title: Sex differences in substance use, health, and social functioning among opioid users receiving methadone treatment: a multicenter cohort study.
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.
authors.affiliation: 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.
authors.forename: Monica
authors.initials: M
authors.lastname: Bawor
authors.affiliation: 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.
authors.forename: Brittany B
authors.initials: BB
authors.lastname: Dennis
authors.affiliation: Canadian Addiction Treatment Centres (CATC), Richmond Hill, Ontario Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Varenbut
authors.affiliation: Canadian Addiction Treatment Centres (CATC), Richmond Hill, Ontario Canada.
authors.forename: Jeff
authors.initials: J
authors.lastname: Daiter
authors.affiliation: Canadian Addiction Treatment Centres (CATC), Richmond Hill, Ontario Canada ; Northern Ontario School of Medicine, Laurentian Campus, Sudbury, Ontario Canada.
authors.forename: David C
authors.initials: DC
authors.lastname: Marsh
authors.affiliation: Canadian Addiction Treatment Centres (CATC), Richmond Hill, Ontario Canada.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Plater
authors.affiliation: 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.
authors.forename: Andrew
authors.initials: A
authors.lastname: Worster
authors.affiliation: 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.
authors.forename: Meir
authors.initials: M
authors.lastname: Steiner
authors.affiliation: Department of Medicine, McMaster University, Hamilton, Ontario Canada ; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario Canada.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Anglin
authors.affiliation: Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, Ontario Canada ; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario Canada.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Pare
authors.affiliation: Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, Ontario Canada.
authors.forename: Dipika
authors.initials: D
authors.lastname: Desai
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario Canada ; Biostatistics Unit, Centre for Evaluation of Medicine, Hamilton, Ontario Canada.
authors.forename: Lehana
authors.initials: L
authors.lastname: Thabane
authors.affiliation: 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 ; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario Canada ; Mood Disorders Program, St. Joseph's Healthcare, 100 West 5th Street, Hamilton, Ontario L8N 3K7 Canada.
authors.forename: Zainab
authors.initials: Z
authors.lastname: Samaan
keywords: Methadone maintenance treatment; Opioid addiction; Sex differences; Substance use disorders; Women’s health