title: Differences in drug consumption, comorbidity and health service use of opioid addicts across six European urban regions (TREAT-project).
abstract: OBJECTIVE
  This comparative study investigated consumption patterns, comorbidity and treatment utilization of opioid addicts in six European cities (Athens, Essen, London, Padua, Stockholm, Zurich).
  
  
  METHODS
  Data were collected by structured face-to-face interviews. The representative sample comprises 599 addicts (100 patients per centre, 99 in London) at the start of a treatment episode.
  
  
  RESULTS
  Patients were dependent on opioids for about 10 years. Regional differences were significant regarding the patients' drug consumption pattern and their method of heroin administration (up to a fourth of the patients in Essen, London and Zurich usually smoke heroin). Concomitant use of benzodiazepines, cannabis and alcohol was common in all regions with the German and English samples showing the highest level of polydrug use. The prevalence of major depression was high in all regions (50%). Stockholm and London patients worry most about their physical health. Differences in the amount of needle sharing and especially in the use of public health service were prominent between the sites. Opioid addiction was a long-term disorder associated with a high burden of comorbidity and social problems in all cities.
  
  
  CONCLUSIONS
  The results of the study show significant interregional differences of opioid addicts which might require different treatment strategies in European countries to handle the problem.
authors.affiliation: Addiction Research Group at the Department of Psychiatry and Psychotherapy, Department of Child and Adolescent Psychiatry and Psychotherapy, LVR Hospital, University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Reissner
authors.forename: A
authors.initials: A
authors.lastname: Kokkevi
authors.forename: F
authors.initials: F
authors.lastname: Schifano
authors.forename: R
authors.initials: R
authors.lastname: Room
authors.forename: J
authors.initials: J
authors.lastname: Storbjörk
authors.forename: R
authors.initials: R
authors.lastname: Stohler
authors.forename: L
authors.initials: L
authors.lastname: DiFuria
authors.forename: J
authors.initials: J
authors.lastname: Rehm
authors.forename: M
authors.initials: M
authors.lastname: Geyer
authors.forename: F
authors.initials: F
authors.lastname: Hölscher
authors.forename: N
authors.initials: N
authors.lastname: Scherbaum
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology*; D019970:Cocaine-Related Disorders / Q000453:epidemiology; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology; D055030:Drug Users; D005060:Europe / Q000453:epidemiology; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016485:Needle Sharing; D009293:Opioid-Related Disorders / Q000453:epidemiology*