Stress-related genes and heroin addiction: A role for functional fkbp5 variants

Abstract

Aims: Retention in methadone maintenance treatment (MMT) for at least one year has been associated with positive outcomes. Predictors of retention in MMT have traditionally collapsed across gender. This study hypothesizes that predictors of retention will differ between men and women, and aims to determine which factors best predict retention for each gender. Methods: Data were collected from the files of 290 patients (173 M, 117 F) admitted to MMT at an outpatient clinic in Detroit between 2002 and 2007. The modal participant was a 50-year old African American (84.8%) male (59.7%). Results: Although 35.3% of men and 44.4% of women remained in treatment for over a year, gender did not significantly predict treatment retention (X2(1) =2.47, p= .12). In the overall sample, Kendall correlations (dfs =282) revealed that presenting a urine sample positive for opiates, cocaine, or THC metabolites (rs = .29, .29, .24, respectively, all ps < .001) during the first month of treatment, having a DSM-IV diagnosis of cocaine dependence (r= .24, p<001), a non-drug Axis I diagnosis (r= .12, p= .05), or a history of emotional abuse (r= .12, p= .05) was associated with retention of less than one year. Stepwise logistic regression computed for each gender with years of opioid use entered in step 1 and the variables above entered in step 2 indicated that for males, significant predictors of retention for less than a year were: presenting a urine sample that was positive for opioids (OR=6.6) or THC metabolites (OR=4.9), having a diagnosis of cocaine dependence (OR=2.7), or a non-drug Axis I diagnosis (OR=2.1). For females, significant predictors were: presenting a urine sample positive for cocaine (OR=3.6) or THC metabolites (OR=4.9), and having a history of emotional abuse (OR=2.4). Conclusions: These findings indicate that predictors of retention in MMT differ between males and females. Future studies on MMT outcomes should consider the unique pathways by which females and males adhere to, and benefit from, MMT. Financial support: Joe Young, Sr./Helene Lycacki Funds (State of Michigan).