First-time admissions for opioid treatment: cross-sectional and descriptive study of new opioid users seeking treatment

Abstract

Gerardo Flórez,1,2 Ana López-Durán,3 Yolanda Triñanes,4 Jesús Osorio,5 Jaime Fraga,5 José Manuel Fernández,5 Elisardo Becoña,3 Manuel Arrojo5 1Addictive Disorders Assistance Unit, Complejo Hospitalario, Ourense, Spain; 2Center for Biomedical Research in Mental Health (CIBERSAM), Oviedo, Spain; 3Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Spain; 4Galician Agency for Health Technology Assessment, Directorate General for Innovation and Management of Public Health, Galicia, Spain; 5Directorate General of Health Assistance, Galician Health Service, Galicia, Spain Background: The purpose of this study was to gain an understanding of the profiles of the new treatment demands posed by opioid addicts between 2005 and 2010 at the addictive disorders assistance units in Galicia, Spain. Methods: A cluster analysis was performed using data from 1,655 treatment entrants. Clusters were constructed using sociodemographic and medicolegal variables. A cluster analysis was also conducted according to age. Once clusters were defined, their association with the following variables was analyzed: age at first use of opioids, years of use, frequency of opioid use in the previous month, psychiatric treatment, cocaine use, existence of a drug-dependent partner, and source of referral. Results: Four clusters were obtained in the main analysis. Cluster 1 (34.01%) consisted of young males, cluster 2 (16.19%) consisted of not-so-young males, cluster 3 (32.62%) consisted mainly of older males and a small group of females, and cluster 4 (17.18%) was made up entirely of women. With regard to age-related clusters, two clusters were obtained in those under the age of 30 years: cluster 1 (73%) without medicolegal complications and cluster 2 (27%) with medicolegal complications. For those over the age of 30 years, two clusters were obtained: cluster 1 (53.92%) with hardly any medicolegal complications and cluster 2 (46.08%) with medicolegal complications. Conclusion: Cluster analysis suggests that there have been no substantial changes in variables indicating greater severity in this new group of patients. Women are likely to seek help earlier, which reduces their duration of opioid use. The younger the patient, the shorter the duration of opioid use and the greater the likelihood of cessation of intravenous use. Public health systems should use a two-pronged treatment strategy of short but intense cessation therapies for women and younger treatment entrants and longer maintenance and replacement therapies for older treatment entrants with more psychosocial and medical complications. Keywords: opioid dependence, cluster analysis, treatment-seeking, sex, age