Gender Differences in Heroin Addiction and Treatment: Results from the VEdeTTE Cohort. in Substance use & misuse / Subst Use Misuse. 2016;51(3):295-309. doi: 10.3109/10826084.2015.1108339. Epub 2016 Feb 12.
2016
ASL Torino 3
Tipo pubblicazione
Research Support, Non-U.S. Gov't
Autori/Collaboratori (9)Vedi tutti...
Garneri M
c ASLTO1 , Department of Addictions , Torino , Italy.
Rotelli M
d Eclectica, Health Promotion Agency , Torino , Italy.
Beccaria F
a Department of Clinical and Biological Sciences , University of Torino , Orbassano , Italy.
et alii...
Abstract
BACKGROUND: Gender differences strongly affect heroin addiction, from risk factors to patterns of consumption, access to treatments, and outcomes. OBJECTIVES: To investigate gender differences in the VEdeTTE cohort of heroin addicts. METHODS: VEdeTTE is a cohort of 10,454 heroin users enrolled between 1998 and 2001 in 115 public drug treatment centres in Italy. Clinical and personal information were collected at intake through a structured interview. Treatments were recorded using a standardized form. Gender differences were explored with regard to characteristics at intake, treatments, and retention in methadone maintenance and therapeutic community. Cox Proportional models were carried out to identify risk factors for treatment abandon. RESULTS: Compared with men, at their first access to treatment women with drug addiction were younger, more frequently married, legally separated, divorced or widow, unemployed though better educated, HIV+; more frequently they lived with their partner and sons. They reported a higher use of sedatives, but a lower use of alcohol; more frequently they had psychiatric comorbidity, including depression, self-injuries, and suicide attempts. Psychotherapy was more frequently prescribed to women, pharmacological treatments to men. Methadone maintenance was less frequently abandoned by women. Drug abuse severity factors predicted abandon of methadone among women. High methadone doses and the combination with psychotherapy improved treatment retention in both genders. Low education level and severity factors among women and young age among men predicted abandon of therapeutic community. CONCLUSIONS: Gender differences in the VEdeTTE cohort suggest the need of a gender sensitive approach to improve treatment outcomes among heroin addicts.
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PMID : 26872763
DOI : 10.3109/10826084.2015.1108339
Keywords
heroin addiction; Gender differences; therapeutic community; treatment retention; Treatment Outcome; Sex Factors; Therapeutic Community; Risk Factors; Patient Compliance; Opiate Substitution Treatment; Middle Aged; Methadone/therapeutic use; Male; Humans; Heroin Dependence/drug therapy/psychology/therapy; Female; Combined Modality Therapy; Cohort Studies; Aged; Adult; risk factors; methadone maintenance; Young Adult; Adolescent;