30-Year trajectories of heroin and other drug use among men and women sampled from methadone treatment in California

Abstract

Background This study examines 30-year trajectories of heroin and other drug use among men and women who were in methadone maintenance treatment in California in the late1970s and interviewed in 1978–1981. Methods Nearly half (n = 428; 46.8%) of the original study sample (N = 914) was deceased. Of the remaining 486 subjects, 343 (44.3% female) completed a follow-up interview in 2005-09 (70.6% of those not deceased). Average age at follow-up was 58.3 (SD = 4.9) years for males and 55.0 (SD = 4.1) years for females. Longitudinal data was obtained on their drug use, treatment participation, and criminal justice status over the follow-up period. Trajectory group modeling was used to identify distinctive trajectory groups based on monthly averages of heroin and other drug use per year; group differences were examined. Results Four heroin and five alcohol and other drug (AOD) trajectory groups were identified. A greater proportion of women (60%) were in the “rapid decrease” heroin group (odds of use less than 10% by 10 years following initiation of use) as compared with the other groups. More rapid decrease of heroin use was associated with increases in AOD use, whereas a gradual decrease in heroin use was associated with a gradual decrease in AOD use. More school problems and earlier age at onset of heroin use and first arrest were associated with more persistent heroin use. Conclusion Heroin-use trajectories were linked with changes in AOD use. Childhood antecedents of heroin-use trajectories were identified as well as gender differences.

Treatment for opioid use and outcomes in older adults: a systematic literature review

“…Larger scale longitudinal studies tracking treatment and health outcomes have not included a significant sample of older people (Hubbard et al, 2003;Korper and Council, 2002;Ross et al, 2005). Most of the existing literature involving older adults treats them as a homogenous group and/or compares them to their younger counterparts, however there is some evidence of different subgroups within the ageing opioid population (Roe et al, 2010;Taylor and Grossberg, 2012), gender differences (Grella and Lovinger, 2011;Rosen et al, 2008;Satre et al, 2007;Satre et al, 2004), and drug use trajectories (Aharonovich et al, 2005;Bhatia et al, 2015;Colliver et al, 2006;Gfroerer et al, 2003;Grella and Lovinger, 2011;Lofwall et al, 2005;Vincent and Velkoff, 2011). These and other factors may have important implications for treatment services (Gfroerer et al, 2003;Vincent and Velkoff, 2011).…”

“…The study identified four heroin trajectory groups: (1) women were more likely to enter remission quickly, (2) rapid decreases in heroin use are associated with increased use of other drugs, (3) gradual decreases in heroin use were associated with gradual decreases in the use of other drugs, and (4) problems in school, age first arrested and younger onset of heroin use are associated with persistent use of heroin. The authors concluded that high rates of persistent drug use over 30 years follow-up suggest that ageing heroin users are in need of treatment (Grella and Lovinger, 2011). Hser and colleagues published four articles based on a 33-year longitudinal study , examining outcomes among men attending compulsory treatment for heroin dependant, criminal offenders.…”

“…Physical health appeared better among older women who had significantly lower rates of hypertension and diabetes (Rosen et al, 2008). Grella and Lovinger investigated 30-year trajectories of heroin use and found one trajectory where women were more likely than men to enter remission quickly (Grella and Lovinger, 2011).…”

Effectiveness of treatment for opioid use disorder: A national, five-year, prospective, observational study in England

“…Left untreated, OUD typically follows a chronic course causing substantial health, social and economic problems (Hser et al, 2001;Grella and Lovinger, 2011;Hser et al, 2015). In the classic Grella and Lovinger study, half of the sample died and a quarter did not experience any sustained improvement in their drug use (Grella and Lovinger, 2011).…”

Improvement of Quality of Life and Mental Health in Methadone Maintenance Therapy

“…[6][7][8] Owing to the high morbidity and mortality addicts are often infected with, which are known to be ongoing during years of dependence, addition can be considered as a chronic condition. 9,10 Proposed by WHO as the efficient therapeutic modality in opioid dependence, MMT (Methadone Maintenance Therapy) has been implemented as an effective harm reduction programme the world over, 11,12 practiced in Iran since 2003. Korasan Razavi, a northern state with joined borders with Afghanistan, accommodates more than 500 MMT clinics.…”