Substance Use: Substance use comparisons included lifetime and past 30 day use(Figure 3) and lifetime use. For past 30 day use, more men reported heroin use(p=.03), but more women reported other opiate (p<.01) and amphetamine (p<.01)use. For lifetime use, more men reported alcohol (p=.04), marijuana (p<.01), andmulti substance (p=.04) use, while more women reported other opiate (p<.01) andamphetamine (p<.01) use. Men also reported more past 30 day alcohol use (p=.04),lifetime alcohol use (p<.01), lifetime alcohol use to intoxication (p=.03), lifetime heroinuse (p<.01), lifetime marijuana use (p<.01), lifetime multi substance use (p<.01), andlifetime nicotine use (p=.04). Women reported more amphetamine use in past 30days (p<.01). Based on urine toxicology results, more women had positive results foramphetamine (p<.01), PCP (p=.02), and methamphetamine (p<.01), while more menhad positive results for marijuana (p=.03).
Gender-specific profiles among opiate-dependent individuals were observed withregard to substance use severity, craving, and impairment in associated areas offunctioning. Overall, women demonstrated a more severe clinical profile than men,as evidenced by significantly higher ASI-Lite subscale scores assessing drug use,occupational functioning, family and social relationship functioning, medical, andpsychiatric problems. As compared to men, women also had more past and activemedical conditions and reported higher craving for opiates. The findings highlightthe potential usefulness of gender-sensitive assessment and treatmentinterventions.
Gender Differences at Presentation for Treatment-Seeking Opiate
Dependence
Louise Haynes1, Amy Wahlquist2, Rickey Carter2, Sudie Back1, Rebecca Payne1, Maureen Hillhouse3
1Psychiatry and Behavioral Sciences, 2Biostatistics, Bioinformatics, and Epidemiology,
Medical University of South Carolina, Charleston, SC
3Univeristy of California, Los Angeles
Background
References
Acknowledgements
Results
Methods
Significant gender differences in substance use disordershave been reported in the literature. Little is known, however,with regard to gender differences in patients presenting withopiate dependence.
The NIDA-sponsored Clinical Trials Network (CTN) study ofbuprenorphine taper schedules was designed to compare theeffects of a short and long taper schedule of buprenorphine onparticipant outcomes (CTN-003)1. The study was conductedfrom 2003-2005 at 11 participating treatment programs in 10U.S. cities across the country. A total of 990 individuals agreedto participant in the trial.
Participants: The participants for this secondary data analysiswere individuals seeking outpatient treatment for opiatedependence that were screened for CTN-003. Since the currentstudy aimed to examine
Demographics: There was a statistically significant difference between men andwomen’s race, employment, and education completed. No other significantdifferences were noted (Table 1).
Conclusions
1. Ling W, Hillhouse M, Domier C, Doraimani G, Hunter J, Thomas C, Jenkins J, Hasson A, AnnonJ, Saxon A, Selzer J, Boverman J, Bilangi R. “Buprenorphine tapering schedule and illicit opioiduse.” Addiction 104(2):256-265 (2009).
Figure 1. Participants
Figure 3. Gender differences in percent that reported any use in the past 30 days
p=.10
p=.05
p=.03
p=.25
p=.98
p=.45
p=.19
p=.97
p=.06
p<.01
p=.51
p=.01
p<.01
p=.48
p<.01
Table 1. Demographic characteristics
Figure 2. ASI-Lite subscale scores
p<.01
p<.01
p<.01
p<.01
p=.04
p<.01
p<.01
Demographic characteristics, baseline substance use,withdrawal symptoms, craving, medical history, and otherassociated areas of functioning were assessed. Acomprehensive battery of instruments was administeredincluding the Addiction Severity Index-Lite (ASI-Lite), AdjectiveRating Scale for Withdrawal (ARSW), Clinical Opiate WithdrawalScale (COWS), a medical history for past and current physicalhealth conditions, and a visual analog scale (VAS). The VASconsisted of two questions at baseline: 1) “How much do youcurrently crave opiates?” and 2) “How would you rate yourcurrent opiate withdrawal symptoms?”.
Statistical analysis: Wilcoxon rank sum and Pearson chi-squaretest statistics were used to test the equality of means andfrequencies, respectively, between men and women at baseline.
differences at presentation betweenmales and females, the only inclusioncriteria to be included in the analysiswere 1) DSM-IV diagnosis of opioiddependence and 2) a non-missinggender reported. Two subjects did notreport gender on the baselineassessment and were excluded from theanalysis. The sample for this analysisincluded 892 participants, 293 womenand 599 men (Figure 1).
ASI-Lite: Men had significantly higher alcohol and legal ASI-Lite compositescores. In contrast, women had significantly higher drug, employment, family,medical, and psychiatric ASI-Lite composite scores (Figure 2).
Craving and Withdrawal: Women reported significantly higher baseline cravingfor opiates based on the VAS. No significant gender differences in opiatewithdrawal symptoms were revealed (Table 1).
Physical Health: Women reported more past and active medical conditions, withthe exception of more men reporting active renal conditions.
This study is partially supported by a grant from the National Institute on Drug Abuse (NIDA) CTN SCgrant U10DA013727 (PI: Kathleen Brady). CTN databases and information are available atwww.ctndatashare.org.
