High prevalence of constipation and reduced quality of life in opioid-dependent patients treated with opioid substitution treatments.
Objectives To evaluate prevalence and severity of constipation and quality of life (QoL) in a cohort of opioid-addicted patients treated with opioid substitution treatments (OST).


METHODS
A total of 1057 heroin-dependent patients treated with methadone or buprenorphine were enrolled in a multicenter observational study. Constipation was assessed by Wexner Constipation Scoring System (Wexner CSS), QoL by General Health Questionnaire (GHQ-12).


RESULTS
38.5% patients reported mild constipation, 33.3% reported moderate constipation, 14.8% severe constipation and 5.1% very severe constipation. Mean Wexner CSS score was 6.6 ± 4.8. 44.9% patients showed a GHQ-12 score ≥14; of these 18.3% patients showed a GHQ-12 score ≥20. Mean GHQ score was 13.8 ± 6.5. Mean Wexner CSS score was significantly higher in methadone patients (p = 0.004), in those taking psychoactive drugs (p = 0.0001) and in female (p < 0.0001) with respect to counterparts. Similarly, GHQ-12 mean scores were higher methadone group (p = 0.003), in those taking psychoactive drugs (p < 0.0001), and in female (p = 0.039) with respect to counterparts. ANOVA and ANCOVA showed a significant influence of methadone and female gender on Wexner CSS score while psychoactive drugs significantly influenced both tests.


CONCLUSIONS
The present study shows that patients affected by opioid-dependence in OST with methadone and buprenorphine have a high prevalence of constipation and reduced QoL.
a Addiction Unit, Department of Medicine , Verona University Hospital , Verona , Italy.
Fabio
F
Lugoboni
b Alcohol Use Disorders Unit, Department of Internal Medicine, Gastroenterology and Hepatology , Catholic University of Rome , Rome , Italy.|c Department of Medical Sciences , IRCCS Casa Sollievo della Sofferenza Hospital , San Giovanni Rotondo , Italy.
Antonio
A
Mirijello
a Addiction Unit, Department of Medicine , Verona University Hospital , Verona , Italy.
Lorenzo
L
Zamboni
a Addiction Unit, Department of Medicine , Verona University Hospital , Verona , Italy.
Marco
M
Faccini
a Addiction Unit, Department of Medicine , Verona University Hospital , Verona , Italy.
Rebecca
R
Casari
d Department of Economics, Statistics and Finance , University of Calabria , Rende , Italy.
Anthony
A
Cossari
b Alcohol Use Disorders Unit, Department of Internal Medicine, Gastroenterology and Hepatology , Catholic University of Rome , Rome , Italy.
Antonio
A
Gasbarrini
b Alcohol Use Disorders Unit, Department of Internal Medicine, Gastroenterology and Hepatology , Catholic University of Rome , Rome , Italy.
Giovanni
G
Addolorato
On Behalf Of Gics
D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects; D002047:Buprenorphine / Q000009:adverse effects*; D003248:Constipation / Q000139:chemically induced / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006556:Heroin Dependence / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008691:Methadone / Q000009:adverse effects*; D008875:Middle Aged; D058850:Opiate Substitution Treatment / Q000009:adverse effects*; D009293:Opioid-Related Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology
D000701:Analgesics, Opioid; D002047:Buprenorphine; D008691:Methadone
Constipation; buprenorphine; methadone; opioid induced bowel dysfunction; opioid induced constipation; opioid substitution treatment