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

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.

The impact of comorbid psychiatric disorders on methadone maintenance treatment in opioid use disorder: a prospective cohort study

“…Ethics approval was obtained from the Hamilton Integrated Research Ethics Board (project ID 11-056), and written informed consent was obtained from each study participant. Further details related to GENOA study methods have been previously reported 31–34. This study is reported in accordance with the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines 35…”

Association between cannabis use and methadone maintenance treatment outcomes: an investigation into sex differences

“…Women in MMT tend to show a higher prevalence of comorbid psychiatric and physical illnesses [16, 43, 44], as well as more severe opioid craving upon treatment entry [45] which may represent confounding factors that serve to increase rates of both cannabis and opioid use during MMT. As such, these patients may have motivation to use both drugs for purposes of self-medication.…”

“…Recent studies point to a changing landscape of OUD and those in treatment, one that includes a higher percentage of women, older aged patients, and more individuals abusing prescription opioids rather than heroin [16]. These sociodemographic changes warrant a re-evaluation of risk factors associated with poor MMT outcomes.…”

“…Compared to the general population, patients on MMT show a higher prevalence of cannabis use [16], and because of its documented association with polysubstance use [9, 17], psychiatric disorders [18], and overall worse quality of life [19], represents a potential risk factor for poor MMT outcomes. Several studies have investigated the influence of cannabis use on MMT outcomes in humans, though the results are mixed.…”

Sex differences in prescription opioid use

“…The authors found women compared with men were more likely to have a family history of mental illness and to initiate opioid use through a physician. Alternatively, men were found to have higher rates of cigarette smoking and cannabis use compared to women (12). The other clinic based study used a cross-sectional method to interview 162 participants as part of a 7-week inpatient and 12-week outpatient study.…”