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Gender differences in access to methadone maintenance therapy in a Canadian setting
Paxton Bach1,2, M-J Milloy1,2, Paul Nguyen1
1British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada.
Drug and Alcohol Review
|March 5, 2015
Summary
Male individuals who inject drugs (PWID) access methadone maintenance therapy (MMT) at lower rates than females. Understanding these gender differences is crucial for improving MMT enrollment strategies for opioid addiction treatment.
Area of Science:
- Addiction medicine
- Public health
- Gender studies
Background:
- Methadone maintenance therapy (MMT) is a key treatment for opioid addiction.
- Previous research noted gender disparities in MMT pharmacokinetics and clinical profiles.
- Limited studies compared MMT utilization rates in community-recruited samples of people who inject drugs (PWID).
Purpose of the Study:
- To investigate factors associated with methadone initiation time.
- To compare rates of MMT enrollment between genders in PWID.
- To identify gender-specific predictors for MMT access.
Main Methods:
- Prospective cohort study of PWID in Vancouver, Canada (1996-2013).
- Cox proportional hazards modeling to analyze time to methadone initiation.
- Stratified analyses to assess gender differences in MMT enrollment.
Main Results:
- 1848 methadone-naïve PWID were analyzed; 32% were female.
- Male gender was linked to longer time to MMT initiation and lower enrollment rates (aHR=0.74).
- Caucasian ethnicity and daily heroin injection decreased initiation time; pregnancy accelerated it in females.
Conclusions:
- Significant gender differences exist in MMT utilization among community-recruited PWID.
- While predictors were similar, males accessed MMT less frequently.
- Gender-sensitive strategies are needed to enhance MMT recruitment and access.
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