Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.
Department of Psychology, University of Tennessee, Chattanooga, Tennessee, USA.
Subst Use Misuse. 2021;56(4):529-538. doi: 10.1080/10826084.2021.1887242. Epub 2021 Mar 1.
Continued substance use is common during opioid use disorder (OUD) treatment. There are still inconsistencies in how continued substance use and concurrent patterns of substance use among patients with OUD varies by gender. There is still more to learn regarding how factors associated with continued and concurrent use might differ for men and women in methadone maintenance treatment (MMT). This cross-sectional study examined predictors of concurrent substance use subgroups among patients receiving MMT. The sample included 341 ( = 161 women) MMT patients aged 18 and older from opioid treatment programs in Southern New England and the Pacific Northwest. Patients completed a survey assessing sociodemographic and clinical characteristics including past-month substance use. Latent class analyses were conducted by gender to identify groups based on substance use and determine predictors of those classes. Three-class solutions were the optimal fit for both men and women. For both genders, the first subgroup was characterized as Unlikely Users (59.8% women, 52.8% men). Classes 2 and 3 among women were Cannabis/Opioid Users (23.7%) and Stimulant/Opioid Users (13.0%). Among men, Classes 2 and 3 consisted of Alcohol/Cannabis Users (21.9%) and Cannabis/Stimulant/Opioid Users (25.3%). Ever using Suboxone (buprenorphine/naloxone) and depression/anxiety symptoms were significantly linked to substance use group among women, whereas homelessness and employment status were significantly associated with substance use group among men. This study furthers understanding of gender differences in factors associated with continued substance use and distinctive patterns of concurrent substance use that may guide tailored treatments among patients MMT.
在阿片类药物使用障碍（OUD）治疗期间，持续使用物质是很常见的。在性别方面，OUD 患者的持续物质使用和同时存在的物质使用模式存在不一致的情况。在美沙酮维持治疗（MMT）中，与持续和同时使用相关的因素如何因男性和女性而异，仍有更多需要了解。本横断面研究调查了接受 MMT 的患者中同时存在物质使用亚组的预测因素。该样本包括来自新英格兰南部和太平洋西北地区阿片类药物治疗项目的 341 名（ = 161 名女性）年龄在 18 岁及以上的 MMT 患者。患者完成了一项调查，评估了社会人口统计学和临床特征，包括过去一个月的物质使用情况。根据性别进行潜在类别分析，根据物质使用情况对患者进行分组，并确定这些类别的预测因素。对于男性和女性，三种解决方案都是最佳拟合。对于两种性别，第一个亚组的特征是不太可能使用者（59.8%女性，52.8%男性）。女性的第 2 和第 3 类是大麻/阿片类药物使用者（23.7%）和兴奋剂/阿片类药物使用者（13.0%）。男性的第 2 和第 3 类包括酒精/大麻使用者（21.9%）和大麻/兴奋剂/阿片类药物使用者（25.3%）。女性中，曾使用丁丙诺啡（丁丙诺啡/纳洛酮）和抑郁/焦虑症状与物质使用组显著相关，而男性中，无家可归和就业状况与物质使用组显著相关。本研究进一步了解了与女性持续物质使用相关的因素以及与男性同时存在物质使用模式的性别差异，这可能有助于为 MMT 患者提供有针对性的治疗。
