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Exploratory Study on Drug Users’ Perspectives on Quality of Life: More than Health-Related Quality of Life?

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Abstract

In drug treatment outcome literature, a focus on objective and socially desirable indicators of change (e.g. no drug use) has predominated, while outcome indicators that are important for drug users themselves (e.g. quality of life, satisfaction with treatment) have largely been neglected. Nonetheless, Quality of Life (QoL) has become an important concept to evaluate effectiveness of treatment in mental health care research and disability studies. Given the almost exclusive focus on Health-related Quality of Life (HRQOL) in substance abuse research and the neglect of clients’ perspectives in this field, we explore in this study the concept of QoL as perceived by drug users. Focus group discussions (n = 9) were organised in various treatment settings and community services for drug users in the region of Ghent, Belgium to identify important dimensions of QoL and their interpretation by drug users. Data were clustered and analysed based on the theoretical framework of Robert Schalock (Quality of life. Volume 1: Conceptualization and measurement, 1996). The domains ‘personal relationships’, ‘social inclusion’ and ‘self-determination’ were discussed most frequently by the participants. They stressed the importance of a supportive social network in particular. It can be concluded that QoL is not primarily associated by drug users with health and it involves much more than the aspects typically represented in measures of HRQOL.

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References

  • Ager, A., & Hatton, C. (1999). Discerning the appropriate role and status of ‘quality of life’ assessment for persons with intellectual disability: A reply to Cummins. Journal of Applied Research in Intellectual Disabilities, 12, 335–339.

    Article  Google Scholar 

  • Allison, P. J., Locker, D., & Feine, J. S. (1997). Quality of life: a dynamic construct. Social Science & Medicine, 45, 221–230.

    Article  Google Scholar 

  • Anthony, J. C., & Chen, C. Y. (2004). Epidemiology of drug dependence. In M. Galanter & H. D. Kleber (Eds.), Textbook of substance abuse treatment (pp. 55–72). Arlington, VA: American Psychiatric Publishing.

    Google Scholar 

  • Barnett, P. G., & Hui, S. S. (2000). The cost-effectiveness of methadone maintenance. The Mount Sinai Journal of Medicine, 67, 365–374.

    Google Scholar 

  • Blumer, H. (1969). Symbolic interactionism: Perspective and method. Englewood Cliffs, NJ: Prentice-Hall.

    Google Scholar 

  • Boevink, W. A., Wolf, J. R. L. M., van Nieuwenhuizen, C., & Schene, A. H. (1995). Kwaliteit van leven van langdurig van ambulante zorg afhankelijke psychiatrische patiënten: een conceptuele verkenning. Tijdschrift voor Psychiatrie, 37, 97–109.

    Google Scholar 

  • Brindis, C. D., & Theidon, K. S. (1997). The role of case management in substance abuse treatment services for women and their children. Journal of Psychoactive Drugs, 29, 79–88.

    Google Scholar 

  • Brun, C., & Rapp, R. C. (2001). Strengths-based case management: Individuals’ perspectives on strengths and the case manager relationship. Social Work, 46, 278–288.

    Google Scholar 

  • Carr, A. J., & Higginson, I. J. (2001). Measuring quality of life: Are quality of life measures patient centred? British Medical Journal, 322, 1357–1360.

    Article  Google Scholar 

  • Carr, A. J., Thompson, P. W., & Kirwan, J. R. (1996). Quality of life measures. British Journal of Rheumatology, 35, 275–281.

    Article  Google Scholar 

  • Costenbader, E. C., Zule, W. A., & Coomes, C. M. (2007). The impact of illicit drug use and harmful drinking on quality of life among injection drug users at high risk for hepatitis C infection. Drug and Alcohol Dependence, 89, 251–258.

    Article  Google Scholar 

  • Cummins, R. A. (2000). Objective and subjective quality of life: an interactive model. Social Indicators Research, 52, 55–72.

    Article  Google Scholar 

  • Cummins, R. A. (2005). Moving from the quality of life concept to a theory. Journal of Intellectual Disability Research, 49, 699–706.

    Article  Google Scholar 

  • De Jong, C. A. J., Roozen, H. G., van Rossum, L. G. M., Krabbe, P. F. M., & Kerkhof, A. J. F. M. (2007). High abstinence rates in heroin addicts by a new comprehensive treatment approach. American Journal on Addictions, 16, 124–130.

    Article  Google Scholar 

  • De Waele, I., & Van Hove, G. (2005). Modern times: An ethnographic study on the quality of life of people with a high support need in a Flemish residential facility. Disability & Society, 20, 625–639.

    Article  Google Scholar 

  • Drumm, R., Bride, D., Metsch, L., Page, J., Dickerson, K., & Jones, B. (2003). “The rock always comes first”: Drug users’ accounts about using formal health care. Journal of Psychoactive Drugs, 35, 461–469.

    Google Scholar 

  • Edgerton, R. B. (1996). A longitudinal-ethnographic research perspective on quality of life. In R. Schalock (Ed.), Quality of life. Volume 1: Conceptualization and measurement (pp. 11–22). Washington: American Association on Mental Retardation.

    Google Scholar 

  • European Monitoring Centre for Drugs, Drug Addiction (EMCDDA). (2007). 2007 Annual report on the state of the drugs problem in Europe. Luxembourg: Office for Official Publications of the European Communities.

    Google Scholar 

  • Farquhar, M. (1995). Definitions of quality of life: A taxonomy. Journal of Advanced Nursing, 22, 502–508.

    Article  Google Scholar 

  • Fischer, B., Rehm, J., & Kim, G. (2001a). Quality of Life (QoL) in illicit drug addiction treatment and research: concepts, evidence and questions. In B. Westermann, C. Jellinek & G. Belleman (Eds.), Substitution: Zwischen Leben und Sterben (pp. 21–40). Weilheim: Beltz Deutscher Studien Verlag.

    Google Scholar 

  • Fischer, B., Rehm, J., & Kim, G. (2001b). Whose Quality of Life is it, really? British Medical Journal, 322, 1357–1360.

    Article  Google Scholar 

  • Fischer, B., Rehm, J., Kim, G., & Kirst, M. (2005). Eyes Wide Shut?—A conceptual and empirical critique of methadone maintenance treatment. European Addiction Research, 11, 1–14.

    Article  Google Scholar 

  • Foster, J. H., Peters, T. J., & Marshall, E. J. (2000). Quality of life measures and outcome in alcohol-dependent men and women. Alcohol, 22, 45–52.

    Article  Google Scholar 

  • Foster, J. H., Powell, J. E., Marshall, E. J., & Peters, T. J. (1999). Quality of life in alcohol-dependent subjects: A review. Quality of Life Research, 8, 255–261.

    Article  Google Scholar 

  • Garg, N., Yates, W., Jones, R., Zhou, M., & Williams, S. (1999). Effects of gender, treatment site and psychiatric comorbidity on quality of life outcome in substance dependence. The American Journal on Addictions, 8, 44–54.

    Article  Google Scholar 

  • Giacomuzzi, S. M., Riemer, Y., Ertl, M., Kemmler, G., Rössler, H., Hinterhuber, H., et al. (2003). Buprenorphine versus methadone maintenance treatment in an ambulant setting: a health-related quality of life assessment. Addiction, 98, 693–702.

    Article  Google Scholar 

  • Giacomuzzi, S. M., Riemer, Y., Ertl, M., Kemmler, G., Rössler, H., Hinterhuber, H., et al. (2005). Gender differences in health-related quality of life on admission to a maintenance treatment program. European Addiction Research, 11, 69–75.

    Article  Google Scholar 

  • Giacomuzzi, S., Kemmler, G., Ertl, M., & Riemer, Y. (2006). Opioid addicts at admission vs slow-release oral morphine, methadone, and sublingual buprenorphine maintenance treatment participants. Substance Use & Misuse, 41, 223–244.

    Article  Google Scholar 

  • Gilbert, T. (2004). Involving people with learning disabilities in research: Issues and possibilities. Health and Social Care in the Community, 12, 298–308.

    Article  Google Scholar 

  • Goode, D., & Hogg, J. (1994). Towards an understanding of holistic quality of life in people with profound intellectual and multiple disabilities. In D. Goode (Ed.), Quality of life for persons with disabilities–international perspectives and issues (pp. 197–207). Cambridge, MA: Brookline Books.

    Google Scholar 

  • Habrat, B., Chmielewska, K., Baran-Furga, H., Keszycka, B., & Taracha, E. (2002). Subjective Quality of Life in opiate-dependent patients before admission after six months and one-year participation in methadone program. Przeglad Lekarski, 59, 351–354.

    Google Scholar 

  • Hser, Y. I., Polinsky, M. L., Maglione, M., & Anglin, M. D. (1999). Matching clients’ needs with drug treatment services. Journal of Substance Abuse Treatment, 16, 299–305.

    Article  Google Scholar 

  • Hunt, G., & Barker, J. (1999). Drug treatment in contemporary anthropology and sociology. European Addiction Research, 5, 126–132.

    Article  Google Scholar 

  • Kalman, D., Lee, A., Chan, E., Miller, D. R., Spiro, A., Ren, X. S., et al. (2004). Alcohol dependence, other psychiatric disorders, and health-related quality of life: A replication study in a large random sample of enrolees in the veterans health administration. American Journal of Drug and Alcohol Abuse, 30, 473–487.

    Article  Google Scholar 

  • Kaplan, C., & Verbraeck, H. (2001). Where have the field notes gone? The changing nature and politics of drugs ethnography in the Netherlands. Addiction Research & Theory, 9, 299–323.

    Article  Google Scholar 

  • Kitzinger, J. (1995). Qualitative Research–Introducing focus groups. British Medical Journal, 311, 299–302.

    Google Scholar 

  • Krueger, R. A., & Casey, M. A. (2000). Focus groups: A practical guide for applied research. Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  • Kuckartz, U. (1998). WinMAX: Scientific text analysis for the social sciences, User’s guide. Berlin: Udo Kuckartz, BSS.

    Google Scholar 

  • Lasalvia, A., Bonetto, C., Malchiodi, F., Salvi, G., Parabiaghi, A., Tansella, M., et al. (2005). Listening to patients’ needs to improve their subjective quality of life. Psychological Medicine, 35, 1655–1665.

    Article  Google Scholar 

  • Maremmani, I., Pani, P. P., Pacini, M., & Perugi, G. (2007). Substance use and quality of life over 12 months among buprenorphine maintenance-treated and methadone maintenance-treated heroin-addicted patients. Journal of Substance Abuse Treatment, 33, 91–98.

    Article  Google Scholar 

  • Masthoff, E., Trompenaars, F., Van Heck, G., Hodiamont, P., & De Vries, J. (2005). Validation of the WHO Quality of Life assessment instrument (WHOQOL-100) in a population of Dutch adult psychiatric outpatients. European Psychiatry, 20, 465–473.

    Article  Google Scholar 

  • McLellan, A. T., Cacciola, J. C., Alterman, A. I., Rikoon, S. H., & Carise, D. (2006). The addiction severity index at 25: Origins, contributions and transitions. American Journal on Addictions, 15, 113–124.

    Article  Google Scholar 

  • McLellan, A. T., Lewis, D. C., O’Brien, C. P., & Kleber, H. D. (2000). Drug dependence, a chronic medical illness—implications for treatment, insurance, and outcomes evaluation. Journal of the American Medical Association, 284, 1689–1695.

    Article  Google Scholar 

  • Mellor, D.J., Cummins, R.A., Karlinski, E., & Storer, S.P. (2003). The management of subjective quality of life by short-stay hospital patients: An exploratory study. Health and quality of life outcomes, 1, 39–55.

    Article  Google Scholar 

  • Michalos, A. C. (2004). Social indicators research and health-related quality of life research. Social Indicators Research, 65, 27–72.

    Article  Google Scholar 

  • Millson, P. E., Challacombe, L., Villeneuve, P. J., Fischer, B., Strike, C. J., Myers, T., et al. (2004). Self-perceived health among Canadian opiate users. A comparison to the general population and to other chronic disease populations. Canadian Journal of Public Health, 95, 99–103.

    Google Scholar 

  • Mooney, A. (2006). Quality of life: Questionnaires and questions. Journal of Health Communication, 11, 327–341.

    Article  Google Scholar 

  • Moons, P., Budts, W., & De Geest, S. (2006). Critique on the conceptualisation of quality of life: A review and evaluation of different conceptual approaches. International Journal of Nursing Studies, 43, 891–901.

    Article  Google Scholar 

  • Morgan, D. L. (1998). The focus group guidebook. London: Sage Publications.

    Google Scholar 

  • Noll, H.H. (2000). Social indicators and social reporting: The international experience. Retrieved, January 15, 2008, from http://www.ccsd.ca/noll1.html.

  • Oliver, J. P. J., Huxley, P. J., Priebe, S., & Kaiser, W. (1997). Measuring the quality of life of severely mentally ill people using the Lancashire Quality of Life Profile. Social Psychiatry and Psychiatric Epidemiology, 32, 76–83.

    Article  Google Scholar 

  • Padaiga, Z., Subata, E., & Vanagas, G. (2007). Outpatient methadone maintenance treatment program Quality of Life and health of opioid-dependent persons in Lithuania. Medicina (Kaunas), 43, 235–241.

    Google Scholar 

  • Power, R., Jones, S., Kearns, G., & Ward, J. (1996). An ethnography of risk management amongst illicit drug injectors and its implications for the development of community-based interventions. Sociology of Health & Illness, 18, 86–106.

    Article  Google Scholar 

  • Rapley, M. (2003). Quality of life research: A critical introduction. London: Sage Publications.

    Google Scholar 

  • Rapp, R. C. (2006). Strengths-based case management: Enhancing treatment for persons with substance abuse problems. In D. Saleebey (Ed.), The Strengths perspective in social work practice (pp. 128–147). Boston: Pearson Education.

    Google Scholar 

  • Romney, D. M., Brown, R. I., & Fry, P. S. (1994). Improving the quality of life: Prescriptions for change. Social Indicators Research, 33, 237–272.

    Article  Google Scholar 

  • Rosenfield, S. (1997). Labelling mental illness: The effects of received services and perceived stigma on life satisfaction. American Sociological Review, 62, 660–672.

    Article  Google Scholar 

  • Rudolf, H., & Watts, J. (2002). Quality of life in substance abuse and dependency. International Review of Psychiatry, 14, 190–197.

    Article  Google Scholar 

  • Ryan, C. F., & White, J. M. (1996). Health status at entry to methadone maintenance treatment using the SF-36 health survey questionnaire. Addiction, 91, 39–45.

    Article  Google Scholar 

  • Saleebey, D. (1996). The strengths perspective in social work practice: Extensions and cautions. Social Work, 41, 296–305.

    Google Scholar 

  • Saleebey, D. (2006). Introduction: Power in the people. In D. Saleebey (Ed.), The Strengths perspective in social work practice (pp. 1–24). Boston: Pearson Education.

    Google Scholar 

  • Schalock, R. (1996). Quality of life. Volume 1: Conceptualization and measurement. Washington: American Association on Mental Retardation.

    Google Scholar 

  • Schalock, R. (2005). Quality of life: introduction and overview. Journal of Intellectual Disability Research, 49(10), 695–698.

    Article  Google Scholar 

  • Schalock, R., & Verdugo Alonso, M. A. (2002). Handbook on quality of life for human service practitioners. Washington: American Association on Mental Retardation.

    Google Scholar 

  • Senbanjo, R., Wolff, K., & Marshall, J. (2006). Excessive alcohol consumption is associated with reduced quality of life among methadone patients. Addiction, 102, 257–263.

    Article  Google Scholar 

  • Smith, K. W., & Larson, M. (2003). Quality of life assessments by adult substance abusers receiving publicly funded treatment in Massachusetts. The American Journal of Drug and Alcohol Abuse, 29, 323–335.

    Article  Google Scholar 

  • Stein, M. D., Mulvey, K. P., Plough, A., & Samet, J. H. (1998). The functioning and well being of persons who seek treatment for drug and alcohol use. Journal of Substance Abuse, 10, 75–84.

    Article  Google Scholar 

  • Taillefer, M. C., Dupuis, G., Roberge, M. A., & Le May, S. (2003). Health-related quality of life models: systematic review of the literature. Social Indicators Research, 64, 293–323.

    Article  Google Scholar 

  • Taylor, J., & Bogdan, R. (1996). Quality of life and the individual’s perspective. In R. Schalock (Ed.), Quality of life. Volume 1: Conceptualization and measurement (pp. 11–22). Washington: American Association on Mental Retardation.

    Google Scholar 

  • Torrens, M., San, L., Martinez, A., Castillo, C., Domingo-Salvany, A., & Alonso, J. (1997). Use of the Nottingham Health Profile for measuring health status of patients in methadone maintenance treatment. Addiction, 92, 707–716.

    Article  Google Scholar 

  • Vanagas, G., Padaiga, Z., & Bagdonas, E. (2006). Cost-utility analysis of methadone maintenance treatment: A methodological approach. Substance Use & Misuse, 41, 87–101.

    Article  Google Scholar 

  • Vanderplasschen, W., & De Maeyer, J. (2007). The practice of case management for substance abusers: what’s in a name? Adiktologie, 7, 460–469.

    Google Scholar 

  • Vanderplasschen, W., Rapp, R. C., Wolf, J., & Broekaert, E. (2004). The development and implementation of case management for substance use disorders in North America and Europe. Psychiatric Services, 55(8), 913–922.

    Article  Google Scholar 

  • Vandevelde, S., Vanderplasschen, W., & Broekaert, E. (2003). Cultural responsiveness in substance-abuse treatment: a qualitative study using professionals’ and clients’ perspectives. International Journal of Social Welfare, 12, 221–228.

    Article  Google Scholar 

  • Van Loon, J. (2001). Arduin. Ontmantelen van de instituutzorg. Emancipatie en zelfbepaling van mensen met een verstandelijke handicap. Leuven-Apeldoorn: Garant.

    Google Scholar 

  • van Nieuwenhuizen, C., Schene, A. H., & Koeter, M. W. J. (2002). Quality of life in forensic psychiatry: an unreclaimed territory? International Review of Psychiatry, 14, 198–202.

    Article  Google Scholar 

  • Ventegodt, S., & Merrick, J. (2003). Psychoactive drugs and quality of life. The Scientific World Journal, 3, 694–706.

    Google Scholar 

  • Walmsley, J. (2001). Normalisation, emancipatory research and inclusive research in learning disability. Disability and Society, 16, 187–205.

    Article  Google Scholar 

  • World Health Organization (WHO). (2004). Global status report on alcohol 2004. Geneva: World Health Organization, Department of Mental Health and Substance Abuse.

    Google Scholar 

  • Zautra, A., & Goodhart, D. (1979). Quality of life indicators: A review of literature. Community Mental Health Review, 4, 1–10.

    Google Scholar 

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  1. Department of Orthopedagogics, Ghent University, H. Dunantlaan 2, 9000, Ghent, Belgium

    Jessica De Maeyer, Wouter Vanderplasschen & Eric Broekaert

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  1. Jessica De Maeyer
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  2. Wouter Vanderplasschen
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  3. Eric Broekaert
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Correspondence to Jessica De Maeyer.

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De Maeyer, J., Vanderplasschen, W. & Broekaert, E. Exploratory Study on Drug Users’ Perspectives on Quality of Life: More than Health-Related Quality of Life?. Soc Indic Res 90, 107–126 (2009). https://doi.org/10.1007/s11205-008-9315-7

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