Maintenance pharmacotherapy for opioid dependence and SF-36 health status: A comparison with general population norms and other chronic disorders

OBJECTIVES: To assess the health status of heroin users starting and following 3 months of pharmacotherapy for opioid dependence, and to compare outcomes to a range of other chronic medical illnesses treated with maintenance medication. METHODS: The study uses pooled data from 6 clinical trials included in an Australian National Evaluation of Pharmacotherapies for Opioid Dependence. Participants received maintenance pharmacotherapy (oral naltrexone treatment, methadone, or buprenorphine) for the treatment of heroin dependence. Participants' health status was measured using the Short Form 36 health survey completed before treatment and at 3-month follow-up. Baseline data from 326 heroin-dependent participants starting maintenance treatment, and 3-month follow-up data for the 117 participants retained in trial treatment are presented. RESULTS: Heroin users at entry into pharmacotherapy for opioid dependence were in very poor psychological and physical health in relation to Australian population norms. For the 117 participants retained in treatment, clinically and statistically significant improvements in physical health, and emotional and social health were observed in just 3 months. Importantly, the health status of treated heroin users improves to a comparable or greater degree than that observed with other chronic illnesses treated with maintenance medication. CONCLUSIONS: Existing, evidence-based pharmacotherapies should be used in the treatment of heroin dependence with the same long-term care and medical monitoring strategies currently used in the treatment of other chronic illnesses.