[Evaluation on the long-term effectiveness among the first set eight methadone maintenance treatment clinics in China].

OBJECTIVE: To evaluate the long-term effectiveness of the first set 8 methadone maintenance treatment (MMT) clinics in China. METHODS: Repeated cross-sectional surveys were conducted on the first month after the enrollment and 5 years later, among drug users who received MMT, using a standard questionnaire. Data on demographic characteristics, HIV-related high-risk behaviors, criminal records associated with drug use and related family/social functions were collected and analyzed. RESULTS: There were 252 and 195 participants being interviewed at the baseline and the 5-year surveys, respectively. Of them, 66 participants were involved in both surveys. There was no significant differences on factors as ethnicity, level of education, working status, marital status and living status (P > 0.05) between the baseline and the 5-year surveys. Compared with data from the baseline survey, participants' behavior on drug abuse (100.0% vs. 24.1%, P < 0.001), needle sharing behavior (19.4% vs. 0.0%, P < 0.001), and exchanging sex for drugs (34.5% vs. 0.0%, P < 0.001) had significant decreases at the 5-year survey. Rates on condom use (10.6% vs. 25.0%, P = 0.004), and having jobs (27.8% vs. 47.7%, P < 0.001) had been improved significantly, while self-reported criminal cases related to drug use (15.1% vs. 1.5%, P < 0.001) and the contacts with drug users (88.9% vs. 31.3%, P < 0.001) had been significantly reduced after joining the MMT program. CONCLUSION: MMT could play an active role in reducing the HIV-related high-risk behaviors, criminal cases associated with drug abuse as well as enhancing the family and social functions of the MMT patients. Providing high quality service to the MMT clinic and trying to keep the drug users stick to the program remain difficult. It was also important to improve the training programs for staff working at the MMT clinics.

[Characteristics and associated factors of long-term retention for methadone maintenance treatment patients].

OBJECTIVE: To describe the characteristics and factors associated with long-term retention for methadone maintenance treatment (MMT) patients. METHODS: This study was conducted in eight MMT clinics located in Sichuan, Yunnan, Guangxi, Guizhou and Zhejiang provinces. Five hundred and thirty-nine MMT patients who enrolled in MMT clinics in 2004 and retained in treatment by June 2010 were selected as study subjects. Chi-square tests were used to compare the demographics and drug abuse history at enrollment and treatment characteristics during the follow-up period between continuous treatment patients and discontinuous treatment patients. RESULTS: Of the 539 patients, 110 (20.4%) were continuous treatment patients whereas 429 (79.6%) were discontinuous treatment patients. Of these 429 discontinuous treatment patients, 84.1% (361/429) had 2-4 treatment episodes whereas 15.9% (68/429) had 5 or more episodes during follow-up period. When continuous treatment patients were compared with discontinuous treatment patients, living with family members or friends (88.2% (97/110), 78.5% (337/429)), age of first drug use under 25 (61.8% (68/110), 71.3% (306/429)), low urine morphine positive test results (67.3% (74/110), 38.2% (164/429)) and living within 5 kilometers of the MMT clinic (72.7% (80/110), 61.3% (263/429)) were positively associated with higher possibility of continuous treat retention (P < 0.05). Demographics and drug abuse characteristics at enrollment, including gender, age, employment status, family relationship, injection, needle sharing, criminal behavior, contacts with drug users, MMT daily dosage and family members receiving MMT were not significantly associated with treatment retention (P > 0.05). CONCLUSION: Illicit drug use during the treatment and longer distance travelling to MMT clinic might have negative impact on patients' continuous treatment retention. Mobile MMT vehicles and expanded MMT service sites could be introduced to improve compliance of treatment retention of MMT patients.

[Risk factors which were associated with heroin use during the methadone maintenance treatment among 1301 patients in 9 cities of China.].

OBJECTIVE: To determine the proportion of heroin use among patients who were involved in community-based methadone maintenance treatment (MMT) program and to identify the risk factors associated with heroin use. METHODS: This study was conducted in 9 MMT clinics within 3 provinces. Thirteen hundred and one patients who met the study criteria were selected from each of the five groups with different dosages of methadone users. An administrative questionnaire was applied to explore the demographics, drug abuse-related behaviors and MMT services received by the clients, etc. The prevalence of depression and anxiety among the clients were also collected by SAS and SDS. Urine samples were collected as a biological marker to indicate if heroin had been used. RESULTS: Of the 1301 patients, 76.2% were males. The mean age was (34.6 +/- 6.5) years while 71.7% had an education level of primary school or below. The average daily dosage of methadone was (48.1 +/- 29.4) mg and self-satisfied evaluation score on treatment was 8.6. On average, 27.7% urine samples showed positive opiate evidence. Marital status, employment status, treatment retention, self-satisfied evaluation score on dosage and dropout history were found to be significantly associated with heroin use, while gender, education level and dosage had no significant association with heroin use. It seemed that risk factors that associated with heroin use were different from areas to areas. CONCLUSION: High quality MMT clinic services, high self-satisfied score, longer treatment retention and low dropout rate seemed to have the effects of reducing the risk of ongoing heroin abuse under the methadone maintenance treatment program.