculiar and seem to be dose-dependent, rang-

ing from psycho-stimulant to sedative-narcotic. Available data

on Kratom suggest caution: this psychoactive plant could exhibit

a serious harmful potential. Kratom use seems to be associated

with drug dependency, development of withdrawal symptoms,

craving, serious adverse effects and life-threatening effects in a

multidrug-intoxicating scenario. On the other hand, its anxyiolitic,

antidepressant and analgesic properties deserve to be further stud-

ied.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1002

EV18

Assessing Comorbidities and service

use among patients with

benzodiazepine abuse

B. Cook

1 ,

, L. Chavez

2

, R. Carmona

3

, M. Alegria

4

1

CMMHR – Cambridge Health Alliance and Harvard Medical School,

Psychiatry, Cambridge, USA

2

University of Puerto Rico, Medical Sciences, San Juan, PR, USA

3

Fundacion Jimenez Diaz, Psychiatry, Madrid, Spain

4

Massachusetts General Hospital/Harvard Medical School, Medicine,

Boston, USA

Corresponding author.

Prior studies have identified that individuals with comorbid sub-

stance use disorder and mental health disorder are at a greater risk

of benzodiazepine abuse compared to individuals that present with

mental health disorder without an accompanying substance use

disorder. These studies were conducted in predominantly white

populations, and little is known if the same associations are seen

in safety net health care networks. Also, the literature is mixed as

to whether or not psychiatrists’ prescription of benzodiazepines

places individuals at undue risk of benzodiazepine abuse.

We use 2013–2015 electronic health record data from a Boston

healthcare system. Patients with benzodiazapene abuse were iden-

tified if they had received treatment under the ICD-9 code 304.1.

Benzodiazepine abuse was compared between patients with only

mental illness and patients with existing comorbid substance and

mental health disorder, in unadjusted comparisons and adjusted

regression models. Covariates in regression models were used to

identify subgroups at higher risk of benzodiazepine abuse.

Individuals with benzodiazepine abuse had higher rates of emer-

gency room and inpatient use than patients with other mental

health and/or substance use disorders. Those with comorbid

substance and mental disorder were significantly more likely

than individuals with mental or substance use disorder alone to

abuse benzodiazepines (

P

< .01). Among thosewith benzodiazepine

abuse, 93.3%were diagnosedwith amental illness, 75.6%were diag-

nosed with a substance use disorder (other than benzodiazepine),

and 64.4% had comorbid anxiety disorder and substance use dis-

order. These analyses suggest that patients with benzodiazepine

abuse have complex presentations and intensive service use.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1003

EV19

Methadone withdrawal psychosis –

case report

A. Coutinho

1 ,

, L. Maia

2

, J. Perestrelo

2

, I. Carvalho

2

, L. Ribeiro

2

1

V.N. de Gaia, Portugal

2

Centro Hospitalar V.N. Gaia/Espinho, Psychiatry and Mental Health,

V.N. Gaia, Portugal

Corresponding author.

Introduction

Opiates’s substitution therapy with methadone is

one of themain approaches used for drug-addicted patients, in Por-

tugal. The symptoms of withdrawal of methadone are the same as

the classical abstinence syndrome of opiates. In a minority of cases,

withdrawal of methadone has been related to the sudden appear-

ance of affective disorders and to a minor degree with psychotic

disorders.

Objectives

The authors propose to do a brief literature review

about methadone and it is neuromodulation in central opiate-

dopamine system.

Aims

The authors intend to report a clinical case illustrative of a

psychosis possible related to methadone rapid withdrawal, in a 39-

year-old woman without previous personal or familiar psychiatric

illness, except for the use of toxic substances.

Methods

Literature review in scientific databases – Pubmed;

ScienceDirect. Case report of a patient admitted in Psychiatry

Department of Vila Nova de Gaia Hospital Center.

Results

During admission, the patient’s condition consisted of

disorganized behavior, paranoid delusions and the presence of

auditory hallucinations. Was excluded other possible causes of

psychotic conditions and was admitted rapid methadone detox-

ification as the probable etiology. Neuroleptic treatment was

prescribed and psychotic symptoms improved progressively.

Conclusions

In test animals, the behavioral effects of methadone

withdrawal have been related to its effects on cerebral amines,

especially on dopamine. A change in the neuromodulation of the

central opiate-dopamine systems, due to opiates’s substitution

therapy with methadone, could be related to psychotic pathogene-

sis. This work supports other authors that suggest that methadone

withdrawal can cause psychosis in individuals without previous

psychiatric conditions.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1004

EV20

The incidence of hepatitis C virus

infection among opiate drug users in

Mamoura hospital patient in

Alexandria, Egypt

S. Darwish

1 ,

, N. Sadek

2

, H. Hoda

3

, M. Bothaina

3

, I. Farag

3

1

Mamoura Mental State Hospital, Adult Psychiatry and Addiction,

Alexandria, Egypt

2

Medical Research Institute, Department of Hematology, Alexandria,

Egypt

3

Medical Research Institute, Department of Biochemistry,

Alexandria, Egypt

Corresponding author.

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Introduction

Egypt is one of the most famous endemic areas for

hepatitis C virus. Drug use in Egypt is rising exponentially. Drug use

is always considered one of the main risk factors for HCV.

Objectives

To assess the effect the route of drug use on the inci-

dence of HCV in the Egyptian population.

Aim

To study the effects of opiates (tramadol and heroin) use and

the route of intake on the incidence of HCV infection among addicts

treated in Mamoura mental state hospital, Alexandria, Egypt.

Methods

This is a cross-sectional study on drug dependence

patients visiting the out patient clinic for addiction in Elmamora

Hospital.

Subjects were divided into two groups.

Group I: Control group.

Twenty non-addict volunteers.

Group II: Cases groups (comprising 60 subjects)

This group will be divided into three sub-groups each contains 20

cases.