title: Changes and predictors of change in the physical health status of heroin users over 24 months.
abstract: OBJECTIVE
  (i) To describe the course of physical health among the ATOS cohort over 24 months; and (ii) to examine the effects of treatment, drug use patterns and social and psychological factors on health status over 24 months.
  
  
  METHODS
  Longitudinal cohort.
  
  
  METHODS
  Sydney, Australia.
  
  
  METHODS
  A total of 615 heroin users recruited for the Australian Treatment Outcome Study (ATOS).
  
  
  RESULTS
  The general health of the cohort improved significantly over 24 months. Significant predictors of poor health over 24 months were: being older, being female, past month heroin, other opiate and tobacco use, past month unemployment and current major depression. Spending a greater proportion of time in residential rehabilitation (RR) was associated with better health over 24 months. No other treatment factors demonstrated a significant, independent relationship with health.
  
  
  CONCLUSIONS
  The physical health of dependent heroin users is affected by drug use and psychosocial problems. RR treatment appears to be particularly beneficial to the health of heroin users, suggesting the importance of a comprehensive approach to improving health among this group.
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales, NSW, Australia. anna.williamson@unsw.edu.au
authors.forename: Anna
authors.initials: A
authors.lastname: Williamson
authors.forename: Shane
authors.initials: S
authors.lastname: Darke
authors.forename: Joanne
authors.initials: J
authors.lastname: Ross
authors.forename: Maree
authors.initials: M
authors.lastname: Teesson
mesh_terms: D000293:Adolescent; D000328:Adult; D003865:Major Depressive Disorder; D005260:Female; D005544:Forecasting; D006304:Health Status; D006556:Heroin Dependence / Q000150:complications* / Q000523:psychology / Q000534:rehabilitation; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D012114:Residential Treatment; D016320:Substance Abuse Treatment Centers; D016896:Treatment Outcome