Quality of life improvement in Latinas receiving combined substance use disorders and trauma-specific treatment: a cohort evaluation report.

BACKGROUND: This study evaluates the benefits of integrating behavioral health and trauma services for Latinas with a history drug use. Changes in quality of life (QOL) domains were documented after participation in a manualized intervention in a cohort of Latinas. METHODS: Participants were part of a prospective cohort study of 136 Latinas with co-occurring disorders (COD) who may have experienced trauma and receiving services in our outpatient treatment facility in Bayamón, Puerto Rico. The WHOQOL-BREF Spanish version was used to score physical, psychological, social, and environmental QOL domains, at intake and after six months. Sociodemographic variables, alcohol, drug use, mental health disorders, and severity of substance use disorders (as defined by the DSM-5) were also tabulated. Descriptive statistics and paired t test or the Wilcoxon signed-rank test were computed for comparison. RESULTS: A median age of 39 years was seen and with 76% high school education or higher degree. The majority were unemployed (95.9%). A diagnosis of severe cocaine use (51.4%) was present and almost half (49.5%) had three or more DSM-5 diagnoses. Mean QOL scores were higher at six months with statistically significant differences in each domain. Women with neurodevelopmental disorders and schizophrenia yielded higher mean QOL scores for each domain at six months except for the social domain. Women with polydrug use and women who reported exposure to trauma and depressive disorder experienced statistically significant increments in the physical, psychological and social domains in comparison to counterpart women. CONCLUSIONS: Significant and positive changes in QOL were found in each domain. Latinas who reported traumatic events had lower scores in the physical and psychological QOL domains. There was a high prevalence of diminished physical and mental functioning in Latinas with COD. The exposure to trauma and the lack of social support negatively affect treatment access and retention for Latinas.

Are Stressful Life Events (SLEs) Associated with the Utilization of Substance Use Treatment-Related Services?

OBJECTIVE: This study described herein explored the association of stressful life events with the utilization of substance use treatment-related services among substance users living in Puerto Rico. METHODS: A secondary data analysis was conducted using data collected by a research project entitled Puerto Rico Drug Abuse Research Development Program II (PRDARDP II). The study population consisted of 378 individuals from 18 to 35 years of age who were residents of the San Juan metropolitan area and who presented evidence of substance use in the 30 days prior to the interview. The analysis considered demographic data, information on patterns of substance use, substance use treatment history, stressful events, and depression and anxiety symptomatology. RESULTS: As the number of stressful life events increased, substance users were more likely to report having utilized substance use treatment-related services (OR = 1.11, 95% CI [1.06, 1.17], p < 0.001). Relapsing, the inability to afford drugs, and poor working conditions were statistically significant stressful life events associated with the utilization of substance use treatment-related services. CONCLUSION: Despite the structural limitations associated with access to and with the quality of the services in the substance use treatment-related system of Puerto Rico, findings suggest that stressful life events play a significant role in the utilization of those services. Researchers and clinicians should consider screening for stressful life events in outreach and engagement strategies. At the same time, the assessment of stressful life events should be integrated into the treatment planning stage to support the recovery process of people with substance use disorders.