Sex differences in substance use, health, and social functioning among opioid users receiving methadone treatment: a multicenter cohort study.

Monica Bawor,Carolyn Plater,Lehana Thabane,Jeff Daiter,David C Marsh,Rebecca Anglin,Dipika Desai,Brittany B Dennis,Meir Steiner,Andrew Worster,Michael Varenbut,Guillaume Pare,Zainab Samaan

doi:10.1186/s13293-015-0038-6

Abstract

BackgroundDespite the growing numbers of men and women with opioid use disorder in Canada, sex-specific issues in treatment have not been re-examined in the current population of patients with opioid addiction. We aimed to evaluate sex differences in substance use, health, and social functioning among men and women currently receiving methadone treatment for opioid use disorder in Ontario, Canada.MethodsWe recruited 503 participants with opioid dependence disorder receiving methadone maintenance treatment. We collected data on demographics, treatment characteristics, psychiatric history, addiction severity, and drug use patterns through urinalysis. We performed adjusted univariate analyses and logistic regression to identify distinct factors affecting men and women.ResultsAmong our sample of 54 % (n = 266) men and 46 % women (n = 226) with mean age 38.3 years, less than half of participants were employed (35.6 %) and married (31.8 %) and had completed a high school education (27.9 %). Compared to men, women had frequent physical and psychological health problems, family history of psychiatric illness, and childcare responsibilities and began using opioids through a physician prescription. Men had higher rates of employment, cigarette smoking, and cannabis use compared to women.ConclusionsOur results have revealed different patterns of substance use, health, and social functioning among men and women currently receiving methadone treatment for opioid addiction in Ontario, Canada. This information can be used to develop an integrative treatment regimen that caters to the individual needs of men and women, as well as to inform methadone treatment protocols to include specialized services (including vocational counseling, childcare and parenting assistance, medical assistance, relationship or domestic violence counseling, etc.) and increase their availability and accessibility on a larger scale.

Highlights

Despite the growing numbers of men and women with opioid use disorder in Canada, sex-specific issues in treatment have not been re-examined in the current population of patients with opioid addiction
We used STATA Version 12 (StataCorp LP, College Station, USA) for all statistical analyses and we reported this study in adherence to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines [31]
We recruited a total of 503 participants receiving opioid agonist treatment from 13 Canadian Addiction Treatment Centres (CATC) clinics

Summary

Introduction

Despite the growing numbers of men and women with opioid use disorder in Canada, sex-specific issues in treatment have not been re-examined in the current population of patients with opioid addiction. We aimed to evaluate sex differences in substance use, health, and social functioning among men and women currently receiving methadone treatment for opioid use disorder in Ontario, Canada. Patterns of opioid prescribing are higher among women [15], who are more likely than men to suffer from poor health including pain conditions [16], making them especially vulnerable to misuse prescription narcotics. The number of women seeking treatment for opioid-related disorders has markedly increased since the 1960s, reaching current levels that are comparable to men [17]

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