In this paper, we used the QLICD-DA scale to measure the quality of life of people with substance-abuse disorders. To the best of our knowledge, generic QOL instruments, such as the SF-36, were developed for the general population, and they have biases and low sensitivity in measuring the quality of life of drug-dependent people. These scales can only reflect a small part of the quality of life of persons with substance-abuse disorders, so it is not sufficient to explore the influencing factors. Compared with generic QOL instruments, the QLICD-DA scale has better validity, reliability, and responsiveness. This scale adopts a combination of a general module and the specific module, which is suitable for the Chinese culture and is sensitive to the factors affecting the quality of life of drug-dependent people. The QLICD-DA has been applied by many Chinese scholars after it was first publishing, reflecting its stability and effectiveness. For example, Zhang et al. used the QLICD-DA scale to measure the quality of life and its influencing factors for maintenance patients and Guo et al. also measured the quality of life and its influencing factors on male drug-dependent people in compulsory treatment. Therefore, we can use the QLICD-DA to identify the factors influencing the quality of life of drug-dependent persons more directly and effectively.
It is concluded from this study that the quality of life of people with substance-abuse disorders is lower than for patients with other chronic diseases. A similar observation has been made by Smith and Larson . Drug addiction is recurrent and chronic, similar to chronic diseases. Susannah et al.  considered that heroin dependence is a serious chronic disease, which has harmful effects on physical and mental health. Compared with patients with other chronic diseases, the decline in the quality of life of drug-dependent persons is determined by the comprehensive negative impact of drug use in several areas. Moreover, drug-dependent persons usually only seek treatment when they suffer from serious consequences, while patients with other chronic diseases pay more attention to their diseases and will engage in a certain degree of prevention and health care consumption. Moreover, drug-dependent persons are more likely to experience criminal charges, which puts them under various pressures.
Mònica Astals et al. also found that the psychological domain of heroin patients was seriously damaged, which is similar the findings of our study. Anxiety disorders and mood disorders are common mental disorders among people who abuse drugs. There are some reasons for this. Firstly, drug abuse easily leads to adverse consequences, and may even prompt the performance of criminal acts, which applies a psychological burden. What's more, the feeling of withdrawal when attempting to stop drug abuse is strong and unbearable, causing physical and mental suffering. Finally, substance abusers are not respected or accepted in society, causing them to lose the support of their friends and family. There is no doubt that these factors together will generate many negative emotions. Therefore, it can be seen that the physical and mental health of drug-dependent persons must be taken seriously.
On the whole, sex played an important role in the total score and in the special domain. The quality of life of female drug abusers is worse than that of male drug abusers. The mode of drug abuse was found to be a common factor affecting the total score, common general domain, and the special domain. The quality of life of people who administered addictive drugs by snorting or oral administration was relatively poor. What’s more, a bad past family atmosphere worsened their quality of life. A specific discussion is given below.
Sex is a vital influencing factor. Our results showed that the quality of life of female drug users was not good, which was consistent with Karow et al.. Here are some reasons for why this may be. First, although the number of women who abuse drugs is relatively low, their dependence tends to be more severe than that of men. What’s more, Chinese society gives men more personal freedom and it has a lot of restrictions on women. The social tolerance of female drug users is much lower than that of male drug users, so female drug users are more likely to be rejected by their relatives and friends. Social stigma would increase these women's sense of helplessness and negative emotions. Also, drug use increases women's risk of AIDS/HIV, which is possibly due to needle sharing or prostitution. Meanwhile, in the present study, we also found that female drug abusers were more likely to suffer from overt mental illness than male drug abusers, such as depression.
Our findings indicated that the modes of drug abuse are also an important influencing factor. This study concluded that the quality of life of people who use other modes of drug use is lower than among those who inject drugs. The author conjectures that although intravenous injection is harmful to the human body, other ways of administering drugs, such as by inhalation, will lead to a stronger drug addiction. What’s more, inhalation users are more likely to relapse after treatment.
At the same time, the past family atmosphere cannot be ignored. Several previous studies also clearly demonstrated that drug addiction is related to broken family relationships and an unhealthy family atmosphere. A similar observation has been documented for the effect of the past family atmosphere on drug addiction. Al-Kandari et al. reported that having one person in the family taking drugs often leads to another, especially in situations where a parent abusing drugs leads to the children doing so as well. Albert Bandura, a famous psychologist, put forward the theory of observation learning. It’s a powerful theory that proposes that children learn from their parents by imitation. Moreover, in this present study, we found that drug abuse was closely related to childhood trauma. An uneasy and tense family atmosphere can make children feel insecure. Consequently, they tend to rely on drugs to compensate for their anxiety. Families with a supportive structure tend to pay more attention to the reasons why their members are using drugs and they are more willing to help them return to a normal life. Drug-dependent persons are affected by family support and use it as a positive force and a motivation to return to society. In contrast, if the reason for the drug abuse comes from the bad family atmosphere, it is difficult for these individuals to find the necessary psychological support to return to normal life, which may make the detoxification stage more intolerable.
Generally speaking, we have revealed that the quality of life of persons with a substance-abuse disorder is low. They may have symptoms of pain, which can easily be accompanied by irritability. Besides, drug abuse will have a certain negative impact on their work and life. For example, relatives will alienate them and their interpersonal relationships will worsen, which could put them in a vicious downward cycle. Therefore, we must pay more attention to the quality of life of people who abuse drugs, which can help them to get rid of their habit and to find meaning in life.
There are some suggestions based on our results. First of all, the government needs to attach importance to the causes of drug addiction, building a good social atmosphere and eliminating discrimination against drug abusers. Also, the government must help the rehabilitated people to integrate with society, providing jobs and relevant assistance services. Moreover, the community is regarded as an early place to prevent drug addiction, playing an important role in the early identification of possible drug addiction. What's more, the community has a responsibility to increase publicity efforts to provide education about the causes of drug addiction and to provide psychological counseling services to relieve people's stress. In the meantime, the community is also seen as the main front for drug treatment. Compared with China, many foreign community’s drug rehabilitation practices focus on a people-oriented model, correcting the drug dependence psychology, and enhancing social adaptability. The low-level development of the community, the lack of funds, and a lack of professional teams in the community are still problems hindering China's community drug rehabilitation.
The family is also the primary site of drug addiction prevention. The family needs to create a harmonious atmosphere and be aware of when family members are beginning drug-taking behaviors. We should not discriminate against and alienate drug-dependent persons. On the contrary, we should them more support so that they can get through their difficulties with confidence.
For intravenous drug users, we should pay more attention to their physiological and psychological needs, and provide more social support. Recovery is a long process and they should be guided throughout the detoxification and recovery process.
The participants in this study were only selected from one detoxification center, and the verification of the QLICD-DA scale is only applicable to heroin patients. Its application in other environments and among other types of drug abuse needs to be further explored.