European Psychiatry - Volume 33 - March 2016

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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.
EV18
Assessing Comorbidities and service
use among patients with
benzodiazepine abuse
B. Cook ∗, L. Chavez , R. Carmona , M. Alegria
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.
EV19
Methadone withdrawal psychosis –
case report
A. Coutinho ∗, L. Maia , J. Perestrelo , I. Carvalho , L. Ribeiro
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.
EV20
The incidence of hepatitis C virus
infection among opiate drug users in
Mamoura hospital patient in
Alexandria, Egypt
S. Darwish ∗, N. Sadek , H. Hoda , M. Bothaina , I. Farag
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.
0 0 1 276 1575 recovery 13 3 1848 14.0 96 800x600 Normal 0 false
false false EN-US JA X-NONE.
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.