Quality of Life among Heroin Addicts at Entry to the Methadone Maintenance Treatment

Objectives: This study was to investigate quality of life (QoL) among heroin users receiving the methadone maintenance treatment (MMT) in Taiwan, and to explore the QoL-associated factors. Methods: In this study, we enrolled 781 heroin users who were participating in the MMT programs at Tsaotun Psychiatric Center in central Taiwan. We used the World Health Organization Quality of Life-Short Form (WHOQOL-BREF) Taiwan version for assessing their QoL. The Center for Epidemiologic Studies Depression Scale, the Barratt Impulsiveness Scale, the Chinese Version of the Severity of Dependence Scale, and the Family APGAR score were used to evaluate comorbid depressive symptoms and other characteristics. Blood tests for related infectious disease were also conducted. ANCOVA statistics was used to identify significant associated factors independently linked to poorer QoL after adjusting for confounders. Results: The mean participant age was 36.0 years and most patients (90.9%) were men. Comorbid HIV infection was found in 20.7% of heroin-dependent patients and hepatitis C virus infection was common (90.5%). Unemployment was significantly and negatvely linked to the physical, psychological, social, and environmental domains of QoL (p ＜ 0.05 or p ＜ 0.01). Needle-sharing and polysubstance abuse presented lower scores in the physical domain. Impulsivity was significantly associated with a poorer psychological domain of QoL (p ＜ 0.01). Better family support had a significant positive effect on the environmental parameters of QoL (p ＜ 0.01). Depression was significantly associated with lower scores in all four domains of QoL after controlling demographic characteristics, drug use, and comorbid infectious disease variables (p ＜ 0.05 or p ＜ 0.01). Conclusion: The study findings show the associated factors of QoL among heroin users. The presence of depression was found to negatively influence QoL of heroin-dependent patients. Further studies are required to examine the effect of alleviating these factors (e.g., depression) on heroin users' QoL.