Gender differences in severity of addiction in opiate-dependent outpatients

Background. Opioid dependence is a prevalent health problem. The literature now available on how to achieve a better knowledge of how this problem affects women, and on the importance of gender differences, is still limited. Aim. The aim of this study was to characterize gender differences in socio-demographic features, clinical manifestations, comorbid disorders and severity of opiate addiction, so as to define the role of gender differences in the severity of the addiction. Methods. A cross-sectional, observational, descriptive study evaluated a total of 124 opiate-dependent patients seeking treatment from an urban outpatient programme. Both Axis I and Axis II diagnoses were assessed by applying the Structured Clinical Interview for DSM Disorders I and II (SCID-I and SCID-II). The severity of addiction was evaluated through the application of the European Addiction Severity Index (EuropASI) instrument. Results. Women experienced a stronger impact from opioid addiction on their employment status, considering that the risk of presenting a severe ASI composite score was 4.4 times higher than the risk for men (IC95% 1.3-15.1). Females had a higher likelihood of being diagnosed with an affective disorder. Men showed a greater duration of regular heroin use, and were more likely to meet the current criteria for alcohol dependence; these data correlated with a higher severity of the related ASI composite score (OR=3.8 (IC95% 1.1-13.5)). Conclusions. Significant differences in the severity of addiction, substance use profile, psychiatric comorbidity and areas of impaired functioning were found to be due to gender differences.