Improving the quality of life of persons with a substance use disorder is a major challenge, yet an explicit goal of those entering treatment. Improvement is also necessitated because of the positive predictive value of improved quality of life on treatment outcomes, and the high personal and societal costs associated with the severely reduced quality of life most patients report.
For people in treatment, focus is often on health-related quality of life, both physical and mental, and appropriately so. But substance issues also have serious consequences on one's environment, such as living situation and safety, and social support systems.
In the third article published in the NorComt study - the Norwegian cohort of patients in opioid maintenance and other drug treatment (OMT) - we administered a newly created quality of life instrument (QOL10) to a subset of patients, one year after they began outpatient OMT or inpatient treatment.
We hypothesized that it would produce an overall measure of quality of life. Instead, factor analysis revealed questions grouped themselves into social-related questions and more global questions. Anxiety, depression, and not exercising predicted lower global quality of life, similar to what previous article from this study found when these patients entered treatment one year earlier (link to ).
The social questions included self-evaluations of patients’ relationships to friends and partners, their sex lives, social functioning, and their ability to love – and these were less influenced by typically-measured health, substance and treatment-specific factors than global quality of life.
While reducing substance use, improving mental health, and encouraging exercise may improve global quality of life, patients’ social quality of life may “respond” differently to typical treatment practices, meaning interventions must be targeted specifically at their social lives.
In order to design such interventions, patients’ social lives must be prioritized in treatment, and patients themselves must be able to evaluate their own social functioning, the support they receive, the roles of various persons in the networks, and so on. Administering the QOL10 during treatment can be one way to introduce social lives as a priority.
Read the full article in BMC Medical Research Methodology here