Longitudinal application of the Medical Outcomes Study 36-item short-form health survey with not-in-treatment crack-cocaine users

BACKGROUND. The Medical Outcomes Study SF-36 has been used infrequently wit h substance abusers. OBJECTIVES. The objectives of this study were to use the SF-36 to assess ch anges in the health status of crack-cocaine users over time, to determine t he characteristics of users who change, to assess the influence of frequenc y of crack use on SF-36 health status, and to determine the utility of the SF-36 with crack users. DESIGN. A multilevel model was used to analyze data that were collected eve ry 6 months over a 2-year period. SUBJECTS. The sample consisted of 439 not-in-treatment crack-cocaine users. MEASURES. The SF-36 was administered at baseline and follow-up interviews. Data on the frequency of crack-cocaine use were also collected. RESULTS. On average, SF-36 health status remained fairly static during the study although statistically significant increases in scores occurred on th e social functioning and role-emotional subscales. Variation in subjects' h ealth trajectories occurred but Tvas not, for the most part, explained by i ndividual characteristics. Frequency of crack use was negatively related to scores on the physical functioning, social functioning, and mental health subscales. Most subscales did not reflect what are commonly recognized to b e the health-compromising effects of cocaine use, raising questions about t he use of the SF-36 with illicit drug users. CONCLUSIONS. Changes in crack users' SF-36 health status were uncommon. Fre quency of crack use was negatively associated with health status. Several S F-36 subscales may be helpful in studies involving illicit drug users in wh ich limited assessments of health status are needed.