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      Sex differences in substance use, health, and social functioning among opioid users receiving methadone treatment: a multicenter cohort study

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          Abstract

          Background

          Despite the growing numbers of men and women with opioid use disorder in Canada, sex-specific issues in treatment have not been re-examined in the current population of patients with opioid addiction. We aimed to evaluate sex differences in substance use, health, and social functioning among men and women currently receiving methadone treatment for opioid use disorder in Ontario, Canada.

          Methods

          We recruited 503 participants with opioid dependence disorder receiving methadone maintenance treatment. We collected data on demographics, treatment characteristics, psychiatric history, addiction severity, and drug use patterns through urinalysis. We performed adjusted univariate analyses and logistic regression to identify distinct factors affecting men and women.

          Results

          Among our sample of 54 % ( n = 266) men and 46 % women ( n = 226) with mean age 38.3 years, less than half of participants were employed (35.6 %) and married (31.8 %) and had completed a high school education (27.9 %). Compared to men, women had frequent physical and psychological health problems, family history of psychiatric illness, and childcare responsibilities and began using opioids through a physician prescription. Men had higher rates of employment, cigarette smoking, and cannabis use compared to women.

          Conclusions

          Our results have revealed different patterns of substance use, health, and social functioning among men and women currently receiving methadone treatment for opioid addiction in Ontario, Canada. This information can be used to develop an integrative treatment regimen that caters to the individual needs of men and women, as well as to inform methadone treatment protocols to include specialized services (including vocational counseling, childcare and parenting assistance, medical assistance, relationship or domestic violence counseling, etc.) and increase their availability and accessibility on a larger scale.

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          Most cited references68

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          Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing

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            The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.

            Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September, 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles.18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies.A detailed explanation and elaboration document is published separately and is freely available on the websites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE statement will contribute to improving the quality of reporting of observational studies
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              A simulation study of the number of events per variable in logistic regression analysis

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                Author and article information

                Contributors
                baworm@mcmaster.ca
                dennisbb@mcmaster.ca
                MVarenbut@canatc.ca
                jdaiter@toxpro.ca
                dmarsh@nosm.ca
                cplater@toxpro.ca
                worster@mcmaster.ca
                mst@mcmaster.ca
                anglinr@mcmaster.ca
                pareg@mcmaster.ca
                dipika.desai@phri.ca
                thabanl@mcmaster.ca
                905-522-1155 ext. 36372 , samaanz@mcmaster.ca
                Journal
                Biol Sex Differ
                Biol Sex Differ
                Biology of Sex Differences
                BioMed Central (London )
                2042-6410
                10 November 2015
                10 November 2015
                2015
                : 6
                : 21
                Affiliations
                [ ]MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, Ontario Canada
                [ ]St. George’s, University of London, London, UK
                [ ]Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, Ontario Canada
                [ ]Peter Boris Centre for Addiction Research, St. Joseph’s Healthcare Hamilton, Hamilton, Ontario Canada
                [ ]Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario Canada
                [ ]Canadian Addiction Treatment Centres (CATC), Richmond Hill, Ontario Canada
                [ ]Department of Medicine, McMaster University, Hamilton, Ontario Canada
                [ ]Northern Ontario School of Medicine, Laurentian Campus, Sudbury, Ontario Canada
                [ ]Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario Canada
                [ ]Women’s Health Concerns Clinic, St. Joseph’s Healthcare Hamilton, Hamilton, Ontario Canada
                [ ]Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario Canada
                [ ]Biostatistics Unit, Centre for Evaluation of Medicine, Hamilton, Ontario Canada
                [ ]Mood Disorders Program, St. Joseph’s Healthcare, 100 West 5th Street, Hamilton, Ontario L8N 3K7 Canada
                Article
                38
                10.1186/s13293-015-0038-6
                4640383
                26557977
                4c8c0282-4571-437a-bce3-d883ea6b9590
                © Bawor et al. 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 27 June 2015
                : 5 October 2015
                Categories
                Research
                Custom metadata
                © The Author(s) 2015

                Human biology
                substance use disorders,opioid addiction,methadone maintenance treatment,sex differences,women’s health

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