Nemati Ahmad, Raouf-Rahmati Amene, Serhan Hosein, Mashreghi Ahmad Reza, DadgarMoghaddam Maliheh, Hakim Hakime Ghadiri, Talebi Mahdi, Ahmadi Reza, Niroumand Shabnam
Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Immunology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Sci Rep. 2025 Aug 17;15(1):30107. doi: 10.1038/s41598-025-15747-6.
Opioid use disorder (OUD) is a significant global health issue, with harm reduction strategies like Opioid Substitution Treatment (OST) playing a crucial role in improving quality of life (QoL) for affected individuals. In Iran, Methadone Maintenance Treatment (MMT) and Buprenorphine Maintenance Treatment (BMT) have been implemented for over two decades. This study aims to compare the QoL outcomes between these two treatment modalities among opioid-dependent individuals in three outpatient OST clinics. The World Health Organization Quality of Life - Brief Version (WHOQOL-BREF) questionnaire was utilized to evaluate QoL in domains of physical health, psychological health, social relationships, environment, and general health. QoL was compared between patients receiving methadone and buprenorphine while considering demographic characteristics and treatment duration. Multivariate linear regression analysis identified factors associated with QoL. The study included 200 participants with a mean age of 42.7, comprising 103 individuals treated with buprenorphine and 97 treated with methadone. Buprenorphine-treated patients were more likely to be married, female, younger, and have shorter treatment durations. Methadone-treated patients reported higher QoL in physical health (P = 0.001) and social relationship (P = 0.002) domains, while buprenorphine-treated patients reported better environmental health (P < 0.001). No significant differences were found in psychological domains. These QoL differences remained significant after adjusting for confounders. Age, marital status, and gender were significantly associated with various QoL dimensions. The findings indicate that methadone patients reported higher QoL in the social and physical domains in comparison with buprenorphine group, which contrasts with previous studies in other countries. These results highlight the potential impact of cultural context on QoL outcomes for individuals with OUD and provide a basis for future research and development of optimized, culturally sensitive treatment strategies within harm reduction frameworks in developing countries.
阿片类物质使用障碍（OUD）是一个重大的全球健康问题，阿片类物质替代治疗（OST）等减少伤害策略在改善受影响个体的生活质量（QoL）方面发挥着关键作用。在伊朗，美沙酮维持治疗（MMT）和丁丙诺啡维持治疗（BMT）已经实施了二十多年。本研究旨在比较这两种治疗方式在三个门诊OST诊所的阿片类物质依赖个体中的生活质量结果。使用世界卫生组织生活质量简表（WHOQOL-BREF）问卷来评估身体健康、心理健康、社会关系、环境和总体健康领域的生活质量。在考虑人口统计学特征和治疗持续时间的同时，对接受美沙酮和丁丙诺啡治疗的患者的生活质量进行了比较。多变量线性回归分析确定了与生活质量相关的因素。该研究纳入了200名平均年龄为42.7岁的参与者，其中103人接受丁丙诺啡治疗，97人接受美沙酮治疗。接受丁丙诺啡治疗的患者更有可能已婚、为女性、年龄较小且治疗持续时间较短。接受美沙酮治疗的患者在身体健康（P = 0.001）和社会关系（P = 0.002）领域报告的生活质量较高，而接受丁丙诺啡治疗的患者报告的环境健康状况较好（P < 0.001）。在心理领域未发现显著差异。在调整混杂因素后，这些生活质量差异仍然显著。年龄、婚姻状况和性别与各个生活质量维度显著相关。研究结果表明，与丁丙诺啡组相比，美沙酮治疗患者在社会和身体领域报告的生活质量较高，这与其他国家以前的研究结果相反。这些结果突出了文化背景对OUD个体生活质量结果的潜在影响，并为发展中国家在减少伤害框架内未来研究和开发优化且具有文化敏感性的治疗策略提供了依据。
