Article

Structural-level factors affecting implementation of the methadone maintenance therapy program in China.

Department of Epidemiology, School of Public Health, University of California at Los Angeles, Los Angeles, CA 90024, USA.
Journal of substance abuse treatment (Impact Factor: 2.9). 12/2009; 38(2):119-27. DOI: 10.1016/j.jsat.2009.09.002
Source: PubMed

ABSTRACT This study identifies structural-level factors influencing methadone maintenance therapy (MMT) program implementation in China. Twenty-eight service providers and 560 randomly selected clients from 28 MMT clinics in the study area underwent face-to-face interviews. Number of clients, retention rate, coverage, and structural-level factors were collected from a survey of service providers. Individual-level factors and self-reported illicit drug use information were obtained from clients. Urine specimens were collected from the client participants to test for heroin use. Clinics affiliated with the local Centers for Disease Control and Prevention (CDC) had more clients, higher retention rates, and broader coverage than those not affiliated with the CDC. Longer operating hours, incentive for compliant clients, and comprehensive services were positively associated with client recruitment and coverage. Comprehensive services and incentives for compliant clients were negatively associated with concurrent illicit drug use. Comprehensive services should be incorporated into the MMT program. Extended operating hours and incentives for compliant clients should be implemented.

Download full-text

Full-text

Available from: Chunqing Lin, May 08, 2014
0 Followers
 · 
166 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The initiation of the first methadone maintenance treatment program (MMT) in Macao was founded in collaboration between MMT clinics in the USA and Israel. All patients admitted into treatment between October 2005 and October 2008 were prospectively followed through March 2010. Of the 163 patients, 81% were male, the mean age on admission was 39.5 (sd = 10.2). Seventy-three percent (n = 119) were hepatitis C sera positive, and 4.9% (n = 8) were HIV sera positive. One-year treatment retention rate was 59.5%, with 52.6% of the 95 patients who stayed in treatment having an opiate-negative urine test at the 10-month evaluation. Four and a half years of follow-up showed mean long-term retention (Kaplan Meier analyses) of 2.2 years. Higher methadone dose (> or = 80 mg/day) and hepatitis C sera positive status were predictors for longer treatment retention. This study describes an effective model of MMT that supports the expansion of addiction treatment in other countries.
    Journal of psychoactive drugs 09/2013; 45(4):313-21. DOI:10.1080/02791072.2013.825032 · 1.10 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The study examined concurrent illicit heroin use among methadone maintenance clients in China and its association with clients' demographic characteristics, treatment experience, and personal social network. Face-to-face surveys were conducted with 178 clients randomly recruited from six methadone maintenance treatment (MMT) clinics in Sichuan, China. Concurrent heroin use was measured based on self-report of heroin use during the past 30 days and a confirmatory urine morphine test. The participants' demographic characteristics and treatment factors were measured and examined. The drug use status of their family members and friends was also assessed. A total of 80 participants (44.9%) who either reported illicit heroin use in the past 30 days or had a positive urine test were defined as using heroin concurrently. Having drug-using friends was significantly associated with increased concurrent heroin use. Longer length of treatment (2 years or longer) was associated with increased concurrent heroin use. Among those who had both drug-using family members and friends, more women (71.4%) than men (50.0%) used heroin. For those who had no drug-using family members or friends, more men (34.8%) than women (20.8%) used heroin. Study findings indicate an urgent need to address concurrent illicit heroin use among MMT clients. Further examination of the influence of social networks on concurrent drug abuse behavior is encouraged. Results also highlight the importance of understanding gender differences in treatment seeking and behavioral changes, which is crucial to the development of gender-specific treatment strategies.
    Addictive behaviors 11/2012; 37(3):264-8. DOI:10.1016/j.addbeh.2011.11.004 · 2.44 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Dosage of methadone maintenance therapy (MMT) is an important factor influencing retention in methadone treatment. MMT clients in China received lower dosages of methadone compared with those provided in other countries. The objective of this study is to elucidate the reason for the low methadone dosage prescribed in MMT clinics in China. Twenty-eight service providers were recruited from the MMT clinics in Zhejiang and Jiangxi Provinces, China. Qualitative in-depth interviews were conducted to ascertain the procedure for prescribing methadone in the MMT clinics. The average dosage prescribed in the 28 clinics was 35 mg/person/day. Four major themes resulting in low dosage of methadone were identified: (1) the service providers fear the liability resulting from large doses of methadone in combination with other substances which might result in overdose fatalities, (2) lack of understanding of harm reduction which resulted in low acceptance of the long term maintenance treatment approach, (3) break-down in communication between clients and service providers about dosage adjustment, and (4) dosage reduction is perceived by most service providers as an effective way to treat the side-effects associated with MMT. The findings of the study highlighted the necessity to formulate clear guidelines concerning individualized dosage management and to improve training among service providers' in MMT clinics in China.
    Drug and alcohol dependence 02/2011; 117(1):45-9. DOI:10.1016/j.drugalcdep.2011.01.004 · 3.28 Impact Factor