Patients in long-term maintenance therapy for drug use in Italy: analysis of some parameters of social integration and serological status for infectious diseases in a cohort of 1091 patients

BACKGROUND: Heroin addiction often severely disrupts normal social functioning. The aims of this multi-centre study of heroin users in long-term replacement treatment were: i) to provide information on aspects of social condition such as employment, educational background, living status, partner status and any history of drug addiction for partners, comparing these data with that of the general population; ii) to assess the prevalence of hepatitis, syphilis and HIV, because serological status could be a reflection of the social conditions of patients undergoing replacement treatment for drug addiction; iii) to analyse possible relationships between social conditions and serological status. METHODS: A cross-sectional study was carried out in sixteen National Health Service Drug Addiction Units in northern Italy. The data were collected from February 1, 2002 to August 31, 2002. Recruitment eligibility was: maintenance treatment with methadone or buprenorphine, treatment for the previous six months, and at least 18 years of age. In the centres involved in the study no specific criteria or regulations were established concerning the duration of replacement therapy. Participants underwent a face-to-face interview. RESULTS: The conditions of 1091 drug treatment patients were evaluated. The mean duration of drug use was 14.5 years. Duration was shorter in females, in subjects with a higher educational background, and in stable relationships. Most (68%) had completed middle school (11–14 years of age). Seventy-nine percent were employed and 16% were unemployed. Fifty percent lived with their parents, 34% with a partner and 14% alone. Males lived more frequently with their parents (55%), and females more frequently with a partner (60%). Sixty-seven percent of male patients with a stable relationship had a partner who had never used heroin. HCV prevalence was 72%, HBV antibodies were detected in 42% of patients, while 30% had been vaccinated; 12.5% of subjects were HIV positive and 1.5% were positive for TPHA. CONCLUSION: A significant percentage of heroin users in treatment for opiate addiction in the cohort study have characteristics which indicate reasonable integration within broader society. We posit that the combination of effective treatment and a setting of economic prosperity may enhance the social integration of patients with a history of heroin use

Education and union formation as simultaneous processes in Italy and Spain

'In recent times, both the time spent on education and the age at first union formation have significantly increased in Italy and Spain. In this paper, we provide empirical evidence of the endogeneity of the two processes. We use panel data (European Community Household Panel), which provide detailed standardised information for both countries about education and training processes as a well as household formation. The effect of unobservable characteristics affecting the two processes at the same time has been controlled for, using simultaneous hazard modelling. On the one hand, the exit from the educational system increases the risk of entering the first union. On the other hand, there exist individual unobserved characteristics that influence the occurrence of the two processes simultaneously. If these characteristics are not controlled for, the effect of a completed education on union formation becomes biased upward.' (author's abstract)In den letzten Jahren sind sowohl die Zahl der im Bildungssystem verbrachten Jahre als auch das Alter bei der ersten Heirat in Italien und Spanien signifikant angestiegen. Beide Prozesse, so zeigt die Verfasserin, sind endogen. Auf der Basis des European Community Household Panel werden fuer beide Laender detaillierte Daten zu Bildungs- und Ausbildungsprozessen sowie Familiengruendung vorgelegt. Effekte nicht zu beobachtender Merkmale auf beide Prozesse werden kontrolliert. Einerseits erhoeht der Austritt aus dem Bildungssystem die Wahrscheinlichkeit, die erste Ehe einzugehen. Andererseits existieren nicht beobachtete Merkmale auf individueller Ebene, die beide Prozesse gleichzeitig beeinflussen. Werden diese Merkmale nicht kontrolliert, wird der Effekt des Ausbildungsabschlusses auf eine Heirat nach oben verzerrt. (ICEUebers)German title: Bildung und Heirat als simultane Prozesse in Italien und SpanienAvailable from Max-Planck-Institut fuer demografische Forschung, Rostock (DE) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman