This study aimed to determine the QoL and its related factors among drug-dependent women covered by substance abuse treatment centers in Hamadan. According to the study results, the participants’ age at first abuse of different materials ranged between 16 and 25 years, with a mean age of 23.57 ± 1.54. These findings indicate that the vulnerability to substance use is higher among people at a young age [24]. Therefore, it can be concluded that the probability of drug use increases in this age range. Undoubtedly, women in the mentioned age range experience severe stress and distress and may consider drug use to reduce stress. As observed in the results, the most frequently used drugs by the participants in their lifetime were opium and its derivatives, crystal, methadone, and heroin. This finding is in line with the results reported by Rahimi-Movaghar et al. [7].
The findings of this study indicate an undesirable QoL among the drug-dependent women in Hamadan. Consistent with our research, Muller et al. reported the poor status of life quality among drug-dependent women [25]. In another study by Tracy et al. in the United States, low QoL was reported among drug-dependent women [26].
The development of tolerance and physiological and psychological dependence on addictive substances can lead to irritability, aggression, and other psychological symptoms. In general, this process reduces physical functioning, undermines psychosocial capabilities, and decreases individuals’ QoL. Generally, QoL is a function of several factors such as the mental health dimension. In the current study, this dimension was lower compared to the other dimensions. However, mental state disorders usually encompass those psychiatric disorders, such as mood, anxiety, and substance use disorders [27]. Thus, personality disorder commonly co-occurs with mental state disorders, causing enormous consequences of substance use disorders. Several studies have shown that mental state disorders are associated with an increased risk of low QoL in physical, psychological, and social domains [28]. Therefore, mental state disorders have been associated with significant impairment in QoL [27, 29]. Accordingly, it is necessary to conduct an analytical study including a case group (women with substance use disorder) and a control group (healthy women). It is also necessary to design and implement educational interventions to improve the QoL of these women.
In the present study, age, education, and age at first drug abuse were associated with women’s QoL. As observed, the QoL was lower among drug-dependent women who were younger, had lower education levels, and started drug abuse at younger ages. The results of this study are consistent with those of other studies. For example, Marini et al. reported a relationship between the QoL of people with a history of substance use and their level of education [30]. In another study, Muller et al. showed that the QoL in illiterate women and those with a low education level was unfavorable [25]. Sadeghi et al. showed that implementing therapeutic interventions in young women and those who started taking drugs at an early age helped to improve different dimensions of QoL one, four, and eight months after the treatment [31]. Therefore, it is necessary to design mental health intervention, school-based prevention, and harm reduction programs of substance use interventions for drug-dependent women who are younger, have a low level of education, and started taking drugs at an early age.
In the present study, the use category of methamphetamine was identified as the predictor of drug-dependent women’s QoL. Findings of a study by Mihan et al. showed negative impacts on their global functioning and QoL among methamphetamine users. In this regard, the evidence suggests a high prevalence of attention-deficit hyperactivity disorder (ADHD) in adults who take methamphetamine. Also, QoL scores were significantly lower in those with ADHD and duration of methamphetamine use [32]. Hence, it is vital to design interventions for drug-dependent women who are methamphetamine users.
This study had some limitations, as it was conducted only on women with a history of drug use referring to substance abuse treatment centers in Hamadan. Thus, it is recommended to conduct similar studies on other drug-dependent women who do not refer to substance abuse treatment centers. Self-reporting and the use of a cross-sectional design were among the other limitations of the study. Due to this study design, causality could not be demonstrated. So, it is suggested to conduct qualitative studies to explain the reasons for women’s addiction and explain the low QoL in women who use substances. Examination variance in the severity of harm with Substance Consumption level and purity of substance investigations in participation is another limitation of our study. Thus, it is suggested to perform preclinical toxicology and observational assessment to understand the damages related to the QoL. A multi-centric data gathering method was used in this study. As indicated, all women present in treatment centers during data gathering were recruited in the study. As a result, the sample size is small and it does not represent all the women with substance use disorder population for generalizability. As the strength of this study, age, education, early drug abuse, use of methamphetamine category, and cocaine category are essential factors that were used in identifying QOL in women with substance use disorder population. Also, applying the SF-36 questionnaire for evaluating QOL in drug-dependent women may confirm the reliability of using this questionnaire even in such a sample.
