Abstract
Background
There are an estimated 40,000 to 90,000 injection opiate users in Canada. The social, economic and health consequences of opiate addiction have been well documented. However, there are no data on the self-perceived health status of opiate users in Canada. Therefore, the goal of this research is to gain an understanding of the selfperceived health status of opiate users by comparing the health-related quality of life of opiate users to chronic disease populations and to the general population.
Methods
The SF-36 was administered to a nonrandom sample of 143 opiate users entering low-threshold methadone treatment. Two sample t-tests were performed to assess statistical differences, at a 5% level of significance, between population scores across SF-36 dimensions.
Results
Opiate users perceived both their mental and physical health as worse than the general population and individuals with minor and serious medical problems, but comparable to those with diagnosed psychiatric illnesses.
Conclusions
Methadone treatment services should incorporate both primary care and psychiatric care into their programs, or at the very least secure appropriate referral mechanisms to ancillary services to ensure that the health concerns of opiate users are dealt with in the context of their treatment program.
Résumé
Contexte
Selon les estimations, il y aurait entre 40 000 et 90 000 utilisateurs d’opiacés injectables au Canada. Les conséquences sociales, économiques et sanitaires des toxicomanies opiacées sont bien documentées, mais il n’existe aucune donnée sur l’état de santé autoperçu des utilisateurs d’opiacés au Canada. Nous avons donc cherché à comprendre l’état de santé autoperçu des utilisateurs d’opiacés en comparant leur qualité de vie (du point de vue de la santé) à celle de personnes atteintes de maladies chroniques et de la population générale.
Méthode
Nous avons administré le questionnaire SF-36 à un échantillon non aléatoire de 143 utilisateurs d’opiacés qui entreprenaient un traitement à la méthadone à seuil bas. Nous avons ensuite exécuté deux tests t modèles afin d’évaluer l’écart statistique, à un seuil de signification de 5 %, entre les notes obtenues par les segments démographiques selon les volets du questionnaire.
Résultats
L’état de santé mentale et physique perçu par les utilisateurs d’opiacés était pire que dans la population générale et pire que chez les personnes atteintes de problèmes de santé mineurs ou graves, mais il était comparable à l’état de santé perçu des personnes ayant un diagnostic de maladie psychiatrique.
Conclusions
Les services de traitement à la méthadone devraient intégrer à la fois des soins primaires et psychiatriques dans leurs programmes, ou à tout le moins des mécanismes d’aiguillage appropriés vers des services complémentaires, pour que l’on s’occupe des préoccupations de santé des utilisateurs d’opiacés dans le cadre de leur traitement.
Footnotes
Acknowledgements: This study was originally funded by National Health Research and Development Program (NHRDP) grant no. 6606-06-2000, with continued support from the Canadian Institute for Health Research (CIHR) grant HHP-50150. Dr. Millson is supported by a Scientist Award from the Ontario HIV Treatment Network (OHTN). We gratefully acknowledge the methadone programme staff for their assistance with recruitment, and the study participants for their time and effort in being part of this study.
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