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Objective@#To analyze the factors affecting the dropping-out from methadone maintenance treatment (MMT) in Hangzhou City, so as to provide the evidence for improving the compliance to MMT.@*Methods@#One MMT clinic was sampled from each of the eight districts in Hangzhou City using a cluster random sampling method, and patients that received MMT and were at ages of 18 years and older and registered during the period from December 2020 through June 2021 were recruited. Participants' basic characteristics, illegality and crime within 6 months prior to MMT and family and social relationships were collected through questionnaire surveys, and factors affecting the dropping-out from MMT were identified using a multivariable logistic regression model. @*Results@#A total of 315 outpatients were included from MMT clinics. The participants had a mean age of (45.33±7.63) years, and included 245 men (77.78%) and 70 women (22.22%), with a dropping-out rate of 65.71%. Multivariable logistic regression analysis showed a low likelihood of dropping-out from MMT among patients at ages of 60 years and older (OR=0.080, 95%CI: 0.018-0.350), employees (OR=0.415, 95%CI: 0.236-0.727), patients without drug-related infectious diseases (OR=0.411, 95%CI: 0.231-0.731), patients with per dossing of 60 mL and higher (OR=0.431, 95%CI: 0.236-0.787) and patients without contact with drug-using friends (OR=0.328, 95%CI: 0.185-0.582), and a high possibility of dropping-out from MMT among patients with poor relationship with family members (OR=2.905, 95%CI: 1.127-7.488). @*Conclusion@#Age, working status, drug-related infectious diseases, dosing, relationship with family members and contact with drug-using friends affected the dropping-out from MTT in Hangzhou City.
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Objective: To investigate the effects of protracted abstinence (PA) and methadone maintenance treatment (MMT) on the brain function of heroin addicts for 6 months. Methods: Twenty-two heroin addicts with PA for 6 months intervention (PA group), 25 heroin addicts with MMT for 6 months intervention (MMT group), and 35 normal controls (control group) were recruited. The resting data were collected by fMRI. The low-frequency amplitude (ALFF) method was used to calculate the intensity of local brain spontaneous activity in the 3 groups. The differences in ALFF of the 3 groups were analyzed and compared. Results: There were significant differences in ALFF between the 3 groups in the right frontal medial, left medial frontal gyrus, left island leaf, left tongue lingual, right lingual gyrus and right auxiliary motion zone (all P0.05). Conclusion: After 6 months of intervention, there are still abnormalities in some brain regions between PA and MMT, but PA may be more conducive to brain function recovery in heroin addicts.
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Objective To investigate the effect of transfer service utilization in increased methadone dosage after missed dose of participants in methadone maintenance treatment (MMT).Methods We selected 9 MMT clinics in Guangdong Province and collected the data from the web-based system of MMT management. All the participants who had utilized the transfer service from January 2008 to December 2016 were included in our study. We explored multilevel Logistic regression analysis to explore the associated factors of changing methadone dosage after missed dosage of transfer participants.Results A total of 197 patients were included in the study for a total of 840 person-time transfer services. Of these, 119 (14.26%) had increased-dose after transfer. The patients whose (1) dose of methadone was less than 60 ml/d during the transfer period (OR=2.88, 95%CI:1.85-4.50, P<0.001), (2)had longer transfer period (OR=1.02, 95%CI: 1.01-1.03, P<0.001), and (3) fewer cumulative transfertimes (OR=0.97, 95%CI:0.95-0.99, P=0.004) were more likely to increase the methadone dosage after the missed.Conclusions The characteristic of transfer service utilization could result in the increasing methadone dosage after missed doses in transfer participants. This finding suggest MMT clinic should strengthen the supervision of transfer patients, especially those who failed to return on time after transfer. The doctors in MMT should carefully consider the dose adjustment requirements from patients and improve the efficacy of methadone maintenance treatment.
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Objective: To investigate the prevalence of alcohol use and related influencing factors among the patients with methadone maintenance treatment (MMT) in Shanghai, and to provide information for the alcohol intervention in the future. Methods: A total of 837 MMT patients were investigated and evaluated by General Situation Questionnaire, Alcohol Use Disorders Identification Test, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, General Well-being Schedule. According to whether drinking or not in the past year, the two groups were divided into the non-drinking group and the drinking group. T-test, Chi-square test and multivariate Logistic regression analysis were used to detected between two groups. Results: 30.9% of the patients had drinking behavior in the past year, 13.8% of them had problem drinking behavior. The main factors affecting patients' drinking behavior were sex (P=0.029), age of first drug use (P=0.005), drinking before taking heroin (P=0.000) and drinking when taking heroin (P=0.000). Conclusion: In Shanghai, alcohol consumption is generally prevalent among MMT patients who lack awareness of the dangerous of drinking. In the future, targeted intervention measures should be taken to reduce the harm of drinking among MMT patients.
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Objective To investigate the characteristics of methadone maintenance treatment(MMT)clients, and to explore their retention rate and associated factors in Taizhou, Zhejiang Province. Methods Heroin or opiate addicts who started MMT between 2006 and 2014 in study area were included. Data including demographics, history of drug use and treatment information was extracted from the National MMT Data Management System and descriptive analysis were conducted. Multiple logistic regression models were used to explore factors associated with retention rate. Results In total, 2 262 MMT clients were included for analysis. Most of them were male(87.53%), single, divorced or widowed(55.75%), and had an education of junior middle school or below(88.68%). Almost all of them (98.32%)were heroin addicts, and the age at first drug use ranged from 9 years to 54 years, with average age of(25.06±6.34)years. A total of 1 123(49.65%)clients had a history of inject drug use and 81(3.58%)clients had ever shared needles with others. The average duration on MMT was 5.02±2.01 years, and the average methadone dosage during treatment was (34.49 ±22.69)mL. The MMT retention rate was 29.2% (661/2 262). In multivariable analysis, districts such as Huangyan District, Yuhuan County and Linhai City, aged≥40 years and average methadone dosage>20 mL during treatment were independently and positively associated with retention rate. Conclusion Most of MMT clients in Taizhou are male, unmarried, and had low education level. The retention rate is low in Taizhou but older patents and those receive high methadone dosage have a relatively higher retention rate.
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When facing the worldwide abuse of opioid substance,one of the effective responses is opioid substitution therapy (OST).However,different OST service patterns may affect the therapeutic outcome.Using the System Engineering Initiative for Patient Safety (SEIPS) model,we can analyze the factors that affecting the outcomes of patients from the perspective work system.In this paper,SEIPS model is used to describe the existing OST service model.According to the operation mechanism of the methadone maintenance treatment in China and the existing OST service model,some suggestions are put forward to carry out effective OST service in the country.
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Objective To estimate the prevalence of HIV/HCV co-infection and explore the influence factors and their interaction on HIV/HCV co-infection of patient's access to methadone maintenance treatment (MMT).Methods A face to face interviews were conducted among 750 patients at two MMT clinics in Guangxi Zhuang Autonomous Region.The questionnaires information included demographic characteristics,HIV and HCV infection status,history of drug abuse,urine test for morphine,high risk sex behaviors,needle sharing,dropped out etc.Methods of x2 test one-way,multivariate logistic regression and interactions were used to analyze the related factors of HIV/HCV co-infection.Results The study subjects included 750 participants,18.31％ (127/691) of patients were co-infected with HIV and HCV.The HIV/HCV co-infection rate in patients who shared needles with others or dropped out of treatment was 35.84％ (81/226) and 19.88％ (64/322) respectively,which were higher than those who have never shared needles or dropped out (9.89％,46/465 and 17.07％,63/369).Logistic regression analysis results showed that after adjusted for confounding factors,patients who shared needles (OR=4.50,95％CI:2.72-7.43) and dropped out of treatment (OR=1.71,95％CI:1.04-2.80) were more likely to be infected with HIV/HCV.Interaction analysis showed that sharing needles and dropping out of treatment exist additive effect on co-infection of HIV and HCV (RERI=4.21,AP=0.44,SI=1.95).Conclusions Needle sharing and dropping out of treatment are associated with HIV/HCV co-infection.Health education,psychological counseling and other measures should be taken to reduce needle sharing and dropping out of MMT.
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Objective To explore the reasons and factors associated with new psychoactive substances abuse among patients with access to methadone maintenance treatment (MMT).Methods A well-developed questionnaire and urine tests were used to collect information about demographic characteristics,condition of MMT and drug abuse,family and social support of MMT clients.A 1 ∶ 1 matched case-control study was conducted,and conditional logistic regression model was used to identify factors associated with new psychoactive substances abuse.Results A total of 212 (106 pairs) clients receiving MMT were recruited,and most of them were males (78.3％,166/212),married or cohabitant (48.6％,103/212) and unemployed (63.2％,134/212).The average age of the clients was (45.1 ± 7.2) years.The main types of abused new psychoactive substances were benzodiazepine (62.3％,66/106) and methamphetamine (39.6％,42/106).The proportion of abusing multi new psychoactive substances was 8.5％ (9/106).Results from multivariate conditional logistic regression analysis indicated that using opioid drug during the past 6 months of MMT treatment might increase the risk of abusing new psychoactive substances (OR=3.25,95％CI:1.35-7.79),benzodiazepine (OR=3.25,95％CI:1.11-9.47) and methamphetamine (OR =13.31,95 ％ CI:1.12-158.01).Moreover,MMT for more than 9 years reduced the risk of abuse of new psychoactive substances (OR=0.03,95％ CI:0.01-0.21),benzodiazepine (OR=0.02,95％ CI:0.00-0.36) and methamphetamine (OR=0.02,95％ CI:0.00-0.69).Conclusion Less new psychoactive substances abuse might be associated with longer duration of MMT treatment.And inappropriate support from family and friends might increase the risk of abusing new psychoactive substances in MMT clients,especially in clients who used opioid.
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Methadone maintenance treatment (MMT) greatly contributed to the successful outcomes of prevention and control on both AIDS and drug abuse in China.However,the features on drug abuse changed in the past decades,and the prevalence of new psychoactive substances abuse potentially somehow offset the achievement of MMT.This paper concised the information on research and surveys of this issue that targeting on the current situation,characteristics,related factors and relevant public health problem on new psychoactive substances abuse,among patients who have been on MMT,in China.
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Objective To investigate the association between three single nucleotide polymorphism (SNP) genes DRD2 (rs1800497,rs6275,and rs1799978) and the dosage used on methadone maintenance treatment (MMT).Methods From the methadone maintenance treatment centers,257 MMT patients were recruited to participate in a case-control study and divided into two groups—control groups under low dosage (n=89) and case (n=168) group with high dosage.Quanto software was used to estimate the sample size as 180.Information related to social-demographic status,history on drug use and medication were collected.And DRD2 SNPs were genotyped to explore the relationship between polymorphism of DRD2 gene and the dosage of methadone maintenance treatment.Results Distributions of DRD2 rs6275 between different groups were significantly different.Patients carrying TC genotype needed lower dose of methadone when compared to the patients that carrying CC genotype counterparts (OR=0.338,95％ CI:0.115-0.986).Patients that carrying C allele at rs6275 needed lower methadone dose than those that carrying genotype TT (OR=0.352,95％CI:0.127-0.975).Distributions of genotypes,alles in the other two SNPs (rs1800497,rs1799978) were not significantly different between groups under different dosages.Conclusion DRD2 rs6275 was associated with dosage of methadone used for the MMT patients.However,no significant associations were found between rs 1800497,rs 1799978 and the dosage of methadone.
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When facing the worldwide abuse of opioid substance,one of the effective responses is opioid substitution therapy (OST).However,different OST service patterns may affect the therapeutic outcome.Using the System Engineering Initiative for Patient Safety (SEIPS) model,we can analyze the factors that affecting the outcomes of patients from the perspective work system.In this paper,SEIPS model is used to describe the existing OST service model.According to the operation mechanism of the methadone maintenance treatment in China and the existing OST service model,some suggestions are put forward to carry out effective OST service in the country.
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Objective To estimate the prevalence of HIV/HCV co-infection and explore the influence factors and their interaction on HIV/HCV co-infection of patient's access to methadone maintenance treatment (MMT).Methods A face to face interviews were conducted among 750 patients at two MMT clinics in Guangxi Zhuang Autonomous Region.The questionnaires information included demographic characteristics,HIV and HCV infection status,history of drug abuse,urine test for morphine,high risk sex behaviors,needle sharing,dropped out etc.Methods of x2 test one-way,multivariate logistic regression and interactions were used to analyze the related factors of HIV/HCV co-infection.Results The study subjects included 750 participants,18.31％ (127/691) of patients were co-infected with HIV and HCV.The HIV/HCV co-infection rate in patients who shared needles with others or dropped out of treatment was 35.84％ (81/226) and 19.88％ (64/322) respectively,which were higher than those who have never shared needles or dropped out (9.89％,46/465 and 17.07％,63/369).Logistic regression analysis results showed that after adjusted for confounding factors,patients who shared needles (OR=4.50,95％CI:2.72-7.43) and dropped out of treatment (OR=1.71,95％CI:1.04-2.80) were more likely to be infected with HIV/HCV.Interaction analysis showed that sharing needles and dropping out of treatment exist additive effect on co-infection of HIV and HCV (RERI=4.21,AP=0.44,SI=1.95).Conclusions Needle sharing and dropping out of treatment are associated with HIV/HCV co-infection.Health education,psychological counseling and other measures should be taken to reduce needle sharing and dropping out of MMT.
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Objective To explore the reasons and factors associated with new psychoactive substances abuse among patients with access to methadone maintenance treatment (MMT).Methods A well-developed questionnaire and urine tests were used to collect information about demographic characteristics,condition of MMT and drug abuse,family and social support of MMT clients.A 1 ∶ 1 matched case-control study was conducted,and conditional logistic regression model was used to identify factors associated with new psychoactive substances abuse.Results A total of 212 (106 pairs) clients receiving MMT were recruited,and most of them were males (78.3％,166/212),married or cohabitant (48.6％,103/212) and unemployed (63.2％,134/212).The average age of the clients was (45.1 ± 7.2) years.The main types of abused new psychoactive substances were benzodiazepine (62.3％,66/106) and methamphetamine (39.6％,42/106).The proportion of abusing multi new psychoactive substances was 8.5％ (9/106).Results from multivariate conditional logistic regression analysis indicated that using opioid drug during the past 6 months of MMT treatment might increase the risk of abusing new psychoactive substances (OR=3.25,95％CI:1.35-7.79),benzodiazepine (OR=3.25,95％CI:1.11-9.47) and methamphetamine (OR =13.31,95 ％ CI:1.12-158.01).Moreover,MMT for more than 9 years reduced the risk of abuse of new psychoactive substances (OR=0.03,95％ CI:0.01-0.21),benzodiazepine (OR=0.02,95％ CI:0.00-0.36) and methamphetamine (OR=0.02,95％ CI:0.00-0.69).Conclusion Less new psychoactive substances abuse might be associated with longer duration of MMT treatment.And inappropriate support from family and friends might increase the risk of abusing new psychoactive substances in MMT clients,especially in clients who used opioid.
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Methadone maintenance treatment (MMT) greatly contributed to the successful outcomes of prevention and control on both AIDS and drug abuse in China.However,the features on drug abuse changed in the past decades,and the prevalence of new psychoactive substances abuse potentially somehow offset the achievement of MMT.This paper concised the information on research and surveys of this issue that targeting on the current situation,characteristics,related factors and relevant public health problem on new psychoactive substances abuse,among patients who have been on MMT,in China.
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Objective To investigate the association between three single nucleotide polymorphism (SNP) genes DRD2 (rs1800497,rs6275,and rs1799978) and the dosage used on methadone maintenance treatment (MMT).Methods From the methadone maintenance treatment centers,257 MMT patients were recruited to participate in a case-control study and divided into two groups—control groups under low dosage (n=89) and case (n=168) group with high dosage.Quanto software was used to estimate the sample size as 180.Information related to social-demographic status,history on drug use and medication were collected.And DRD2 SNPs were genotyped to explore the relationship between polymorphism of DRD2 gene and the dosage of methadone maintenance treatment.Results Distributions of DRD2 rs6275 between different groups were significantly different.Patients carrying TC genotype needed lower dose of methadone when compared to the patients that carrying CC genotype counterparts (OR=0.338,95％ CI:0.115-0.986).Patients that carrying C allele at rs6275 needed lower methadone dose than those that carrying genotype TT (OR=0.352,95％CI:0.127-0.975).Distributions of genotypes,alles in the other two SNPs (rs1800497,rs1799978) were not significantly different between groups under different dosages.Conclusion DRD2 rs6275 was associated with dosage of methadone used for the MMT patients.However,no significant associations were found between rs 1800497,rs 1799978 and the dosage of methadone.
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Objective To explore the association between the genetic polymorphism of CYP3A4,CYP2D6 and response to methadone maintenance treatment(MMT)among heroin-dependent patients.Methods Patients undergoing MMT in 6 MMT clinics were randomly selected,information about general socia-demographic characteristics,drug abuse history,and MMT data of patients were collected,genotypes of peripheral blood CYP3A4 and CYP2D6 polymorphic loci were detected.Results A total of 820 patients were enrolled in the study,210 cases were with good response and 610 cases with poor response to MMT.Difference in age between different response groups was statistically significant(P0.05).Conclusion The association between CYP3A4 rs2242480,CYP2D6 rs16947 and response to MMT has not yet found in heroin-dependent patients.
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Objective To analyze the quality of life status and its influencing factors of drug addicts with methadone maintenance treatment (MMT) in Wenzhou, in order to provide a basis for developing health service measures to improve their quality of life. Methods A total of 199 drug addicts with MMT in Wenzhou were investigated by the Quality of Life for Drug Addicts (QOL-DA) and Self-made questionnaire, influencing factors on quality of life were analyzed by multiple linear regression analysis. Results Most of 199 drug addicts with MMT were male, middle aged, local residents, lower educational level, and unemployed. Most of them used traditional drugs such as heroin by intravenous injection, and the proportion of who continually used drugs more than 10 years was 78.39%. The majority of them had abandoned drug habits many times. The proportions of abandoning drug habits more than 12 months this time and self-reported involving drug abuse related diseases were 77.39%, 61.81%, respectively. Scores of physical function and hunger sensory (PH), psychological spirit and self-esteem (PS), withdrawal syndrome and toxic effects (ST), social support and operational capability (SO) were 32.96±6.75, 33.03±5.96, 47.61±8.51 and 38.42±6.86, respectively. The total score of QOL-DA was 152.01±23.55. Marital status, occupation, age of first using drug, time of drug use and drug abuse related diseases were its influencing factors. Conclusion The quality of life of drug addicts with MMT is lower. Comprehensive health service measures for influencing factors should be taken to improve their quality of life.
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Objective To estimate the incidence of drop out of treatment in patients with access to methadone maintenance treatment and explore the correlation and interaction between insufficient methadone dosage and morphine positive urine on the drop out in Guangxi Zhuang Autonomous Region.Methods Face to face interview was conducted in 1 031 patients at 3 methadone maintenance treatment clinics in Guangxi.Results The study included 1 031 participants,40.6％ of them (419/1 031) had stopped treatment.The drop out rates in urine morphine positive group and methadone dosage ＜ 100 mg/d group were 57.6％ (99/172) and 37.4％ (347/929) respectively,higher than those in urine morphine negative group and methadone dosage ≥ 100 mg/d group (42.3％,363/ 859,and 26.5％,27/102).Orderly logistic regression analysis results showed that after adjusted factors,such as gender,age,marital status,ethnic group,patients who received a dosage less than 1 00 mg/day (OR=3.05,95％CI:1.84-5.06) and had morphine positive urine (OR=2.25,95％CI:1.59-3.19) were more likely to drop out of the treatment.Interaction analysis showed that dosage less than 100 mg/d and morphine positive urine during treatment had additive interaction (RERI=256.46,AP=0.87,S=8.05) and multiplication interaction (OR=2.45,95％CI:1.71-3.49).Conclusion Insufficient dosage and morphine positive urine were significantly correlated with drop out of treatment in patients with access to methadone maintenance treatment.
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Objective To understand the current status of receiving no methadone maintenance treatment (MMT) and influencing factors in HIV infected injecting drug users (IDUs) in Dehong Dai and Jingpo autonomous prefectures,Yunnan province.Methods Data of survival of IDUs with AIDS in Dehong were collected from "Chinese National Comprehensive HIV/AIDS and Care Information System" in December,2014.Results There were 987 IDUs who should receive MMT,the majority of them were males (94.6％,934/987),aged 35-44 years (53.0％,523/987) and farmers (77.2％,762/987).Among the 987 IDUs,60.2％ (592/987) received no MMT.Multivariate logistic regression analysis showed that being female (OR=2.66,95％CI:1.21-5.87),in Jingpo ethnic group (OR=3.05,95％CI:1.97-4.71) were the major risk factors for receiving no MMT;not being farmers (OR=0.46,95％CI:0.31-0.70),in Dai ethnic group (OR=0.53,95％CI:0.36-0.79),diagnosed HIV infection history ≥ 10 years (OR=0.60,95％CI:0.45-0.81) were the major protective factors for receiving no MMT.The reasons for receiving no MMT included long distance journey (289,48.8％),fear of exposure (124,20.9％),poor daily medication compliance (59,10.0％),fear of side effects (47,7.9％),others (73,12.3％).Conclusions The proportion of receiving no MMT in IDUs with AIDS in Dehong was high.Being female and farmer,in Jingpo ethnic group,low educational level,short diagnosed HIV infection history were influencing factors for receiving no MMT.The effective intervention measures should be taken to further improve MMT coverage according to the different characteristics of the patients.
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Objective To estimate the incidence of drop out of treatment in patients with access to methadone maintenance treatment and explore the correlation and interaction between insufficient methadone dosage and morphine positive urine on the drop out in Guangxi Zhuang Autonomous Region.Methods Face to face interview was conducted in 1 031 patients at 3 methadone maintenance treatment clinics in Guangxi.Results The study included 1 031 participants,40.6％ of them (419/1 031) had stopped treatment.The drop out rates in urine morphine positive group and methadone dosage ＜ 100 mg/d group were 57.6％ (99/172) and 37.4％ (347/929) respectively,higher than those in urine morphine negative group and methadone dosage ≥ 100 mg/d group (42.3％,363/ 859,and 26.5％,27/102).Orderly logistic regression analysis results showed that after adjusted factors,such as gender,age,marital status,ethnic group,patients who received a dosage less than 1 00 mg/day (OR=3.05,95％CI:1.84-5.06) and had morphine positive urine (OR=2.25,95％CI:1.59-3.19) were more likely to drop out of the treatment.Interaction analysis showed that dosage less than 100 mg/d and morphine positive urine during treatment had additive interaction (RERI=256.46,AP=0.87,S=8.05) and multiplication interaction (OR=2.45,95％CI:1.71-3.49).Conclusion Insufficient dosage and morphine positive urine were significantly correlated with drop out of treatment in patients with access to methadone maintenance treatment.