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Thank you for visiting nature. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser or turn off compatibility mode in Internet Explorer. In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript. Studies on recovery patterns and how baseline factors influence recovery consequences among heroin dependent patients have shown mixed results. This study is aimed at describing the gender differences in long-term recovery patterns and exploring the predictors of negative recovery consequences by gender among heroin dependent patients in Shanghai, China. At baseline, this study recruited heroin dependent patients discharged from Shanghai compulsory rehabilitation facilities in and Generalized Estimating Equations GEE were used to compare males with females in terms of the presence of negative consequences incarceration, or readmission to compulsory treatment, or both , in the subsequent 5-years after their discharge from compulsory treatment. Ordinary least squares OLS regression was used to explore factors associated to the time length of negative consequences in 5 years after the discharge for males and females separately. Our findings indicate that female heroin dependent patients tend to have less negative recovery outcomes than male patients. Male patients with a life-time history of poly drug use and female patients with borderline personality disorder are especially at risk of incarceration and readmission into compulsory treatment programs. Despite the increased use of a wide range of stimulative drugs, the use of opioids continues to be a major drug problem globally 1 , 2. Obviously heroin dependence is associated with high rates of mortality, morbidity and other adverse consequences, such as criminal involvement and incarceration 3 , 4 , 5 , 6. However, studies on recovery patterns and how baseline factors influence recovery consequences among heroin dependent patients have shown mixed results. Moreover, most previous studies focused on the population in Europe and North America and the population in Asia was largely understudied. In this study, we are especially interested in gender differences in recovery. Past researches have shown that men and women differ in treatment processes, retention, completion, outcomes and determinants of post-treatment outcomes 7 , 8 , 9. Such variations may be explained by gender differences in social supports and mental health status 6 , 10 , However, previous studies on the gender effects on long-term recovery consequences have revealed mixed results 12 , Predictors for recovery consequences by gender were also understudied among population in Asia. Thus, studies on the gender effects, especially in diverse settings and cultural backgrounds, are still in need. The lack of empirical data on patterns of relapse and criminal activities and predictors to recovery consequence among Chinese patient population has become one major challenge to evaluate and improve the recovery model, particularly when China shift to a new recovery model and system. To date, the recovery pattern and associated factors among Chinese population who evolved in the new model has not been reported before. In order to fill the knowledge gaps discussed above, this study obtained longitudinal data on a group of heroin dependent patients who were discharged from compulsory treatment facilities in Shanghai. This study examined how males and females differ in recovery patterns and predictors of negative consequences re-use and criminality from heroin addiction. We hope that better understanding of how females and males differ in their recovery patterns and the influential factors can contribute to improving gender-appropriate interventions and recovery strategies. On average, heroin dependent patients in our study had a baseline history of 2. The analytic sample included males and females. Of all participants, the mean age was Most of them were Han, more than one-half Prior to being admitted to compulsory treatment, the reported average daily heroin dose of the participants was 0. In terms of mental health status of participants, Table 1 presents the demographic and clinical characteristics of the participants. Initial GEE analyses based on 5 years 60 months longitudinal data showed the odds of having negative consequences in 5 years after the discharge from compulsory treatment among females are 0. Natural history of heroin dependent patients who discharged from the compulsory treatment program in Shanghai, China. Percentage of male and female participants who having negative consequences in 5 years after the discharge from compulsory treatment. OLS analyses were conducted for males and females separately. After excluding death cases and adjusting age, education differences, results showed that having a life-time history of using other illegal drugs was associated with having 6. This study examined gender differences in recovery patterns among a sample of patients discharged from compulsory treatment over a five-year period in Shanghai, China. The present study also suggested that baseline predictors of incarceration and readmission to compulsory treatment at post-treatment follow-up were different for male and female. This is the first study that has used longitudinal data to explore gender difference among a Chinese population. These findings also extended our knowledge of gender difference in longitudinal patterns of recovery and predictors for negative consequence. Foremost among the findings is the confirmation that the longitudinal patterns of recovery differ by gender. After adjusting life-time history of mental disorders, demographic characteristics and baseline addiction severity, this study still found a significant gender differences in longitudinal patterns of recovery among Chinese heroin dependent patients. This finding suggests that except for those known factors, there are perhaps some additional factors which may potentially mediate or moderate the effects of gender. However, the underlying mechanisms of gender effects still could not be identified in this study, as in most previous studies. Future studies that have analysis with those potential factors will help to explore whether the gender per se or other factors correlated with gender are the key drivers of gender difference in recovery. The significant predictor at baseline for higher risk of negative consequences was using multiple drugs for men. This result is consistent with previous studies Thus, we suggest healthcare providers to pay special attention to heroin dependent patients who use multiple substances, especially among males. For women, the significant predictor at baseline is having a life-time history of Borderline Personality Disorder BPD. Previous studies revealed that having a co-occurring mental illness is associated with worse substance abuse treatment outcomes 16 , 17 and more crime involvements 16 , Since co-morbidity of personality disorder and substance use was common among heroin addicts in Chinese compulsory treatment programs 19 , our finding highlight the importance of integrating psychological intervention in compulsory treatment for females to achieve optimal recovery outcomes. Different from findings reported in the literature 16 , 20 , 21 , 22 , age, marriage, education, employment, life-time history of antisocial personality disorder and life-time history of depression or anxiety were not significant predictors to post-treatment negative consequences. The study findings should be considered within the context of the limitations. First, due to limitations of the data, we were not able to check the abstinence status of each participant when they were in MMT or in the community. Some patients may relapse but were not found or sent to a compulsory treatment center. Second, all samples were recruited from the compulsory treatment programs in Shanghai. Thus, our results might not be generalized to heroin dependent patients who have never entered a compulsory treatment program or from other areas of China. In summary, our study explored the gender differences in longitudinal recovery patterns and predictors for negative consequences after being discharged from compulsory treatment programs. This information can contribute to improving gender-appropriate interventions and recovery strategies. This study was designed as a cohort study. The follow-up data was extracted from an electronic monthly summary record system, initially built by Shanghai Municipal Narcotics Control Committee in March This electronic database was managed by social workers who are employed by the government to help drug users in the community and to monitor drug use behaviors. This official electronic database now contains the following information of over 40, registered drug users: ID number, basic demographic information, legal status and drug abuse treatment history. The unique ID number was used to link our baseline data to the official record database. In the official record database, the following categories of drug-related information were recorded each month in a chronological order: incarceration, readmission to compulsory treatment, methadone maintenance treatment participation. These events were recorded as binomial variables happened or not. Informed consent was obtained from all participants. All procedures were in accordance with the approved guidelines. The baseline study used convenience sampling to recruit any patients who met study inclusion criteria and were mandated to undergo drug rehabilitation programs. After informed consent, participants would be followed for 5 years. The baseline study recruited heroin dependent patients from three compulsory rehabilitation centers in Shanghai during April of to May of according to the following criteria: a meeting the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders DSM-IV diagnostic criteria for heroin dependence; b being at least 18 years of age; c having heroin use during the 30 days prior to admission to a rehabilitation program; and d having the cognitive capacity to give consent. The present study included all participants from the baseline project. At the baseline, a Chinese version of the Addiction Severity Index ASI was used to assess the social demographic characteristics and history of drug abuse. For the present study, the recovery statue of each month was classified into 5 outcomes: incarceration, readmission to compulsory treatment, methadone maintenance treatment participation, death and maintained in community Not encoded as anyone of other cases. According to laws in China, an illegal drug use case will be readmitted to compulsory treatment but not be defined as incarceration. In compulsory treatment centers, drug users will receive detoxification, education, labor work, etc. However, we consider readmission to compulsory treatment as negative outcome during community recovery, because readmission was only triggered by seriously violating the community recovery agreement or re-using drugs after compulsory treatment, which means that those readmission cases relapsed or had other serious consequences. We used Stata 12 25 for our data analysis. Gender differences in baseline characteristics were assessed using chi-square statistics for categorical variables and t test for continuous variables. Generalized Estimating Equations GEE was used to compare males with females in terms of the presence of negative outcomes incarceration and readmission to compulsory treatment in the subsequent 5 years after the discharge from compulsory treatment. In the GEE model, as our outcome variable is binary, we specified the model using the binomial distribution function and a logit link function with identity covariance matrix. The following covariates were included in the model: life-time history of mental disorders anxiety disorder, mood disorders and psychotic disorders , the life-time history of using illicit drugs other than heroin, the life-time history of borderline personality disorder and antisocial personality disorder, education, baseline employment status, baseline marriage status, age of onset of using heroin, baseline age, baseline dose of heroin use, baseline frequency of heroin use and incarceration and compulsory treatment experience before baseline. The interaction between gender and time effect was also examined in the model. In addition, we also used ordinary least squares OLS to explore factors associated to the time length of negative outcomes in 5 years after the discharge for both gender. How to cite this article : Haifeng, J. Gender differences in recovery consequences among heroin dependent patients after compulsory treatment programs. Accessed: 26th June Accessed: 20th May Nunn, A. Methadone and buprenorphine prescribing and referral practices in US prison systems: results from a nationwide survey. Drug Alcohol Depend , 83—88 Drug use and opioid substitution treatment for prisoners. Harm Reduct J 7, Grella, C. Drug treatment outcomes for adolescents with comorbid mental and substance use disorders. J Nerv Ment Dis , — Hser, Y. Gender differences in treatment outcomes over a three-year period: A path model analysis. J Drug Issues 34, — Article Google Scholar. Green, C. Gender and use of substance abuse treatment services. Alcohol Res Health 29, 55 Long-term course of opioid addiction. Harv Rev Psychiatry 23, 76—89 Messina, N. Predictors of treatment outcomes in men and women admitted to a therapeutic community. Am J Drug Alcohol Abuse 26, — Weisner, C. Short-term alcohol and drug treatment outcomes predict long-term outcome. Drug Alcohol Depend 71, — Gender similarities and differences in the treatment, relapse and recovery cycle. Eval Rev 32, —, Greenfield, S. Substance abuse treatment entry, retention and outcome in women: A review of the literature. Drug Alcohol Depend 86, 1—21 Liu, Y. Int J Drug Policy 21, — Gender comparisons of drug abuse treatment outcomes and predictors. Drug Alcohol Depend 72, — Monahan, J. Mental disorder and violent behavior: Perceptions and evidence. Am Psychol 47, Predictors of prison-based treatment outcomes: A comparison of men and women participants. Am J Drug Alcohol Abuse 32, 7—28 Yang, M. Profiles of psychiatric disorders among heroin dependent individuals in Changsha, China. Drug Alcohol Depend , — Schneider, K. Evaluating multiple outcomes and gender differences in alcoholism treatment. Addict Behav 20, 1—21 Gender differences in predictors of initiation, retention and completion in an HMO-based substance abuse treatment program. J Subst Abuse Treat 23, — Veach, L. Retention predictors related to intensive outpatient programs for substance use disorders. Zhao, M. A preliminary study of the reliability and validity of the Addiction Severity Index. Chin Med Res J 4, — Google Scholar. Luo, W. Chinese assimilation of the fifth edition of Addiction severity index scale and the evaluations on its applications in addiction status investigation. Chin J Drug Depend 16, — Stata StataCorp, L. Download references. The authors thank the patients and staff from the Shanghai compulsory rehabilitation center who participated in this study. You can also search for this author in PubMed Google Scholar. All authors made substantial contributions to this study and article. All the authors reviewed the manuscript. This work is licensed under a Creative Commons Attribution 4. Reprints and permissions. Haifeng, J. Sci Rep 5 , Download citation. Received : 29 July Accepted : 10 November Published : 08 December Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily. Skip to main content Thank you for visiting nature. Download PDF. Subjects Health care Risk factors. Abstract Studies on recovery patterns and how baseline factors influence recovery consequences among heroin dependent patients have shown mixed results. Prevalence and correlates of suicide attempt among Chinese individuals receiving methadone maintenance treatment for heroin dependence Article Open access 30 October Overdose mortality rates for opioids and stimulant drugs are substantially higher in men than in women: state-level analysis Article 15 June The Penrose Effect and its acceleration by the war on drugs: a crisis of untranslated neuroscience and untreated addiction and mental illness Article Open access 28 November Introduction Despite the increased use of a wide range of stimulative drugs, the use of opioids continues to be a major drug problem globally 1 , 2. Results Descriptive analysis On average, heroin dependent patients in our study had a baseline history of 2. Table 1 The demographic and clinical characteristics of the participants. Full size table. Figure 1. Full size image. Figure 2. Table 3 Risk factors associated with the number of months in incarceration and compulsory treatment during 5 years after discharge from compulsory treatment for both gender estimated by OLS model. Discussion This study examined gender differences in recovery patterns among a sample of patients discharged from compulsory treatment over a five-year period in Shanghai, China. Methods Study design and Data Sources This study was designed as a cohort study. Setting and Participants The baseline study used convenience sampling to recruit any patients who met study inclusion criteria and were mandated to undergo drug rehabilitation programs. Variables and Measurement At the baseline, a Chinese version of the Addiction Severity Index ASI was used to assess the social demographic characteristics and history of drug abuse. Statistical methods We used Stata 12 25 for our data analysis. Additional Information How to cite this article : Haifeng, J. Article Google Scholar Grella, C. Article Google Scholar Green, C. Article Google Scholar Messina, N. Article Google Scholar Liu, Y. Article Google Scholar Monahan, J. Article Google Scholar Yang, M. Article Google Scholar Schneider, K. Article Google Scholar Veach, L. Google Scholar Luo, W. Google Scholar Stata View author publications. Ethics declarations Competing interests The authors declare no competing financial interests. Rights and permissions This work is licensed under a Creative Commons Attribution 4. About this article. Cite this article Haifeng, J. Copy to clipboard. Publish with us For authors Language editing services Submit manuscript. Search Search articles by subject, keyword or author. Show results from All journals This journal. Advanced search. Close banner Close. Email address Sign up. Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing.

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Buy Heroin Isola 2000

Heroin users represent a challenging group of patients for GPs, with a high morbidity including a high prevalence of depression. To examine heroin users' beliefs about connections between depressive symptoms and drug taking. A total of 17 semi-structured interviews were conducted with patients receiving opioid substitution therapy and antidepressants. One focus group of service users was also interviewed. Adverse childhood events were viewed as both the cause of depression and as simultaneously placing the individual in social circles where drug use was common. Drug taking was thought to lead to depression through resultant adverse social consequences, though illicit drug use was also regarded as an understandable way to cope with depression. Examples of stigma from taking drugs were commonly described and thought a cause of depression; in contrast, stigmatizing effects of depression were not apparent. The participants often felt isolated. Beliefs about how antidepressants worked incorporated ideas about blocking out thoughts, stopping thoughts racing and keeping emotions level. Self-management techniques for treating depression were rarely described. Heroin users' experiences of depression—including ideas about causation, how symptoms are felt and experienced and treatment strategies—are overwhelmingly framed by the context of drug taking. Access to content on Oxford Academic is often provided through institutional subscriptions and purchases. If you are a member of an institution with an active account, you may be able to access content in one of the following ways:. Typically, access is provided across an institutional network to a range of IP addresses. This authentication occurs automatically, and it is not possible to sign out of an IP authenticated account. Choose this option to get remote access when outside your institution. Enter your library card number to sign in. 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To purchase short-term access, please sign in to your personal account above. Don't already have a personal account? Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Advertisement intended for healthcare professionals. Sign in through your institution. Advanced Search. Search Menu. Article Navigation. Close mobile search navigation Article Navigation. Volume Journal Article. Heroin users' experiences of depression: a qualitative study Get access. Oxford Academic. Google Scholar. Kanayo Umeh. Novin Manshani. Select Format Select format. Permissions Icon Permissions. Abstract Background. Issue Section:. You do not currently have access to this article. Download all slides. Sign in Get help with access. Institutional access Sign in through your institution Sign in through your institution. 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