Characteristics of Heroin Addicts Entering Methadone Maintenance Treatment: Quality of Life and Gender

Abstract

Study objective. To provide information on MMP patient's characteristics, particularly those related with Health Related Quality of Life (HRQoL) and gender. Design. Cross-sectional study. Data were collected on socio-demographic, toxicological variables, HIV risk behaviors, and HRQoL through the Nottingham Health Profile (NHP). Patients and setting. Over a 30-month period (1996–1999) Barcelona's Municipal Drug Care Centres recruited 586 patients. Main results. Mean age of patients was 31 years, 70% were males and 25% were HIV-infected. Rates of unemployment, criminal records and low educational level were high. Most poly-drug users used cocaine. NHP mean score was related with poly-drug use, educational level and HIV status. Consistent condom use was related with HIV status. Females’ route of administration was less likely to be injection, even though they were more frequently HIV-positive and manifested contemporary poorer general health. Conclusions. Patients QoL was poor. Nowadays harm reduction health strategies would need to face cocaine use, and sexual risk behaviors mainly among females and sexual partners.

• Heroin dependence
• Methadone
• Treatment
• Gender
• Quality of life
• Harm reduction

Resumen

Objetivo del estudio. Dar información sobre las características de los pacientes que inician PMM, especialmente aquellas relacionadas con la Calidad de Vida Relacionada con la Salud (CVRS) y el género. Diseño. Estudio transversal. Se recogieron datos de variables socio-demográficas, toxicológicas, comportamientos de riesgo relacionados con el VIH y la CVRS con el Perfil de Salud de Nottingham (PSN). Pacientes y entorno. Durante un período de 30 meses (1996–1999) se reclutaron 586 pacientes en los Centros de Atención y Seguimiento de Barcelona. Resultados principales. La media de edad de los pacientes fue de 31 años, el 70% eran hombres y el 25% estaban infectados por el VIH. Los índices de desempleo, antecedentes penales y bajo nivel educativo eran altos. La mayoría de poli-adictos utilizaban la cocaína. La puntuación global del PSN estaba relacionada con la poli-adicción, el nivel educativo y con el VIH. El uso sistemático del preservativo estaba relacionado con el VIH. Las mujeres, aunque usaban menos frecuentemente la vía inyectada, estaban con más frecuencia infectadas por el VIH y su salud general era peor. Conclusiones. La CVRS de los pacientes era pobre. Actualmente los programas de reducción de riesgos deberían hacer frente al abuso de cocaína y a los comportamientos sexuales de riesgo, especialmente en las mujeres y en las parejas sexuales.

Résumé

Objectif de l’étude. Donner de l’information sur les caractéristiques des patients entrant pour première fois dans un Programme de Maintenance avec Méthadone (PMM) spécialement celles qui ont rapport à la Qualité de Vie Liée à la Santé (QVLS) et au genre. Dessin. Étude transversale. L’information recueillie concernait des variables socio-demógraphiques, toxicologiques, conduites à risque pour le VIH et la QVLS avec le Profile de Santé de Nottingham (PSN). Patients et environnement. On rassemblait 586 patients dans les Centres Municipaux pour l’Attention à les Toxicomanies de Barcelone, pendant un période de 30 mois (1996–1999). Résultats Principaux. L’age moyenne des participants était 31 ans, le 70% étaient des hommes et le 25% étaient infectés par le VIH. Caractéristiques fréquentes étaient le chômage, les antécédents légaux et le niveau éducatif bas. La ponctuation globale du PSN était rapportée avec la poli-toxicomanie, le VIH et le niveau éducatif. L’utilisation systématique du préservatif était rapportée avec le VIH. Encore que les femmes utilisaient moins la piqûre que les homes, elles étaient plus fréquemment infectées par le VIH et sa santé générale était plus mauvaise. Conclusions. La QVLS des patients était mauvaise. Actuellement les programmes de réduction des méfaits devraient faire front à l’abus de la cocaïne et les conduites sexuelles à risque, spécialement concernant aux femmes et aux copains sexuels.

Additional information

Notes on contributors

Elisabet Puigdollers

Elisabet Puigdollers, Psychologist, has worked in the Health Services Research Unit of the Municipal Institute of Medical Research. She is Associate Professor of psychology (Universitat de Barcelona). Her main research interests are “drug dependence” and the effectiveness of health services.

Antònia Domingo-Salvany

Antònia Domingo-Salvany, M.D., with Ph.D. in Medicine. She is working on drug abuse epidemiology at the Institut Municipal d’Investigació Mèdica (IMIM) since 1989, currently focusing in psychiatric co-morbidity in drug abusers and health services research.

M. Teresa Brugal

M. Teresa Brugal Puig, M.D. She's a Public Health and Preventive Medicine specialist. Currently she is responsible for Barcelona's Drug Information System. Her main research interests are related to comorbidity, risky behaviors and mortality in drug users.

Marta Torrens

Marta Torrens, M.D. psychiatrist with Ph.D. in Medicine. She has been working in the “drug abuse” field since 1985 and currently is Head of the Drug Abuse Unit of the Psychiatry & Drug Abuse Department of the Hospital del Mar in Barcelona. Her main research interests are related to methadone maintenance treatment and psychiatric comorbidity in drug users.

Joan Alvarós

Joan Alvarós Costa, M.D. Master in Clinical Mental Health (Universitat Autònoma de Barcelona). Since 1992 Head of CAS Garbivent, working in the drug abuse field. His main research lines are related to methadone maintenance treatment, infectious diseases and psychiatric co-morbidity in drug users.

Claudio Castillo

Claudio Castillo Buenaventura, Psychiatrist. Currently working at the “Instituto de Atención Psiquiátrica (IAPS).” His main research lines are related to methadone maintenance treatment and psychiatric comorbidity in drug users.

Núria Magrí

Núria Magri, M.D., she has been working in the drug abuse field. She was physician of the CAS-Nou Barris.

Sílvia Martín

Sílvia Martín Berdagué, M.D. She has been working in the drug abuse field since 1996 and is currently physician of the CAS-Sants, CAS-Sarrià and CAS-Granollers. Her main research lines are related to drug user treatment.

Josep M. Vázquez

Josep M. Vázquez, M.D. Working in the “drug abuse” field. Currently physician of the CAS-Sants.