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 with substance abusers. OBJECTIVES. The objectives of this study were to use the SF-36 to assess changes in the health status of crack-cocaine users over time, to determine the characteristics of users who change, to assess the influence of frequency 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 every 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 the social functioning and role-emotional subscales. Variation in subjects' health trajectories occurred but Tvas not, for the most part, explained by individual 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 be the health-compromising effects of cocaine use, raising questions about the use of the SF-36 with illicit drug users. CONCLUSIONS. Changes in crack users' SF-36 health status were uncommon. Frequency of crack use was negatively associated with health status. Several SF-36 subscales may be helpful in studies involving illicit drug users in which limited assessments of health status are needed.