Top

Published in:

Open Access 01-02-2011

Current quality of life and its determinants among opiate-dependent individuals five years after starting methadone treatment

Authors: Jessica De Maeyer, Wouter Vanderplasschen, Jan Lammertyn, Chijs van Nieuwenhuizen, Bernard Sabbe, Eric Broekaert

Published in: Quality of Life Research | Issue 1/2011

Abstract

Purpose

This study explores the current QoL of opiate-dependent individuals who started outpatient methadone treatment at least 5 years ago and assesses the influence of demographic, psychosocial, drug and health-related variables on individuals’ QoL.

Methods

Participants (n = 159) were interviewed about their current QoL, psychological distress and severity of drug-related problems, using the Lancashire Quality of Life Profile, the Brief Symptom Inventory and the Addiction Severity Index. Potential determinants of QoL were assessed in a multiple linear regression analysis.

Results

Five years after the start of methadone treatment, opiate-dependent individuals report low QoL scores on various domains. No association was found between drug-related variables and QoL, but a significant negative impact of psychological distress was identified. Severity of psychological distress, taking medication for psychological problems and the inability to change one’s living situation were associated with lower QoL. Having at least one good friend and a structured daily activity had a significant, positive impact on QoL.

Conclusions

Opiate-dependent individuals’ QoL is mainly determined by their psychological well-being and a number of psychosocial variables. These findings highlight the importance of a holistic approach to treatment and support in methadone maintenance treatment, which goes beyond fixing the negative physical consequences of opiate dependence.

European Monitoring Centre for Drugs, Drug Addiction (EMCDDA). (2009). Stand van de drugsproblematiek in Europa: Jaarverslag 2009. [Annual report: 2009 Annual report of the state of the drugs problem in Europe]. Luxemburg: Bureau voor officiële publicaties der Europese gemeenschappen.

European Monitoring Centre for Drugs, Drug Addiction (EMCDDA). (2008). Stand van de drugsproblematiek in Europa: Jaarverslag 2008. [Annual report: 2008 Annual report of the state of the drugs problem in Europe]. Luxemburg: Bureau voor officiële publicaties der Europese gemeenschappen.

Amato, L., Davoli, M., Perucci, C. A., Ferri, M., Faggiano, F., & Mattick, R. P. (2005). An overview of systematic reviews of the effectiveness of opiate maintenance therapies: Available evidence to inform clinical practice and research. Journal of Substance Abuse Treatment, 28(4), 321–329.CrossRefPubMed

McLellan, A. T., Lewis, D. C., O’Brien, C. P., & Kleber, H. D. (2000). Drug dependence, a chronic medical illness. Implications for treatment, insurance, and outcomes evaluation. JAMA—Journal of the American Medical Association, 284(13), 1689–1695.CrossRef

Vanderplasschen, W., Rapp, R. C., Wolf, J., & Broekaert, E. (2004). The development and implementation of case management for substance use disorders in North America and Europe. Psychiatric Services, 55(8), 913–922.CrossRefPubMed

Zubaran, C., & Foresti, K. (2009). Quality of life and substance use: Concepts and recent tendencies. Current Opinion in Psychiatry, 22(3), 281–286.CrossRefPubMed

Preau, M., Protopopescu, C., Spire, B., Sobel, A., Dellamonica, P., Moatti, J. P., et al. (2007). Health related quality of life among both current and former injection drug users who are HIV-infected. Drug and Alcohol Dependence, 86(2–3), 175–182.CrossRefPubMed

Senbanjo, R., Wolff, K., & Marshall, J. (2006). Excessive alcohol consumption is associated with reduced quality of life among methadone patients. Addiction, 102(2), 257–263.CrossRef

Villeneuve, P. J., Challacombe, L., Strike, C. J., Myers, T., Fischer, B., Shore, R., et al. (2006). Change in health-related quality of life of opiate users in low-threshold methadone programs. Journal of Substance Use, 11(2), 137–149.CrossRef

10.

Ryan, C. F., & White, J. M. (1996). Health status at entry to methadone maintenance treatment using the SF-36 health survey questionnaire. Addiction, 91(1), 39–45.CrossRefPubMed

11.

Millson, P. E., Challacombe, L., Villeneuve, P. J., Fischer, B., Strike, C. J., Myers, T., et al. (2004). Self-perceived health among Canadian opiate users. A comparison to the general population and to other chronic disease populations. Canadian Journal of Public Health, 95(2), 99–103.

12.

De Maeyer, J., Vanderplasschen, W., & Broekaert, E. (2010). Quality of life among opiate-dependent individuals: A review of the literature. International Journal of Drug Policy. doi: 10.1016/j.drugpo.2010.01.010.

13.

Muldoon, M. F., Barger, S. D., Flory, J. D., & Manuck, S. B. (1998). What are quality of life instruments measuring? British Medical Journal, 316(7130), 542–545.PubMed

14.

Cummins, R. A., Lau, A., & Stokes, M. (2004). HRQOL and subjective well-being: Noncomplementary forms of outcome measurement. Expert Review of Pharmacoeconomics & Outcomes Research, 4(4), 413–420.CrossRef

15.

Wiklund, I. (2004). Assessment of patient-reported outcomes in clinical trials: The example of health-related quality of life. Fundamental and Clinical Pharmacology, 18(3), 351–363.CrossRefPubMed

16.

Mooney, A. (2006). Quality of life: Questionnaires and questions. Journal of Health Communication, 11, 327–341.CrossRefPubMed

17.

Laudet, A. B., Becker, J. B., & White, W. L. (2009). Don’t wanna go through that madness no more: Quality of life satisfaction as predictor of sustained remission from illicit drug misuse. Substance Use and Misuse, 44(2), 227–252.CrossRefPubMed

18.

Smith, K. W., Avis, N. E., & Assmann, S. F. (1999). Distinguishing between quality of life and health status in quality of life research: A meta-analysis. Quality of Life Research, 8(5), 447–459.CrossRefPubMed

19.

Anderson, K. L., & Burckhardt, C. S. (1999). Conceptualization and measurement of quality of life as an outcome variable for health care intervention and research. Journal of Advanced Nursing, 29(2), 298–306.CrossRefPubMed

20.

De Maeyer, J., Vanderplasschen, W., & Broekaert, E. (2009). Exploratory study on drug users’ perspectives on quality of life: More than health-related quality of life? Social Indicators Research, 90(1), 107–126.CrossRef

21.

Bizzarri, J., Rucci, P., Vallotta, A., Girelli, M., Scandolari, A., Zerbetto, E., et al. (2005). Dual diagnosis and quality of life in patients in treatment for opioid dependence. Substance Use and Misuse, 40(12), 1765–1776.CrossRefPubMed

22.

Smith, K. W., & Larson, M. (2003). Quality of life assessments by adult substance abusers receiving publicly funded treatment in Massachusetts. The American Journal of Drug and Alcohol Abuse, 29, 323–335.CrossRefPubMed

23.

Schaar, I., & Öjehagen, A. (2003). Predictors of improvement in quality of life of severely mentally ill substance abusers during 18 months of co-operation between psychiatric and social services. Social Psychiatry and Psychiatric Epidemiology, 38(2), 83–87.CrossRefPubMed

24.

Luty, S., & Arokiadass, S. M. R. (2008). Satisfaction with life and opioid dependence. Substance Abuse Treatment, Prevention, and Policy, 3(2). doi:10.1186/1747-597X-3-2

25.

Fassino, S., Abbate Daga, G., Delsedime, N., Rogna, L., & Boggio, S. (2004). Quality of life and personality disorders in heroin abusers. Drug and Alcohol Dependence, 76(1), 73–80.CrossRefPubMed

26.

Winklbaur, B., Jagsch, R., Ebner, N., Thau, K., & Fischer, G. (2008). Quality of life in patients receiving opioid maintenance therapy. European Addiction Research, 14(2), 99–105.CrossRefPubMed

27.

Maremmani, I., Pani, P. P., Pacini, M., & Perugi, G. (2007). Substance use and quality of life over 12 months among buprenorphine maintenance-treated and methadone maintenance-treated heroin-addicted patients. Journal of Substance Abuse Treatment, 33(1), 91–98.CrossRefPubMed

28.

Padaiga, Z., Subata, E., & Vanagas, G. (2007). Outpatient methadone maintenance treatment program. Quality of life and health of opioid-dependent persons in Lithuania. Medicina (Kaunas), 43(3), 235–241.

29.

Torrens, M., San, L., Martinez, A., Castillo, C., Domingo-Salvany, A., & Alonso, J. (1997). Use of the Nottingham health profile for measuring health status of patients in methadone maintenance treatment. Addiction, 92(6), 707–716.CrossRefPubMed

30.

Habrat, B., Chmielewska, K., Baran-Furga, H., Keszycka, B., & Taracha, E. (2002). Subjective quality of life in opiate dependent patients before admission, after six months and one-year participation in methadone program. Przeglad Lekarski, 59(4–5), 351–354.PubMed

31.

March, J. C., Oviedo-Joekes, E., Perea-Milla, E., Carrasco, F., & The PEPSA team. (2006). Controlled trial of prescribed heroin in the treatment of opioid addiction. Journal of Substance Abuse Treatment, 31(2), 203–211.CrossRefPubMed

32.

O’Brien, S., Mattick, R. P., White, J., Breen, C., Kimber, J., Ritter, A., et al. (2006). Maintenance pharmacotherapy for opioid dependence and SF-36 health status: A comparison with general population norms and other chronic disorders. Addictive Disorders & Their Treatment, 5(4), 155–164.CrossRef

33.

Giacomuzzi, S. M., Riemer, Y., Kemmler, G., Ertl, M., Richter, R., Rössler, H., et al. (2001). Subjektives Wohlbefinden und somatische Merkmale bei Methadonsubstitution. Evaluierung bei 61 Heroinabhängigen. Fortschritte der Medizin, 119(3–4), 103–108.PubMed

34.

Giacomuzzi, S. M., Ertl, M., Kemmler, G., Riemer, Y., & Vigl, A. (2005). Sublingual buprenorphine and methadone maintenance treatment: A three-year Follow-up of quality of life assessment. The Scientific World Journal, 5, 452–468.

35.

Carr, A. J., Gibson, B., & Robinson, P. G. (2001). Measuring quality of life—Is quality of life determined by expectations or experience? British Medical Journal, 322(7296), 1240–1243.CrossRefPubMed

36.

Millson, P. E., Challacombe, L., Villeneuve, P. J., Strike, C. J., Fischer, B., Myers, T., et al. (2006). Determinants of health-related quality of life of opiate users at entry to low-threshold methadone programs. European Addiction Research, 12(2), 74–82.CrossRefPubMed

37.

Lofwall, M. R., Brooner, R. K., Bigelow, G. E., Kindbom, K., & Strain, E. C. (2005). Characteristics of older opioid maintenance patients. Journal of Substance Abuse Treatment, 28(3), 265–272.CrossRefPubMed

38.

Deering, D. E., Frampton, M. A., Horn, J., Sellman, J. D., Adamson, S. J., & Potiki, T. L. (2004). Health status of clients receiving methadone maintenance treatment using the SF-36 health survey questionnaire. Drug and Alcohol Review, 23(3), 273–280.CrossRefPubMed

39.

Haug, N. A., Sorensen, J. L., Lollo, N. D., Gruber, V. A., Delucchi, K. L., & Hall, S. M. (2005). Gender differences among HIV-positive methadone maintenance patients enrolled in a medication adherence trial. AIDS Care, 17(8), 1022–1029.CrossRefPubMed

40.

Astals, M., Domingo-Salvany, A., Castillo Buenaventura, C., Tato, J., Vazquez, J. M., Martín-Santos, R., et al. (2008). Impact of substance dependence and dual diagnosis on the quality of life of heroin users seeking treatment. Substance Use and Misuse, 43(5), 612–632.CrossRefPubMed

41.

Karow, A., Verthein, U., Krausz, M., & Schäfer, I. (2008). Association of personality disorders, family conflicts and treatment with quality of life in opiate addiction. European Addiction Research, 14(1), 38–46.CrossRefPubMed

42.

Puigdollers, E., Domingo-Salvany, A., Brugal, M. T., Torrens, M., Alvarós, J., Castillo, C., et al. (2004). Characteristics of heroin addicts entering methadone maintenance treatment: Quality of life and gender. Substance Use and Misuse, 39(9), 1353–1368.CrossRefPubMed

43.

Costenbader, E. C., Zule, W. A., & Coomes, C. M. (2007). The impact of illicit drug use and harmful drinking on quality of life among injection drug users at high risk for hepatitis C infection. Drug and Alcohol Dependence, 89(2–3), 251–258.CrossRefPubMed

44.

Batki, S. L., Canfield, K. M., Smyth, E., & Ploutz-Snyder, R. (2009). Health-related quality of life in methadone maintenance patients with untreated hepatitis C virus infection. Drug and Alcohol Dependence, 101(3), 176–182.CrossRefPubMed

45.

Carpentier, P. J., Krabbe, P. F. M., van Gogh, M. T., Knapen, L. J. M., Buitelaar, J. K., & de Jong, C. A. J. (2009). Psychiatric comorbidity reduces quality of life in chronic methadone maintained patients. American Journal on Addictions, 18(6), 470–480.CrossRefPubMed

46.

Giacomuzzi, S. M., Riemer, Y., Ertl, M., Kemmler, G., Rössler, H., Hinterhuber, H., et al. (2005). Gender differences in health-related quality of life on admission to a maintenance treatment program. European Addiction Research, 11(2), 69–75.CrossRefPubMed

47.

Becker, S. J., Curry, J. F., & Yang, C. M. (2009). Longitudinal association between frequency of substance use and quality of life among adolescents receiving a brief outpatient intervention. Psychology of Addictive Behaviors, 23(3), 482–490.CrossRefPubMed

48.

Conroy, E., Kimber, J., Dolan, K., & Day, C. (2008). An examination of the quality of life among rural and outer metropolitan injecting drug users in NSW, Australia. Addiction Research & Theory, 16(6), 607–617.CrossRef

49.

Colpaert, K., Vanderplasschen, W., & Broekaert, E. (2007). Comparison of single and multiple agency clients in substance abuse treatment services. European Addiction Research, 13(3), 156–166.CrossRefPubMed

50.

Vanderplasschen, W., Colpaert, K., Lievens, K., & Broekaert, E. (2003). De Oost-Vlaamse drughulpverlening in cijfers: Kenmerken, zorggebruik en uitstroom van personen in behandeling. [The drug treatment in East-Flanders in figures: Characteristics, service utilisation and dropout of persons in treatment]. (Orthopedagogische Reeks Gent, 15). Gent: Universiteit Gent, Vakgroep Orthopedagogiek.

51.

Haskew, M., Wolff, K., Dunn, J., & Bearn, J. (2008). Patterns of adherence to oral methadone: Implications for prescribers. Journal of Substance Abuse Treatment, 35(2), 109–115.CrossRefPubMed

52.

van Nieuwenhuizen, C., Schene, A. H., Koeter, M. W. J., & Huxley, P. J. (2001). The Lancashire quality of life profile: Modification and psychometric evaluation. Social Psychiatry and Psychiatric Epidemiology, 36(1), 36–44.CrossRefPubMed

53.

van Nieuwenhuizen, C., Schene, A., Boevink, W., & Wolf, J. (1998). The Lancashire quality of life profile: First experiences in The Netherlands. Community Mental Health Journal, 34(5), 513–524.CrossRefPubMed

54.

Giacomuzzi, S., Kemmler, G., Ertl, M., & Riemer, Y. (2006). Opioid addicts at admission vs. slow-release oral morphine, methadone, and sublingual buprenorphine maintenance treatment participants. Substance Use and Misuse, 41(2), 223–244.CrossRefPubMed

55.

Giacomuzzi, S. M., Riemer, Y., Ertl, M., Kemmler, G., Rössler, H., Hinterhuber, H., et al. (2003). Buprenorphine versus methadone maintenance treatment in an ambulant setting: A health-related quality of life assessment. Addiction, 98(5), 693–702.CrossRefPubMed

56.

Fischer, G., Eder, H., Peternell, A., & Windhaber, J. (2000). Lebensqualität gravider substanzabhängiger Frauen unter oraler Erhaltungstherapie mit synthetischen Opioiden. Nervenheilkunde, 19, 205–211.

57.

Rosenberg, M. (1965). Society and the adolescent self-image. Princeton: Princeton University Press.

58.

van Nieuwenhuizen, C., & Nijman, H. (2009). Quality of life of forensic psychiatric inpatients. International Journal of Forensic Mental Health, 8(1), 9–15.CrossRef

59.

Cantril, H. (1965). The pattern of human concerns. New Brunswick, NJ: Rutgers University Press.

60.

Gurin, G., Veroff, J., & Feld, S. (1960). Americans view their mental health. New York: Basic Books.

61.

Ruggeri, M., Warner, R., Bisoffi, G., & Fontecedro, L. (2001). Subjective and objective dimensions of quality of life in psychiatric patients: A factor analytical approach—The South Verona Outcome Project 4. British Journal of Psychiatry, 178(3), 268–275.CrossRefPubMed

62.

Oliver, J. P. J., Huxley, P. J., Priebe, S., & Kaiser, W. (1997). Measuring the quality of life of severely mentally ill people using the Lancashire quality of life profile. Social Psychiatry and Psychiatric Epidemiology, 32(2), 76–83.CrossRefPubMed

63.

Schneider, J., Wooff, D., Carpenter, J., Brandon, T., & McNiven, F. (2002). Community mental healthcare in England: Associations between service organisation and quality of life. Health & Social Care in the Community, 10(6), 423–434.CrossRef

64.

Kokkevi, A., & Hartgers, C. (1995). EuropASI: European adaptation of a multidimensional assessment instrument for drug and alcohol dependence. European Addiction Research, 1(4), 208–210.CrossRef

65.

McLellan, A. T., Kushner, H., Metzger, D., Peters, R., Smith, I., Grissom, G., et al. (1992). The 5th edition of the addiction severity index. Journal of Substance Abuse Treatment, 9(3), 199–213.CrossRefPubMed

66.

McLellan, A. T., Luborsky, L., Woody, G. E., & O’Brien, C. P. (1980). Improved diagnostic evaluation instrument for substance abuse patients—Addiction severity index. Journal of Nervous and Mental Disease, 168(1), 26–33.CrossRefPubMed

67.

Koeter, M. W. J., & Hartgers, C. (1996). Preliminary procedure for the computation of the EuropASI composite scores. Amsterdam: AIAR.

68.

De Beurs, E. (2006). Brief symptom inventory, handleiding. Leiden: PITS BV.

69.

Derogatis, L. R., & Melis aratos, N. (1983). The brief symptom inventory: An introductory report. Psychological Medicine, 13, 595–605.CrossRefPubMed

70.

Katschnig, H. (2006). How useful is the concept of quality of life in psychiatry? In H. Katschnig, H. Freeman, & N. Sartorius (Eds.), Quality of life in mental disorders (2nd ed., pp. 3–17). West Sussex: Wiley.

71.

Rapley, M. (2003). Quality of life research: A critical introduction. London: Sage Publications.

72.

Schalock, R. (1996). Quality of Life. Volume 1: Conceptualization and measurement. Washington: American Association on Mental Retardation.

73.

Rodríguez-Llera, M. C., Domingo-Salvany, A., Brugal, M. T., Silva, T. C., Sánchez-Niubó, A., Torrens, M., et al. (2006). Psychiatric comorbidity in young heroin users. Drug and Alcohol Dependence, 84(1), 48–55.CrossRefPubMed

74.

Callaly, T., Trauer, T., Munro, L., & Whelan, G. (2001). Prevalence of psychiatric disorder in a methadone maintenance population. Australian and New Zealand Journal of Psychiatry, 35(5), 601–605.CrossRefPubMed

75.

Cacciola, J. S., Alterman, A. I., Rutherford, M. J., McKay, J. R., & Mulvaney, F. D. (2001). The relationship of psychiatric comorbidity to treatment outcomes in methadone maintained patients. Drug and Alcohol Dependence, 61(3), 271–280.CrossRefPubMed

76.

Urbanoski, K. A., Cairney, J., Adlaf, E., & Rush, B. (2007). Substance abuse and quality of life among severely mentally ill consumers. A longitudinal modelling analysis. Social Psychiatry and Psychiatric Epidemiology, 42(10), 810–818.CrossRefPubMed

77.

Lam, J. A., & Rosenheck, R. A. (2000). Correlates of improvement in quality of life among homeless persons with serious mental illness. Psychiatric Services, 51(1), 116–118.PubMed

78.

Drake, R. E., Mueser, K. T., & Brunette, M. F. (2007). Management of persons with co-occurring severe mental illness and substance use disorder: Program implications. World Psychiatry, 6(3), 131–136.PubMed

79.

Information Services. (2007). Drug misuse statistics 2007. Edinburgh: ISD Publications.

80.

Vanderplasschen, W., De Bourdeaudhuij, I., & Van Oost, P. (2002). Co-ordination and continuity of care in substance abuse treatment—An evaluation study in Belgium. European Addiction Research, 8(1), 10–21.CrossRefPubMed

81.

Meulenbeek, P. A. M. (2000). Addiction problems and methadone treatment. Journal of Substance Abuse Treatment, 19(2), 171–174.CrossRefPubMed

82.

Evans, S., & Huxley, P. (2002). Studies of quality of life in the general population. International Review of Psychiatry, 14(3), 203–211.CrossRef

83.

Laudet, A. B., Morgen, K., & White, W. L. (2006). The role of social supports, spirituality, religiousness, life meaning and affiliation with 12-step fellowships in quality of life satisfaction among individuals in recovery from alcohol and drug problems. Alcoholism Treatment Quarterly, 24(1–2), 33–73.CrossRefPubMed

84.

Moomal, Z. (1999). The relationship between meaning in life and mental well-being. South African Journal of Psychology, 29(1), 36–41.

85.

Zika, S., & Chamberlain, K. (1992). On the relation between meaning in life and psychological well-being. British Journal of Psychology, 83(1), 133–145.PubMed

86.

Murphy, S., & Irwin, J. (1992). Living with the dirty secret—Problems of disclosure for methadone-maintenance clients. Journal of Psychoactive Drugs, 24(3), 257–264.PubMed

87.

Young, M., Stuber, J., Ahern, J., & Galea, S. (2005). Interpersonal discrimination and the health of illicit drug users. American Journal of Drug and Alcohol Abuse, 31(3), 371–391.CrossRefPubMed

88.

Ahern, J., Stuber, J., & Galea, S. (2007). Stigma, discrimination and the health of illicit drug users. Drug and Alcohol Dependence, 88(2–3), 188–196.CrossRefPubMed

89.

Kolind, T., Vanderplasschen, W., & De Maeyer, J. (2009). Dilemmas when working with substance abusers with multiple and complex problems: The case manager’s perspective. International Journal of Social Welfare, 18(3), 270–280.CrossRef

90.

Hubley, A. M., Russell, L. B., Palepu, A. (2005). Injection drug use quality of life scale (IDUQOL): A validation study. Health and Quality of Life Outcomes, 3(43). http://www.hqlo.com/content/3/1/43.

91.

Garmendia, M. L., Alvarado, M. E., Montenegro, M., & Pino, P. (2008). Social support as protective factor of recurrence after drug addiction treatment. Revista Medica de Chile, 136(2), 169–178.PubMed

92.

Mizuno, Y., Purcell, D. W., Dawson-Rose, C., Parsons, J. T., & Team, The. S. U. D. I. S. (2003). Correlates of depressive symptoms among HIV-positive injection drug users: The role of social support. AIDS Care, 15(5), 689–698.CrossRefPubMed

93.

Dobkin, P. L., De Civita, M., Paraherakis, A., & Gill, K. (2002). The role of functional social support in treatment retention and outcomes among outpatient adult substance abusers. Addiction, 97(3), 347–356.CrossRefPubMed

94.

Diener, E., & Ryan, K. (2009). Subjective well-being: A general overview. South African Journal of Psychology, 39(4), 391–406.

95.

Chung, L., Pan, A. W., & Hsiung, P. C. (2009). Quality of life for patients with major depression in Taiwan: A model-based study of predictive factors. Psychiatry Research, 168(2), 153–162.CrossRefPubMed

96.

Ay-Woan, P., Sarah, C. P. Y., LyInn, C., Tsyr-Jang, C., & Ping-Chuan, H. (2006). Quality of life in depression: Predictive models. Quality of Life Research, 15(1), 39–48.CrossRefPubMed

97.

Schalock, R., & Verdugo Alonso, M. A. (2002). Handbook on quality of life for human service practitioners. Washington: American Association on Mental Retardation.

98.

Viemerö, V., & Krause, C. (1998). Quality of life in individuals with physical disabilities. Psychotherapy and Psychosomatics, 67(6), 317–322.CrossRefPubMed

99.

Bebout, R. R., Drake, R. E., Xie, H. Y., McHugo, G. J., & Harris, M. (1997). Housing status among formerly homeless dually diagnosed adults. Psychiatric Services, 48(7), 936–941.PubMed

100.

Stark, M. J., & Campbell, B. K. (1991). A psychoeducational approach to methadone-maintenance treatment—A survey of client reactions. Journal of Substance Abuse Treatment, 8(3), 125–131.CrossRefPubMed

101.

Vanagas, G., Padaiga, Z., & Bagdonas, E. (2006). Cost-utility analysis of methadone maintenance treatment: A methodological approach. Substance Use and Misuse, 41, 87–101.CrossRefPubMed

102.

Rudolf, H., & Watts, J. (2002). Quality of life in substance abuse and dependency. International Review of Psychiatry, 14(3), 190–197.CrossRef

103.

Neale, J., Allen, D., & Coombes, L. (2005). Qualitative research methods within the addictions. Addiction, 100(11), 1584–1593.CrossRefPubMed

Title: Current quality of life and its determinants among opiate-dependent individuals five years after starting methadone treatment
Authors: Jessica De Maeyer
Wouter Vanderplasschen
Jan Lammertyn
Chijs van Nieuwenhuizen
Bernard Sabbe
Eric Broekaert
Publication date: 01-02-2011
Publisher: Springer Netherlands
Published in: Quality of Life Research / Issue 1/2011
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-010-9732-3

At a glance: The STEP trials

Springer Medicine

Current quality of life and its determinants among opiate-dependent individuals five years after starting methadone treatment

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2011

Erratum to: Biological pathways and genetic variables involved in pain

Long-term quality of life following primary treatment in men with clinical stage T3 prostate cancer

Health-related quality of life of Iranian children with attention deficit/hyperactivity disorder

Validation of the FACT-G scale for evaluating quality of life in cancer patients in Colombia

Solitary pulmonary nodules: consequences for patient quality of life

Development of sense of coherence in adulthood: a person-centered approach. The population-based HeSSup cohort study