Quality of life among people who use drugs living in poor urban communities in the Philippines

Chika Yamada; Atsuro Tsutsumi; Takashi Izutsu; Maria T R Tuliao; Hiroya Matsuo; Eizaburo Tanaka

doi:10.1016/j.drugpo.2021.103160

Quality of life among people who use drugs living in poor urban communities in the Philippines

Int J Drug Policy. 2021 Jul:93:103160. doi: 10.1016/j.drugpo.2021.103160. Epub 2021 Mar 12.

Authors

Chika Yamada¹, Atsuro Tsutsumi², Takashi Izutsu³, Maria T R Tuliao⁴, Hiroya Matsuo⁵, Eizaburo Tanaka⁶

Affiliations

¹ Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan; Graduate School of Health Sciences, Kobe University, Kobe, Japan. Electronic address: chika128@cseas.kyoto-u.ac.jp.
² College of Human and Social Sciences, Kanazawa University, Kanazawa, Japan.
³ College of Arts and Sciences, The University of Tokyo, Tokyo, Japan.
⁴ City Health Office, City Government of Muntinlupa, Muntinlupa, The Philippines.
⁵ Graduate School of Health Sciences, Kobe University, Kobe, Japan.
⁶ Hyogo Institute for Traumatic Stress, Kobe, Japan.

PMID: 33721576
DOI: 10.1016/j.drugpo.2021.103160

Abstract

Background: The quality of life (QOL) and mental health of people who use drugs (PWUD) in the Philippines, especially those living in poor urban communities, are highly concerning due to the situations surrounding drug use and the ongoing hard-line antidrug policy. This study aimed to investigate the QOL and mental health status of PWUD, compare them with a comparison group with no history of drug use, and identify factors associated with QOL among Filipino PWUD.

Methods: A cross-sectional study was conducted with recruitment from a community-based rehabilitation programme and poor urban communities in Muntinlupa in 2018. QOL was measured using the WHOQOL-BREF, while psychological distress and posttraumatic stress disorder (PTSD) were measured using the Kessler Psychological Distress Scale (K-6) and the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), respectively. Multivariable linear regressions with each WHOQOL-BREF domain as a dependent factor were conducted to establish three predictions: age- and gender-adjusted QOL means, factors associated with QOL among PWUD, and interaction of lifetime drug use with each covariate.

Results: In total, 272 PWUD and 402 comparison participants were recruited. Most PWUD were current drug users (53%), primarily of methamphetamine (70%). Among PWUD, the prevalence of moderate to severe psychological distress was 70%, and probable PTSD was 28%-both rates higher than those among the comparison group. All four QOL domain scores (physical, psychological, social, and environmental) of PWUD were lower than those of the comparison group. Multivariable regressions showed that psychological distress, current drug use, selling drugs, experiencing discrimination, and being never-married were associated with lower QOL. Higher individual income, household resources, social activity participation, and service use for drug use problems were associated with higher QOL among PWUD. Stratified and interaction analyses revealed that the QOL of PWUD was more sensitive to changes in individual income relative to the QOL of comparison group.

Conclusion: A comprehensive intervention addressing psychological distress reduction, economic empowerment, and social inclusion-complementary to abstinence-oriented programmes-may improve the well-being of Filipino PWUD.

Keywords: Developing countries; Drug users; Philippines; Quality of life.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cross-Sectional Studies
Humans
Pharmaceutical Preparations*
Philippines / epidemiology
Quality of Life*
Surveys and Questionnaires

Substances

Pharmaceutical Preparations