TY - JOUR
KW - buprenorphine
KW - Methadone
KW - opioid use disorder
KW - Sex Differences
KW - Social functioning
AU - E. A. van Reekum
AU - T. Rosic
AU - J. Hudson
AU - N. Sanger
AU - D. C. Marsh
AU - A. Worster
AU - L. Thabane
AU - Z. Samaan
A1 - 
AB - BACKGROUND: Social functioning (SF), the ability to engage with life and fulfill roles may be a salient "patient important outcome" in addiction treatment. It is not known if medication-assisted treatment (MAT) impacts SF in opioid use disorder (OUD). There is a growing evidence to suggest that men and women are impacted differently by OUD. This study is the largest to date to study sex differences in OUD and explore associations between MAT and SF. METHODS: Data were collected from 2736 participants with OUD, enrolled in MAT for varying lengths of time, in outpatient clinics across Ontario. SF was defined according to the Maudsley Addiction Profile's domains of (1) employment, (2) criminal activity, and (3) interpersonal conflict. Using logistic regression analysis, we examined sociodemographic and clinical factors associated with domains of SF. RESULTS: There were 1544 men (56%) and 1192 women (44%) in this study, and ages varied from 17 to 76 years for men and 18 to 69 years for women. At study entry, participants had been on MAT for a median of 2 years. Compared to men, women reported more psychological (mean MAP score 14/40, SD = 9.55, versus 11/40, SD = 8.64; p < 0.001) and physical symptoms (mean MAP score 17/40, SD = 7.70 versus 14/40, SD = 7.74; p < 0.001). More women reported unemployment(74% versus 58%; p < 0.0001) and interpersonal conflict (46% versus 35%; p < 0.0001). Men were more likely than women to report criminal activity (11%, versus 8%; p = 0.001). Psychological symptoms increased the risk of worse SF, across domains, for men and for women. Every year on MAT was associated with a 7% increase in the odds of women engaging with criminal activity (OR = 1.07, 95% CI 1.02, 1.12, p = 0.006). CONCLUSIONS: Men and women had different SF profiles and psychological symptoms scores while on MAT. The length of time on MAT increased the risk of criminal activity in women, and overall, duration of MAT was not associated with improvement in SF. This may suggest that MAT alone may not support continual improvements in SF in OUD.
AD - Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada. Emma.vanreekum@medportal.ca.; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.; Northern Ontario School of Medicine, Sudbury, ON, Canada.; Canadian Addiction Treatment Centres, Markham, ON, Canada.; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.; Department of Medicine, McMaster University, Hamilton, ON, Canada.; Biostatistics Unit, Research Institute at St Joseph's Healthcare, Hamilton, ON, Canada.; Departments of Pediatrics/Anesthesia, McMaster University, Hamilton, ON, Canada.; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
BT - Biology of sex differences
C5 - Education & Workforce; Healthcare Disparities; Measures; Opioids & Substance Use
CP - 1
DO - 10.1186/s13293-020-00298-4
IS - 1
JF - Biology of sex differences
LA - eng
M1 - Journal Article
N2 - BACKGROUND: Social functioning (SF), the ability to engage with life and fulfill roles may be a salient "patient important outcome" in addiction treatment. It is not known if medication-assisted treatment (MAT) impacts SF in opioid use disorder (OUD). There is a growing evidence to suggest that men and women are impacted differently by OUD. This study is the largest to date to study sex differences in OUD and explore associations between MAT and SF. METHODS: Data were collected from 2736 participants with OUD, enrolled in MAT for varying lengths of time, in outpatient clinics across Ontario. SF was defined according to the Maudsley Addiction Profile's domains of (1) employment, (2) criminal activity, and (3) interpersonal conflict. Using logistic regression analysis, we examined sociodemographic and clinical factors associated with domains of SF. RESULTS: There were 1544 men (56%) and 1192 women (44%) in this study, and ages varied from 17 to 76 years for men and 18 to 69 years for women. At study entry, participants had been on MAT for a median of 2 years. Compared to men, women reported more psychological (mean MAP score 14/40, SD = 9.55, versus 11/40, SD = 8.64; p < 0.001) and physical symptoms (mean MAP score 17/40, SD = 7.70 versus 14/40, SD = 7.74; p < 0.001). More women reported unemployment(74% versus 58%; p < 0.0001) and interpersonal conflict (46% versus 35%; p < 0.0001). Men were more likely than women to report criminal activity (11%, versus 8%; p = 0.001). Psychological symptoms increased the risk of worse SF, across domains, for men and for women. Every year on MAT was associated with a 7% increase in the odds of women engaging with criminal activity (OR = 1.07, 95% CI 1.02, 1.12, p = 0.006). CONCLUSIONS: Men and women had different SF profiles and psychological symptoms scores while on MAT. The length of time on MAT increased the risk of criminal activity in women, and overall, duration of MAT was not associated with improvement in SF. This may suggest that MAT alone may not support continual improvements in SF in OUD.
PY - 2020
SN - 2042-6410; 2042-6410
SP - 020
EP - 4
EP - 20+
T1 - Social functioning outcomes in men and women receiving medication-assisted treatment for opioid use disorder
T2 - Biology of sex differences
TI - Social functioning outcomes in men and women receiving medication-assisted treatment for opioid use disorder
U1 - Education & Workforce; Healthcare Disparities; Measures; Opioids & Substance Use
U2 - 32326982
U3 - 10.1186/s13293-020-00298-4
VL - 11
VO - 2042-6410; 2042-6410
Y1 - 2020
Y2 - Apr 23
ER -