Predictors for dropping-out from methadone maintenance therapy programs among heroin users in southern Taiwan.

This study examined the methadone maintenance therapy (MMT) retention rates of heroin users in Taiwan and the predictors for dropout in the 18-month period after starting MMT. We consecutively recruited 368 intravenous heroin users receiving MMT in 2007-2008 and applied Cox proportional hazards regression analysis to determine the predictive effect of pre- and in-treatment variables on early discontinuation of MMT. The retention rate at 18 months was 32.3%. High heroin expenses, more severe harm caused by heroin use, perceived lower family support, and lower methadone dosage at 3 months after starting MMT increased the risk of dropout in the follow-up period.

Benzodiazepine prescription among patients with severe mental illness and co-occurring alcohol abuse/dependence in Taiwan.

OBJECTIVE: Because benzodiazepines (BZDs) may be abused, prescribing them is debatable. The purpose of this study was to investigate the prescription of BZDs to explore the current status of BZD use at discharge and at 4 months after discharge. METHODS: From 1 January 2006 to 31 December 2006, prescribed doses for BZDs at discharge and at 4 months after discharge were recorded for all discharged inpatients with schizophrenia, bipolar I disorder, and major depressive disorder. Two­way analysis of variance was used to analyze the effects of severe mental illness and co­occurring alcohol abuse/dependence on BZD doses at discharge and at 4 months after discharge. RESULTS: Patients with severe mental illness prescribed with significantly higher rates and higher doses of BZDs at discharge and at 4 months after discharge are more likely to have major depressive disorder and to have co­occurring alcohol abuse/dependence problems. No significant interactions were found between severe mental illness and co­occurring alcohol abuse/dependence. CONCLUSIONS: These findings suggest that caution should be applied in prescribing BZDs to patients with severe mental illness, particularly those with major depressive disorder and co­occurring alcohol abuse/dependence. Future studies require being conducted in many different mental health­care systems in Taiwan to generalize the findings.