Sex differences amongst dependent heroin users: histories, clinical characteristics and predictors of other substance dependence.
paper
Cited
Public
- Authors
- Shand, Fiona L; Degenhardt, Louisa; Slade, Tim; Nelson, Elliot C
- Year
- 2011
- Journal
- Addictive behaviors
- PMID
- 20833480
- DOI
- 10.1016/j.addbeh.2010.08.008
- PMCID
- PMC2981789
INTRODUCTION AND AIMS: To examine differences in the characteristics and histories of male and female dependent heroin users, and in the clinical characteristics associated with multiple substance dependence diagnoses. DESIGN AND METHODS: 1513 heroin dependent participants underwent an interview covering substance use and dependence, psychiatric history, child maltreatment, family background, adult violence and criminal history. Family background, demographic and clinical characteristics were analysed by sex. Ordinal regression was used to test for a relationship between number of substance dependence diagnoses and other clinical variables. RESULTS: Women were more likely to experience most forms of child maltreatment, to first use heroin with a boyfriend or partner, to experience ongoing adult violence at the hands of a partner, and to have a poorer psychiatric history than men. Males had more prevalent lifetime substance dependence diagnoses and criminal histories and were more likely to meet the criteria for ASPD. Predictors of multiple substance dependence diagnoses for both sexes were mental health variables, antisocial behaviour, childhood sexual abuse, victim of adult violence, younger age at first cannabis use and overdose. As the number of dependence diagnoses increased, clinical and behavioural problems increased. Childhood emotional neglect was related to increasing dependence diagnoses for females but not males, whereas PTSD was a significant predictor for males but not females. DISCUSSION AND CONCLUSIONS: Mental health problems, other substance dependence, childhood and adult trauma were common in this sample, with sex differences indicating different treatment needs and possible different pathways to heroin dependence for men and women.
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| Name | Type |
|---|---|
| abstinence after treatment local | phenotype |
| Abstinence after treatment local | phenotype |
| Adult psychiatric disorders | phenotype |
| Adult victimization local | phenotype |
| Adult violence (victim) local | phenotype |
| Adverse family background local | phenotype |
| adverse family histories local | phenotype |
| age | phenotype |
| age at first cannabis use | phenotype |
| Age at first heroin use local | phenotype |
| Age of first regular drinking local | phenotype |
| Age of initiation to drug or alcohol use local | phenotype |
| aggression | phenotype |
| alcohol | phenotype |
| alcohol abuse | phenotype |
| alcohol dependence | phenotype |
| alcohol intoxication | phenotype |
| antisocial behaviours local | phenotype |
| Antisocial behaviours local | phenotype |
| antisocial personality disorder | phenotype |
| arrest | phenotype |
| ASB | phenotype |
| ASPD | phenotype |
| Australian Treatment Outcome Study local | cohort |
| Axis II disorders | phenotype |
| Barratt Impulsivity Scale version 11 local | phenotype |
| benzodiazepines | drug |
| Blood borne viruses local | phenotype |
| borderline personality disorder | phenotype |
| both sexes local | cohort |
| BPD | phenotype |
| cannabis dependence | phenotype |
| cannabis use | phenotype |
| Childhood emotional neglect local | phenotype |
| childhood_physical_punishment local | phenotype |
| childhood_sexual_abuse local | phenotype |
| childhood trauma | phenotype |
| Christchurch Health and Development Study | cohort |
| Circumscribed Social Phobia local | phenotype |
| cocaine | phenotype |
| Comorbidity and Trauma Study local | cohort |
| Conflict Between Parents local | phenotype |
| Conroy et al 2009 cohort local | cohort |
| Counsellors local | cohort |
| crime | phenotype |
| criminal reoffending local | phenotype |
| current sample | cohort |
| dependence | phenotype |
| Dependence symptoms | phenotype |
| dependent heroin users local | cohort |
| Dependent heroin users local | cohort |
| Dependent opioid users local | cohort |
| depression | phenotype |
| drug | drug |
| drug classes | drug |
| Drug related problems local | phenotype |
| drug users in treatment local | cohort |
| Dysfunctional family background local | phenotype |
| Earlier treatment seeking local | phenotype |
| early cannabis use | phenotype |
| early-onset substance use disorders local | phenotype |
| Early separation from one or both parents local | phenotype |
| early substance use | phenotype |
| education | phenotype |
| educational attainment | phenotype |
| emotional abuse | phenotype |
| emotional_abuse local | phenotype |
| emotional neglect | phenotype |
| emotional_neglect local | phenotype |
| employment | phenotype |
| Ever relapsed to heroin use local | phenotype |
| Ever tried methadone maintenance treatment local | phenotype |
| Experienced unwanted sexual activity local | phenotype |
| externalising disorder local | phenotype |
| Externalising Disorder local | phenotype |
| Externalising disorders | phenotype |
| externalising problems | phenotype |
| Family background | phenotype |
| family conflict | phenotype |
| family dysfunction | phenotype |
| Family History Assessment Module | cohort |
| Family History Screen local | cohort |
| fatal overdose local | phenotype |
| fear of being scrutinized during routine activities local | phenotype |
| fear of social interaction local | phenotype |
| Female dependent heroin users local | cohort |
| Frequent cannabis use | phenotype |
| Friend local | phenotype |
| full sample | cohort |
| Generalised Social Phobia local | phenotype |
| general population studies local | cohort |
| General practitioners local | cohort |
| Greater Sydney region local | cohort |
| Health service utilization local | phenotype |
| heavy drinking | phenotype |
| Hepatitis C virus infection local | phenotype |
| Heroin abstinence local | phenotype |
| Heroin dependent patients in greater Sydney area local | cohort |
| Heroin overdose requiring medical treatment local | phenotype |
| Heroin relapse local | phenotype |
| Heroin use local | drug |
| Heroin use per day local | phenotype |
| Heroin use per day during period of heaviest use local | phenotype |
| heroin users | phenotype |
| illicit drugs | phenotype |
| impulsivity | phenotype |
| incarceration | phenotype |
| Increased mortality risk local | phenotype |
| Injecting behaviours local | phenotype |
| injecting drug users local | cohort |
| injuries_from_physical_punishment local | phenotype |
| internalising disorder local | phenotype |
| Internalising Disorder local | phenotype |
| Internalising disorders | phenotype |
| Latent severity spectra local | phenotype |
| Length of heroin career local | phenotype |
| Lifetime panic disorder local | phenotype |
| liver disease | phenotype |
| Longer treatment retention local | phenotype |
| major depressive disorder | phenotype |
| Male dependent heroin users local | cohort |
| male heroin users local | cohort |
| marital status | phenotype |
| marriage breakdown local | phenotype |
| Marriage Breakdown local | phenotype |
| men | cohort |
| Mental health services local | cohort |
| Mental health variables local | phenotype |
| Methadone | drug |
| Mono-substance dependence local | phenotype |
| mood disorders | phenotype |
| mortality ratios local | phenotype |
| Multiple dependence diagnoses local | phenotype |
| Multiple heroin overdoses requiring medical treatment local | phenotype |
| Multiple lifetime dependence diagnoses local | phenotype |
| multiple substance dependence local | phenotype |
| multiple substance dependence diagnoses local | phenotype |
| Multiple substance dependence diagnoses local | phenotype |
| Negative peer affiliations local | phenotype |
| neglect | phenotype |
| New South Wales local | cohort |
| nicotine | drug |
| nicotine dependence | phenotype |
| Non-fatal heroin overdose local | phenotype |
| non-fatal overdose | phenotype |
| Non-treatment samples local | cohort |
| Number of suicide attempts local | phenotype |
| Ongoing assault and violence local | phenotype |
| onset of cannabis use | phenotype |
| Onset of heroin use local | phenotype |
| opioid dependence | phenotype |
| Opioid pharmacotherapy clinics | cohort |
| Opioid replacement therapy local | drug |
| Opioid replacement treatment local | cohort |
| other drug use | phenotype |
| other substances | phenotype |
| outcome | phenotype |
| Outpatient counseling local | phenotype |
| overdose | phenotype |
| panic disorder | phenotype |
| parental alcohol use | phenotype |
| Parental drug/alcohol problem local | phenotype |
| participants | cohort |
| Partner local | phenotype |
| Perpetrator of adult violence local | phenotype |
| Perpetrator of assault local | phenotype |
| Persistent suicidal thoughts local | phenotype |
| personality disorders | phenotype |
| Pharmacotherapy maintenance treatment local | drug |
| physical abuse | phenotype |
| Physical conflict between parents local | phenotype |
| physical neglect | phenotype |
| polydrug use local | drug |
| polysubstance abuse | phenotype |
| polysubstance dependence | phenotype |
| Poor economic outcomes local | phenotype |
| Poorer psychosocial functioning local | phenotype |
| poorer treatment outcomes local | phenotype |
| Poorest psychosocial functioning local | phenotype |
| Poor legal outcomes local | phenotype |
| poor mental health | phenotype |
| Poor physical health local | phenotype |
| poor_relationship_with_mother local | phenotype |
| Poor social outcomes local | phenotype |
| Post-Traumatic Stress Disorder | phenotype |
| prescribed sedative use local | phenotype |
| Prison local | phenotype |
| prison time local | phenotype |
| Prison time local | phenotype |
| Private practice local | cohort |
| problematic_parental_substance_use local | phenotype |
| Problematic parental substance use local | phenotype |
| psychiatric disorders | phenotype |
| Psychiatrists | cohort |
| psychological problems | phenotype |
| psychologists | cohort |
| psychosis | phenotype |
| psychoticism | phenotype |
| raised_by_both_biological_parents_until_age_16 local | phenotype |
| Reference group local | cohort |
| Relapse to heroin use local | phenotype |
| Residential rehabilitation local | phenotype |
| risky injecting behaviour local | phenotype |
| sedative dependence | phenotype |
| sedatives | drug |
| self-harm | phenotype |
| Self-harming behaviours local | phenotype |
| Self-reported drug use local | drug |
| sentence length local | phenotype |
| Severity spectrum local | phenotype |
| sex | phenotype |
| sex work local | phenotype |
| Social Interaction Anxiety Scale local | phenotype |
| Social Phobia Scale local | phenotype |
| Standardised mortality ratio local | phenotype |
| stimulant dependence | phenotype |
| stimulants | drug |
| Study respondents local | cohort |
| substance use | phenotype |
| suicidal thoughts and behaviours local | phenotype |
| suicide | phenotype |
| Suicide plans local | phenotype |
| Supervised detoxification local | phenotype |
| teenage parenthood | phenotype |
| Time in prison ever local | phenotype |
| trauma | phenotype |
| Treatment dropout local | phenotype |
| Treatment for heroin dependence local | phenotype |
| treatment samples | cohort |
| unemployment | phenotype |
| Unfavourable social factors local | phenotype |
| Unsupervised detoxification local | phenotype |
| Unwanted sexual activity local | phenotype |
| Verbal conflict between parents local | phenotype |
| Victim of adult violence local | phenotype |
| Victim of assault local | phenotype |
| violence | phenotype |
| Violence between parents local | phenotype |
| Violence perpetration local | phenotype |
| women | cohort |
| Women entering opioid replacement treatment local | cohort |
| Younger age at first cannabis use local | phenotype |
| Younger onset of cannabis use local | phenotype |
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