RT Journal Article
SR Electronic
T1 Sex differences in outcomes of methadone maintenance treatment for opioid use disorder: a systematic review and meta-analysis
JF CMAJ Open
FD Canadian Medical Association
SP E344
OP E351
DO 10.9778/cmajo.20140089
VO 3
IS 3
A1 Monica Bawor
A1 Brittany B. Dennis
A1 Anuja Bhalerao
A1 Carolyn Plater
A1 Andrew Worster
A1 Michael Varenbut
A1 Jeff Daiter
A1 David C. Marsh
A1 Dipika Desai
A1 Meir Steiner
A1 Rebecca Anglin
A1 Guillaume Pare
A1 Lehana Thabane
A1 Zainab Samaan
YR 2015
UL http://www.cmajopen.ca/content/3/3/E344.abstract
AB Background: Opioid use disorder is a serious international concern with limited treatment success. Men and women differ in their susceptibility to opioid use disorder and response to methadone treatment and can therefore benefit from sex-specific treatment. We performed a systematic review of the literature on outcomes of methadone maintenance treatment for opioid use disorder in men and women related to drug use, health status and social functioning.Methods: We searched PubMed, Embase, PsycINFO and CINAHL for observational or randomized controlled studies involving adults 18 years of age or older undergoing methadone treatment for opioid use disorder. Studies were included if they investigated sex differences in methadone treatment outcomes. Two authors independently reviewed and extracted data. Meta-analyses were performed when possible; risk of bias and quality of evidence were also assessed.Results: Twenty studies with 9732 participants were included, of which 18 were observational and 2 were randomized controlled trials. Men and women differed significantly in alcohol use (odds ratio [OR] 0.52, 95% confidence interval [CI] 0.31 to 0.86), amphetamine use (OR 1.47, 95% CI 1.12 to 1.94), legal involvement (OR 0.63, 95% CI 0.47 to 0.84) and employment during treatment (OR 0.39, 95% CI 0.21 to 0.73). Opioid use patterns were similar among men and women. Risk of bias was moderate, and quality of evidence was generally low.Interpretation: Sex differences were evident in polysubstance use, legal involvement and employment status among men and women receiving methadone treatment for opioid use disorders. Although the quality of evidence was low, our review highlights the need for improved implementation of sex-specific treatment strategies.