Abstract
BackgroundMethadone and buprenorphine are the most prevalent types of opioid maintenance programs in Andalusia. The main objective is comparing the functional status of patients with pharmacological opioid maintenance treatments according to different socio-demographic characteristic, health and disabilities domains and sexual difficulties.MethodsA total of 593 patients from the Andalusia community, 329 were undergoing methadone treatment and 264 were undergoing buprenorphine treatment. The patients were interviewed by socio-demographic and opioid-related variables, assessed by functioning, disability and health domains (WHODAS 2.0.) and for sexual problems (PRSexDQ-SALSEX).ResultsWe found significant differences in the socio-demographic and the opioid-related variables as the onset of opioid use, being on previous maintenance programs, opioid intravenous use, the length of previous maintenance programs, polydrug use and elevated seroprevalence rates (HCV and HIV) between the methadone group and the buprenorphine group. Regarding health and disability domains there were differences in the Understanding and communication domain, Getting around domain, Participation in society domain and in the WHODAS 2.0. simple and complex score, favoring buprenorphine-treated patients. The methadone group referred elevated sexual impairments compared with the buprenorphine group. Opioid-related variables as seroprevalence rates, other previous lifetime maintenance program, the daily opioid dosage and the daily alcohol use are the most discriminative variables between both groups. Participation in society variables and sexual problems were the most important clinical variables in distinguishing the methadone group from the buprenorphine group regarding their functional status.ConclusionsThe methadone group showed higher prevalence in opioid dependence-related variables, elevated disabilities in participation in society activities and sexual problems compared with the buprenorphine group. This study shows the importance of carry out a functional evaluation in the healthcare follow-up, especially in those areas related with social activity and with sexual problems.
Highlights
Opioid dependence is a chronic and relapsing substance use disorder that causes a significant burden on the global community, leading to 9.2 million disabilities per year [1]
The mean age of the buprenorphine group was younger than methadone group (45.7 years vs. 47.8) and they started opioid dependence later than patients with methadone (21.6 years vs. 23.9 years)
The main findings were as follows: (a) There were significant differences in variables related to the opioid use between both groups, suggesting a better social competence for buprenorphinetreated patients; (b) We found differences between both groups in variables related to functioning, disability and health favoring buprenorphine-treated patients; (c) The methadone group had an elevated prevalence on sexual dysfunction than the buprenorphine group; (d) Opioidrelated variables as HCV and VIH seroprevalence, previous maintenance program, the daily opioid dosage and the alcohol use were the most discriminative variables between both groups; (e) Participation in society activities and the sexual dysfunction are the most relevant functional variables in distinguishing the methadone
Summary
Opioid dependence is a chronic and relapsing substance use disorder that causes a significant burden on the global community, leading to 9.2 million disabilities per year [1]. In Spain, the number of admissions for treatment for opioid use disorders showed a decreasing trend since 2010 but remained stable since 2013–2014 [3]. In Andalusia (Southern Spain), there were 2842 new cases of treatment requests for opioid dependence in 2017, and only 329 of them were made by women [4]. Methadone and buprenorphine are the most prevalent types of opioid maintenance programs in Andalusia. The main objective is comparing the functional status of patients with pharmacological opioid mainte‐ nance treatments according to different socio-demographic characteristic, health and disabilities domains and sexual difficulties
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