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Heroin Addiction and Related Clinical Problems: 2014, 16, 4 (pages: 5 - 14)

Evaluation of the Quality of Life in 171 patients under Methadone Maintenance Treatment and in 46 benzodiazepine mono-dependent patients.

Lugoboni F., Carli S., Bissoli G., Musi G., Florio E., Civitelli G., Brizio M., Smacchia C., Biasin C., Cifelli G., Manzato G., Rosa S., and Manzato E.

Summary: Opiate Substitution Treatment – in particular, with methadone – has been the subject of multiple evaluations of key aspects related to heroin addiction, such as the incidence of overdose, seroconversions for HIV, and the risk of incarceration. It is worth noting that the perceived quality of life (QoL) has been studied far less often in heroin-addicted patients than in those with a variety of other common conditions. Paradoxically, the QoL of chronic users of benzodiazepines (BZD) has been evaluated even less often, although BZDs are among the most widely prescribed drugs in developed countries. The present paper evaluates the QoL by using the GHQ-12 questionnaire and comparing 2 groups: 171 heroin dependents in methadone maintenance treatment and 46 high-dose benzodiazepine monodependents without any history of alcoholism, illicit drug use or psychiatric illness. The data from benzodiazepine high-dose users (B-HDUs) were collected randomly over the period 2010-2012 among the people who had applied to the Addiction Unit, Department of Internal Medicine, Verona University Hospital, Verona, Italy, for admission to detoxification therapy. The average daily BZD intake was 13 times the maximum dose recommended by the package insert. For the 171 heroin addicts, the criteria for inclusion were being over 18 years old and being in MMT, thus excluding other types of treatment or addiction. The following parameters were considered: gender, age, marital status, presence of children, work, whether BZD was being used or not. The average GHQ12 score among the subjects in methadone treatment turned out to be 2.74, while that of B-HDU subjects came out at 8.33. Comparing these results with a cut-off ≥ 4, referring to the general population in Italy, we find that the B-HDUs were "GHQ-12 cases", clearly exceeding the threshold value, whereas patients in opiate substitution treatment were "not GHQ-12 cases". In other words, the GHQ values of heroin addicts were mostly comparable with those of the general population in Italy, whilst those of B-HDUs were absolutely not. The B-HDUs showed that they had a health perception much worse than that of the general population. In sharp contrast, the subjects in MMT had shown that they perceived themselves at a much higher level of psychosocial health than the B-HDUs, and they were completely in line with the general population in Italy in that respect. So far, this has been the first study that has evaluated the QoL in monodependent benzodiazepine abusers.