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

doi:10.1186/s13293-015-0038-6

. 2015 Nov 10:6:21.

doi: 10.1186/s13293-015-0038-6. eCollection 2015.

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

Affiliations

¹ MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, Ontario Canada ; St. George's, University of London, London, UK ; Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, Ontario Canada ; Peter Boris Centre for Addiction Research, St. Joseph's Healthcare Hamilton, Hamilton, Ontario Canada.
² St. George's, University of London, London, UK ; Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, Ontario Canada ; Peter Boris Centre for Addiction Research, St. Joseph's Healthcare Hamilton, Hamilton, Ontario Canada ; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario Canada.
³ Canadian Addiction Treatment Centres (CATC), Richmond Hill, Ontario Canada.
⁴ Canadian Addiction Treatment Centres (CATC), Richmond Hill, Ontario Canada ; Northern Ontario School of Medicine, Laurentian Campus, Sudbury, Ontario Canada.
⁵ Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario Canada ; Canadian Addiction Treatment Centres (CATC), Richmond Hill, Ontario Canada ; Department of Medicine, McMaster University, Hamilton, Ontario Canada.
⁶ Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario Canada ; Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario Canada ; Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario Canada.
⁷ Department of Medicine, McMaster University, Hamilton, Ontario Canada ; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario Canada.
⁸ Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, Ontario Canada ; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario Canada.
⁹ Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, Ontario Canada.
¹⁰ Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario Canada ; Biostatistics Unit, Centre for Evaluation of Medicine, Hamilton, Ontario Canada.
¹¹ Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, Ontario Canada ; Peter Boris Centre for Addiction Research, St. Joseph's Healthcare Hamilton, Hamilton, Ontario Canada ; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario Canada ; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario Canada ; Mood Disorders Program, St. Joseph's Healthcare, 100 West 5th Street, Hamilton, Ontario L8N 3K7 Canada.

PMID: 26557977
PMCID: PMC4640383
DOI: 10.1186/s13293-015-0038-6

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

Monica Bawor et al. Biol Sex Differ. 2015.

. 2015 Nov 10:6:21.

doi: 10.1186/s13293-015-0038-6. eCollection 2015.

Authors

Affiliations

¹ MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, Ontario Canada ; St. George's, University of London, London, UK ; Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, Ontario Canada ; Peter Boris Centre for Addiction Research, St. Joseph's Healthcare Hamilton, Hamilton, Ontario Canada.
² St. George's, University of London, London, UK ; Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, Ontario Canada ; Peter Boris Centre for Addiction Research, St. Joseph's Healthcare Hamilton, Hamilton, Ontario Canada ; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario Canada.
³ Canadian Addiction Treatment Centres (CATC), Richmond Hill, Ontario Canada.
⁴ Canadian Addiction Treatment Centres (CATC), Richmond Hill, Ontario Canada ; Northern Ontario School of Medicine, Laurentian Campus, Sudbury, Ontario Canada.
⁵ Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario Canada ; Canadian Addiction Treatment Centres (CATC), Richmond Hill, Ontario Canada ; Department of Medicine, McMaster University, Hamilton, Ontario Canada.
⁶ Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario Canada ; Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario Canada ; Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario Canada.
⁷ Department of Medicine, McMaster University, Hamilton, Ontario Canada ; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario Canada.
⁸ Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, Ontario Canada ; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario Canada.
⁹ Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, Ontario Canada.
¹⁰ Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario Canada ; Biostatistics Unit, Centre for Evaluation of Medicine, Hamilton, Ontario Canada.
¹¹ Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, Ontario Canada ; Peter Boris Centre for Addiction Research, St. Joseph's Healthcare Hamilton, Hamilton, Ontario Canada ; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario Canada ; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario Canada ; Mood Disorders Program, St. Joseph's Healthcare, 100 West 5th Street, Hamilton, Ontario L8N 3K7 Canada.

PMID: 26557977
PMCID: PMC4640383
DOI: 10.1186/s13293-015-0038-6

Abstract

Background: 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.

Methods: We 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.

Results: Among 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.

Conclusions: Our 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.

Keywords: Methadone maintenance treatment; Opioid addiction; Sex differences; Substance use disorders; Women’s health.

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Figures

**Fig. 1**
Eligibility and screening of candidates for inclusion in the GENOA study

**Fig. 2**
Comparison of substance use behavior among men and women measured by urine drug screening and self-report

See this image and copyright information in PMC

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References

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[1] Fischer B, Rehm J, Patra J, Cruz MF. Changes in illicit opioid use across Canada. CMAJ. 2006;175(11):1385. doi: 10.1503/cmaj.060729. - DOI - PMC - PubMed

[2] Fischer B, Rehm J, Patra J, Cruz MF. Changes in illicit opioid use across Canada. CMAJ. 2006;175(11):1385. doi: 10.1503/cmaj.060729. - DOI - PMC - PubMed

[3] Goodman FD, Glassman P. Evaluating potentially aberrant outpatient prescriptions for extended-release oxycodone. Am J Health Syst Pharm. 2005;62:2604–2608. doi: 10.2146/ajhp040618. - DOI - PubMed

[4] Goodman FD, Glassman P. Evaluating potentially aberrant outpatient prescriptions for extended-release oxycodone. Am J Health Syst Pharm. 2005;62:2604–2608. doi: 10.2146/ajhp040618. - DOI - PubMed

[5] Unick GJ, Rosenblum D, Mars S, Ciccarone D. Intertwined epidemics: national demographic trends in hospitalizations for heroin- and opioid-related overdoses, 1993–2009. PLoS One. 2013;8:e54496. doi: 10.1371/journal.pone.0054496. - DOI - PMC - PubMed

[6] Unick GJ, Rosenblum D, Mars S, Ciccarone D. Intertwined epidemics: national demographic trends in hospitalizations for heroin- and opioid-related overdoses, 1993–2009. PLoS One. 2013;8:e54496. doi: 10.1371/journal.pone.0054496. - DOI - PMC - PubMed

[7] INCB . Narcotic drugs: estimated world requirements for 2010—statistics for 2008. Vienna, Austria: International Narcotics Control Board; 2010.

[8] INCB . Narcotic drugs: estimated world requirements for 2010—statistics for 2008. Vienna, Austria: International Narcotics Control Board; 2010.

[9] Dhalla IA, Mamdani MM, Sivilotti ML, Kopp A, Qureshi O, Juurlink DN. Prescribing of opioid analgesics and related mortality before and after the introduction of long-acting oxycodone. CMAJ. 2009;181:891–896. doi: 10.1503/cmaj.090784. - DOI - PMC - PubMed

[10] Dhalla IA, Mamdani MM, Sivilotti ML, Kopp A, Qureshi O, Juurlink DN. Prescribing of opioid analgesics and related mortality before and after the introduction of long-acting oxycodone. CMAJ. 2009;181:891–896. doi: 10.1503/cmaj.090784. - DOI - PMC - PubMed

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

Affiliations

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

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