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BMC Public Health
Published in: BMC Public Health 1/2013

Open Access 01-12-2013 | Research article

Coexisting social conditions and health problems among clients seeking treatment for illicit drug use in Finland: The HUUTI study

Published in: BMC Public Health | Issue 1/2013

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Abstract

Background

Illicit drug use is an important public health problem. Identifying conditions that coexist with illicit drug use is necessary for planning health services. This study described the prevalence and factors associated with social and health problems among clients seeking treatment for illicit drug use.

Methods

We carried out cross-sectional analyses of baseline data of 2526 clients who sought treatment for illicit drug use at Helsinki Deaconess Institute between 2001 and 2008. At the clients’ first visit, trained clinicians conducted face-to-face interviews using a structured questionnaire. Logistic regression was used to compute adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for factors associated with social and health problems.

Results

The mean age of the clients was 25 years, 21% (n = 519) were homeless, 54% (n = 1363) were unemployed and 7% (n = 183) had experienced threats of violence. Half of the clients (50%, n = 1258) were self-referred and 31% (n = 788) used opiates as their primary drugs of abuse. Hepatitis C (25%, n = 630) was more prevalent than other infectious diseases and depressive symptoms (59%, n = 1490) were the most prevalent psychological problems. Clients who were self-referred to treatment were most likely than others to report social problems (AOR = 1.86; 95% CI = 1.50–2.30) and psychological problems (AOR = 1.51; 95% CI = 1.23–1.85). Using opiates as primary drugs of abuse was the strongest factor associated with infectious diseases (AOR = 3.89; 95% CI = 1.32–11.46) and for reporting a combination of social and health problems (AOR = 3.24; 95% CI = 1.58–6.65).

Conclusion

The existence of illicit drug use with other social and health problems could lead to increased utilisation and cost of healthcare services. Coexisting social and health problems may interfere with clients’ treatment response. Our findings support the call for integration of relevant social, medical and mental health support services within drug treatment programmes.
Literature
1.
Bühringer G, Farrell M, Kraus L, Marsden J, Pfeiff er-Gerschel T, Piontek D, Karachaliou K, Künzel J, Stillwell G: Comparative analysis of research into illicit drugs in the European union (Full report). European Commission. Directorate General for Justice and Home Affairs. Drugs Coordination Unit. Brussels. EMCDDA. 2009, http://​www.​emcdda.​europa.​eu/​html.​cfm/​index53904EN.​html, :3,
2.
Melberg HO, Hakkarainen P, Houborg E, Jääskeläinen M, Skretting A, Ramstedt M, Rosenqvis P: Measuring the harm of illicit drug use on friends and family. Nordic Stud Alcohol and Drugs. 2011, 28: 105-121.CrossRef
3.
4.
5.
Chatterji P: Illicit drug use and educational attainment. Health Econ. 2006, 15: 489-511. 10.1002/hec.1085.CrossRefPubMed
6.
7.
Didenko E, Pankratz N: Substance Use: pathway to homelessness? or a way of adapting to street life?. Visions. 2007, 4: 9-10.
8.
Fountain J, Howes S, Marsden J, Taylor C, Strang J: Drug and alcohol use and the link with homelessness: results from a survey of homeless people in London. Addict Res Theory. 2003, 11: 245-256. 10.1080/1606635031000135631.CrossRef
9.
Barnard M, Mckeganey N: The impact of parental problem drug use on children: what is the problem and what can be done to help?. Addiction. 2004, 99: 552-559. 10.1111/j.1360-0443.2003.00664.x.CrossRefPubMed
10.
Friedland G: Infectious disease comorbidities adversely affecting substance users with HIV: hepatitis C and tuberculosis. J Acquir Immune Defic Syndr. 2010, 55: 37-42.CrossRef
11.
Jürgens R, Ball A, Verster A: Interventions to reduce HIV transmission related to injecting drug use in prison. Lancet Infect Dis. 2009, 9: 57-66. 10.1016/S1473-3099(08)70305-0.CrossRefPubMed
12.
Wang H, Li G, Brown K, Smith K, Jin X, Dong R, Wang N: The characteristics and risk factors for HIV infection among Beijing drug users in different settings. Drug Alcohol Depend. 2011, 113: 37-45. 10.1016/j.drugalcdep.2010.07.010.CrossRefPubMed
13.
Caiaffa WT, Zocratto KF, Osiman ML, Martinez PL, Radulich G, Latorre L, Muzzio E, Segura M, Chiparelli H, Russi J, Rey J, Vazquez E, Cuchi P, Sosa-Estani S, Rossi D, Weissenbacher M: Hepatitis C virus among non-injecting cocaine users (NICUs) in South America: can injectors be a bridge?. Addiction. 2010, 106: 143-151.CrossRefPubMed
14.
15.
Marsden J, Gossop M, Stewart D, Rolfe A, Farrell M: Psychiatric symptoms among clients seeking treatment for drug dependence: intake data from the national treatment outcome research study. Br J Psychiatry. 2000, 176: 285-289. 10.1192/bjp.176.3.285.CrossRefPubMed
16.
Sihvola E, Rose RJ, Dick DM, Pulkkinen L, Marttunen M, Kaprio J: Early-onset depressive disorders predict the use of addictive substances in adolescence: a prospective study of adolescent Finnish twins. Addiction. 2008, 103: 2045-2053. 10.1111/j.1360-0443.2008.02363.x.CrossRefPubMedPubMedCentral
17.
Alaja R, Seppa K, Sillanaukee P, Tienari P, Huyse FJ, Herzog T, Malt UF, Lobo A: Psychiatric referrals associated with substance use disorders: prevalence and gender differences. Alcohol Clin Exp Res. 1997, 21: 620-626.PubMed
18.
Chung T: Does Adolescents’ readiness to change substance use behavior differ depending on profile of psychiatric comorbidity?. J Dual Diagn. 2005, 2: 73-88.CrossRef
19.
Hoff RA, Rosenheck RA: The cost of treating substance abuse patients with and without comorbid psychiatric disorders. Psychiatr Serv. 1999, 50: 1309-1315.CrossRefPubMed
20.
21.
McLellan AT, Kushner H, Metzger D, Peters R, Smith I, Grissom G, Pettinati H, Argeriou M: The fifth edition of the addiction severity index. J Subst Abuse Treat. 1992, 9: 199-213. 10.1016/0740-5472(92)90062-S.CrossRefPubMed
22.
Scheurich A, Müller MJ, Wetzel H, Anghelescu I, Klawe C, Ruppe A, Lörch B, Himmerich H, Heidenreich M, Schmid G, Hautzinger M, Szegedi A: Reliability and validity of the German version of the European addiction severity index (EuropASI). J Stud Alcohol. 2000, 61: 916-919.CrossRefPubMed
23.
Gerevich J, Bácskai E, Kó J, Rózsa S: Reliability and validity of the Hungarian version of the European addiction severity index. Psychopathology. 2005, 38: 301-309. 10.1159/000088918.CrossRefPubMed
24.
Kokkevi A, Richardson C, Palermou B, Leventakou V: Reliability of drug dependents’ self-reports. Drug Alcohol Depend. 1997, 45: 55-61. 10.1016/S0376-8716(97)01339-2.CrossRefPubMed
25.
Simon R, Donmall M, Hartnoll R, Kokkevi A, Ouwehand AW, Stauffacher M, Vicente J: The EMCDDA/Pompidou group treatment indicator protocol: a European core item set for treatment monitoring and reporting. Eur Addict Res. 1999, 5: 197-207. 10.1159/000018994.CrossRefPubMed
26.
Stauffacher M, Kokkevi A: The Pompidou group treatment demand protocol: the first pan-European standard in the field. Eur Addict Res. 1999, 5: 191-196. 10.1159/000018993.CrossRefPubMed
27.
Onyeka IN, Uosukainen H, Korhonen MJ, Beynon C, Bell JS, Ronkainen K, Föhr J, Tiihonen J, Kauhanen J: Sociodemographic characteristics and drug abuse patterns of treatment-seeking illicit drug abusers in Finland, 1997–2008: The HUUTI study. J Addict Dis. 2012, 31: 350-362. 10.1080/10550887.2012.735563.CrossRefPubMed
28.
Kemp PA, Neale J, Robertson M: Homelessness among problem drug users: prevalence, risk factors and trigger events. Health Soc Care Comm. 2006, 14: 319-328. 10.1111/j.1365-2524.2006.00624.x.CrossRef
29.
Rachlis BS, Wood E, Zhang R, Montaner JSG, Kerr T: High rates of homelessness among a cohort of street-involved youth. Health Place. 2009, 15: 10-17. 10.1016/j.healthplace.2008.01.008.CrossRefPubMed
30.
Song JY, Safaeian M, Strathdee SA, Vlahov D, Celentano DD: The prevalence of homelessness among injection drug users with and without HIV infection. J Urban Health. 2000, 77: 678-687. 10.1007/BF02344031.CrossRefPubMedPubMedCentral
31.
Galea S, Vlahov D: Social determinants and the health of drug users: socioeconomic status, homelessness, and incarceration. Public Health Rep. 2002, 117: s135-s145.PubMedPubMedCentral
32.
Small W, Rhodes T, Wood E, Kerr T: Public injection settings in Vancouver: physical environment, social context and risk. Int J Drug Policy. 2007, 18: 27-36. 10.1016/j.drugpo.2006.11.019.CrossRefPubMed
33.
Marshall BDL, Fairbairn N, Li K, Wood E, Kerr T: Physical violence among a prospective cohort of injection drug users: a gender-focused approach. Drug Alcohol Depend. 2008, 97: 237-246. 10.1016/j.drugalcdep.2008.03.028.CrossRefPubMedPubMedCentral
34.
Marcos AC, Bahr SJ, Johnson RE: Test of a bonding/association theory of adolescent drug use. Soc Forces. 1986, 65: 135-162.CrossRef
35.
Mckeganey N, Mcintosh J, Macdonald F, Gannon M, Gilvarry E, Mcardle P, Mccarthy S: Preteen children and illegal drugs. Drugs Educ Prev Policy. 2004, 11: 315-327. 10.1080/09687630410001687888.CrossRef
36.
Stein JA, Leslie MB, Nyamathi A: Relative contributions of parent substance use and childhood maltreatment to chronic homelessness, depression, and substance abuse problems among homeless women: mediating roles of self-esteem and abuse in adulthood. Child Abuse Negl. 2002, 26: 1011-1027. 10.1016/S0145-2134(02)00382-4.CrossRefPubMed
37.
38.
O’Toole TP, Pollini RA, Ford D, Bigelow G: Physical health as a motivator for substance abuse treatment among medically ill adults: is it enough to keep them in treatment?. J Subst Abuse Treat. 2006, 31: 143-150. 10.1016/j.jsat.2006.03.014.CrossRefPubMed
39.
Beynon CM, Bellis MA, McVeigh J: Trends in drop out, drug free discharge and rates of re-presentation: a retrospective cohort study of drug treatment clients in the North West of England. BMC Publ Health. 2006, 6: 205-10.1186/1471-2458-6-205.CrossRef
40.
41.
Aceijas C, Rhodes T: Global estimates of prevalence of HCV infection among injecting drug users. Int J Drug Policy. 2007, 18: 352-358. 10.1016/j.drugpo.2007.04.004.CrossRefPubMed
42.
Kruse GR, Barbour R, Heimer R, Shaboltas AV, Toussova OV, Hoffman IF, Kozlov AP: Drug choice, spatial distribution, HIV risk, and HIV prevalence among injection drug users in St. Petersburg, Russia. Harm Reduct J. 2009, 6: 22-10.1186/1477-7517-6-22.CrossRefPubMedPubMedCentral
43.
44.
Watkins KE, Hunter SB, Wenzel SL, Tu W, Paddock SM, Griffin A, Ebener P: Prevalence and characteristics of clients with co-occurring disorders in outpatient substance abuse treatment. Am J Drug Alcohol Abuse. 2004, 30: 749-764. 10.1081/ADA-200037538.CrossRefPubMed
45.
Borges G, Walters E, Kessler R: Associations of substance use, abuse, and dependence with subsequent suicidal behavior. Am J Epidemiol. 2000, 151: 781-791. 10.1093/oxfordjournals.aje.a010278.CrossRefPubMed
46.
Parthasarathy S, Weisner C, Hu TW, Moore C: Association of outpatient alcohol and drug treatment with health care utilization and cost: Revisiting the offset hypothesis. J Stud Alcohol. 2001, 62: 89-97.CrossRefPubMed
47.
48.
Beynon CM, Taylor A, Allen E, Bellis MA: Visual versus written cues: a comparison of drug injectors’ responses. Have surveys using the written word underestimated risk behaviors for hepatitis C?. Subst Use Misuse. 2010, 45: 1491-1508. 10.3109/10826081003754021.CrossRefPubMed
49.
Demetriou VL, van de Vijver DAMC, Hezka J, Kostrikis LG, Cyprus IVDU Network: Hepatitis C infection among intravenous drug users attending therapy programs in Cyprus. J Med Virol. 2010, 82: 263-270. 10.1002/jmv.21690.CrossRefPubMed
50.
Kolarić B, Štajduhar D, Gajnik D, Rukavina T, Wiessing L: Seroprevalence of blood-borne infections and population sizes estimates in a population of injecting drug users in Croatia. Central Eur J Public Health. 2010, 18 (2): 104-
51.
Taylor A, Goldberg D, Hutchinson S, Cameron S, Gore SM, McMenamin J, Green S, Pithie A, Fox R: Prevalence of hepatitis C virus infection among injecting drug users in Glasgow 1990–1996: are current harm reduction strategies working?. J Infect. 2000, 40: 176-183. 10.1053/jinf.2000.0647.CrossRefPubMed
Metadata
Title
Coexisting social conditions and health problems among clients seeking treatment for illicit drug use in Finland: The HUUTI study
Publication date
01-12-2013
Published in
BMC Public Health / Issue 1/2013
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-13-380

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