title: Gender Differences in Heroin Addiction and Treatment: Results from the VEdeTTE Cohort.
abstract: BACKGROUND
  Gender differences strongly affect heroin addiction, from risk factors to patterns of consumption, access to treatments, and outcomes.
  
  
  OBJECTIVE
  To investigate gender differences in the VEdeTTE cohort of heroin addicts.
  
  
  METHODS
  VEdeTTE is a cohort of 10,454 heroin users enrolled between 1998 and 2001 in 115 public drug treatment centres in Italy. Clinical and personal information were collected at intake through a structured interview. Treatments were recorded using a standardized form. Gender differences were explored with regard to characteristics at intake, treatments, and retention in methadone maintenance and therapeutic community. Cox Proportional models were carried out to identify risk factors for treatment abandon.
  
  
  RESULTS
  Compared with men, at their first access to treatment women with drug addiction were younger, more frequently married, legally separated, divorced or widow, unemployed though better educated, HIV+; more frequently they lived with their partner and sons. They reported a higher use of sedatives, but a lower use of alcohol; more frequently they had psychiatric comorbidity, including depression, self-injuries, and suicide attempts. Psychotherapy was more frequently prescribed to women, pharmacological treatments to men. Methadone maintenance was less frequently abandoned by women. Drug abuse severity factors predicted abandon of methadone among women. High methadone doses and the combination with psychotherapy improved treatment retention in both genders. Low education level and severity factors among women and young age among men predicted abandon of therapeutic community.
  
  
  CONCLUSIONS
  Gender differences in the VEdeTTE cohort suggest the need of a gender sensitive approach to improve treatment outcomes among heroin addicts.
authors.affiliation: a Department of Clinical and Biological Sciences , University of Torino , Orbassano , Italy.|b ASLTO3, Piedmont Centre for Drug Addiction Epidemiology , Grugliasco , Italy.
authors.forename: Federica Daniela
authors.initials: FD
authors.lastname: Vigna-Taglianti
authors.affiliation: c ASLTO1 , Department of Addictions , Torino , Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Burroni
authors.affiliation: b ASLTO3, Piedmont Centre for Drug Addiction Epidemiology , Grugliasco , Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Mathis
authors.affiliation: a Department of Clinical and Biological Sciences , University of Torino , Orbassano , Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Versino
authors.affiliation: d Eclectica, Health Promotion Agency , Torino , Italy.
authors.forename: Franca
authors.initials: F
authors.lastname: Beccaria
authors.affiliation: c ASLTO1 , Department of Addictions , Torino , Italy.
authors.forename: Mara
authors.initials: M
authors.lastname: Rotelli
authors.affiliation: c ASLTO1 , Department of Addictions , Torino , Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Garneri
authors.affiliation: e Parsec Consortium , Roma , Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Picciolini
authors.affiliation: f ASL RME, Department of Epidemiology, Lazio Regional Health Service , Roma , Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Bargagli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D006556:Heroin Dependence / Q000188:drug therapy / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D058850:Opiate Substitution Treatment; D010349:Patient Compliance; D012307:Risk Factors; D012737:Sex Factors; D013808:Therapeutic Community; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D008691:Methadone
keywords: Gender differences; heroin addiction; methadone maintenance; risk factors; therapeutic community; treatment retention