Gender differences in health related quality of life of young heroin users
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RESEARCH
Open Access
Gender differences in health related quality of life of young heroin users Antònia Domingo-Salvany1,2*, M Teresa Brugal2,3, Gregorio Barrio2,4, Francisco González-Saiz5, M José Bravo2,6, Luís de la Fuente2,6, the ITINERE Investigators1
Abstract Background: Health Related Quality of Life (HRQL) of opiate users has been studied in treatment settings, where assistance for drug use was sought. In this study we ascertain factors related to HRQL of young opiate users recruited outside treatment facilities, considering both genders separately. Methods: Current opiate users (18-30 y) were recruited in outdoor settings in three Spanish cities (Barcelona, Madrid, Sevilla). Standardised laptop interviews included socio-demographic data, drug use patterns, health related issues, the Severity of Dependence Scale (SDS) and the Nottingham Health Profile (NHP). Results: A total of 991 subjects (73% males), mean age = 25.7 years were interviewed. The mean global NHP score differed by gender (women: 41.2 (sd:23.8); men:34.1(sd:23.6);p < 0.05). Multivariate analysis was implemented separately by gender, variables independently related with global NHP score, both for males and females, were heroin and cocaine SDS scores. For women, only other drug related variables (alcohol intake and length of cocaine use) were independently associated with their HRQL. HIV+ males who suffered an opiate overdose or had psychiatric care in the last 12 months perceived their health as poorer, while those who had ever been in methadone treatment in the last 12 months perceived it as better. The model with both genders showed all factors for males plus quantity of alcohol and an interaction between gender and HIV status. Conclusions: Heroin users were found to be at a considerable risk of impaired HRQL, even in these young ages. A score approaching severity of dependence was the factor with the strongest relation with it.
Background Although some changes seem to be taking place in the incidence trends of specific illegal drugs, heroin use is still an important health concern in Europe. In most countries heroin remains the principal drug involved in treatment episodes[1] and heroin users are at a greater risk of dying from different causes, particularly overdoses but also infectious diseases related to injection [2-4]. Health Related Quality of Life (HRQL) has progressively been applied in the evaluation of health status of patients, including substance users[5,6]. Poor HRQL has been reported among heroin users starting treatment, being comparable to other chronic disease patients[7-9]. As a patient centred outcome variable, HRQL has also * Correspondence: [email protected] 1 Drug Abuse Epidemiology Research Group. IMIM-Hospital del Mar. Dr. Aiguader, 88. E-08003 Barcelona, Spain Full list of author information is available at the end of the article
been used to assess treatment effectiveness and in randomised trials providing evidence of HRQL improvement with opioid substitution therapies [10-13]. Variables that have been related
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