Female Sexual Health Problems in a Drug Dependency Unit

Abstract

The Government of the United Kingdom has produced a strategic plan called the Health of the Nation aimed at achieving better health in key areas including a reduction in rates of unwanted pregnancies, sexually transmitted diseases and cervical cancer. Conventional health care systems fail some groups with special needs. This cross-sectional interview study was undertaken to determine the level and type of contraceptive use, and the attitudes of female opiate abusers to the use and availability of contraceptives and cytology services. The subjects were 201 opiate-dependent women enrolled in a methadone maintenance programme in a large drug dependency unit: 169 (84.5%) were sexually active and 65 (44.2%) of non-pregnant sexually active women did not use a contraceptive method. Thirty-six (43.9%) of those using a contraceptive were using condoms, with which the majority were dissatisfied. Sixty-one (30.3%) had never had a cervical cytology smear and of those who had, 21.4% reported an abnormal result. The contraceptive practices and uptake of cervical screening services by the women studied are inadequate, reflecting poor use of conventional health care services. In addition to providing information on safer sexual practices, particularly promotion of condom use, we suggest that drug dependency units should expand their role to provide educational and preventative services to include aspects of women's health.

Opioid Use in Pregnancy, Neonatal Abstinence Syndrome, and Childhood Outcomes

“…(118–121) Even among women using contraception, approximately two-thirds of women report using condoms. (115, 120, 121)…”

Pharmacotherapy in the Treatment of Addiction: Methadone

“…Few studies have examined sexual activity and contraceptive practices in methadone-maintained females. Those that specifically addressed this topic reported the number of sexually active women in MMT ranged from 61% at a rural MMTP to 84.5% at an urban clinic; however birth control rates were similar in both MMT programs, with at least a third of sexually active women reporting no use of contraception130, 131. In one study, Harding and colleagues interviewed a subset of seven women who did not use contraception, and cited a perceived low risk of pregnancy due to a variety of reasons: infrequent sex, a history of infertility, difficulties with male erection due to partner drug use and falsely assuming breastfeeding afforded protection against pregnancy.…”

Using behavioral economic theory to increase use of effective contraceptives among opioid-maintained women at risk of unintended pregnancy

“…Even among maintained women, unintended pregnancy rates average 77% (Black et al, 2012; Welle-Strand et al, 2013) and use of effective contraceptives is low (36%; Black et al, 2012; Harding & Ritchie, 2003; Morrison et al, 1995; Ralph & Spigner, 1986). The intervention had two components.…”