China ; Heroin Dependence ; rehabilitation ; Humans ; Methadone ; adverse effects ; therapeutic use ; Narcotics ; adverse effects ; therapeutic use

Buprenorphine ; therapeutic use ; Humans ; Methadone ; therapeutic use ; Naltrexone ; therapeutic use ; Narcotic Antagonists ; therapeutic use ; Narcotics ; therapeutic use ; Opioid-Related Disorders ; rehabilitation

Adult ; Heroin Dependence ; drug therapy ; prevention & control ; Humans ; Male ; Methadone ; therapeutic use ; Patient Compliance ; Treatment Outcome

Objective: To analyze the withdrawal in patients receiving methadone maintenance treatment (MMT) and its related influencing factors in Hubei province. Methods: The patients receiving MMT in clinics in Hubei province were selected from June 2006 to December 2021. The general demographic data, drug abuse history, and MMT information were collected. The survival data of patients with MMT were analyzed by the Kaplan-Meier method, and the Cox proportional hazards model was used for multivariate analysis. Results: A total of 26 716 patients receiving MMT were included in this study, and the gender ratio between men and women was 3.34∶1(20 557∶6 159). The duration of MMT was 0.01-15.72 years, and the median duration was 2.21 (95%CI: 2.16-2.26) years. At the end of the follow-up, the withdrawal proportion was 86.75% (23 175/26 716). MMT's 0-year, 2-year, 4-year, 9-year and 14-year cumulative probabilities appeared as 67.61%, 40.24%, 30.03%, 15.49% and 6.56%, respectively. Results from the Cox proportional hazards regression model showed that the factors of the withdrawal risk were higher in patients receiving MMT, including minority nationality (HR=1.66,95%CI:1.52-1.82), having jobs (HR=1.05, 95%CI:1.01-1.08), no history of compulsory isolation or detoxification (HR=1.04, 95%CI:1.01-1.09) and the enrollment in 2016-2021 (HR=1.46,95%CI:1.35-1.58). The factors of the withdrawal risk were lower in patients receiving MMT, including 60-year-olds or above (HR=0.56,95%CI:0.42-0.75), college degree or above education level (HR=0.83, 95%CI:0.75-0.91), outpatient services of other cities (HR=0.90, 95%CI:0.87-0.93), drug use for 20 years or more (HR=0.72, 95%CI:0.66-0.80), 90 mg or more per daily dosage (HR=0.73,95%CI:0.69-0.78) and the enrollment in 2011-2015 (HR=0.93,95%CI:0.89-0.97). Conclusions: The withdrawal proportions of patients receiving MMT were high in Hubei province. The withdrawal influencing factors were complex. The daily dose was an essential factor that can be intervened under the safe MMT condition, and a higher dose should be appropriately prescribed.
Male ; Humans ; Female ; Methadone/therapeutic use* ; Opiate Substitution Treatment ; Ambulatory Care ; Cities

Adult ; China ; Genes, Viral ; Genotype ; Hepacivirus ; genetics ; Hepatitis C ; virology ; Humans ; Methadone ; therapeutic use ; Middle Aged ; Opioid-Related Disorders ; virology

OBJECTIVETo study the efficacy and safety of acupuncture therapy for the improvement of sleep quality of outpatients receiving methadone maintenance treatment (MMT).

METHODSUsing randomized double-blinded controlled design, seventy-five MMT outpatients with low sleep quality [score of Pittsburgh sleep quality index (PSQI) > or = 8], were randomly assigned to the acupuncture group (38 cases) and the sham-acupuncture group (37 cases). All patients maintained previous MMT. Acupuncture was applied to Baihui (GV20), Shenmen (bilateral, TF4), Shenting (GV24), Sanyinjiao (bilateral, SP6), and Sishencong (EX-HN1) in the acupuncture group. The same procedures were performed in the sham-acupuncture group, but not to the acupoints (5 mm lateral to the acupoints selected in the acupuncture group) with shallow needling technique. The treatment was performed 5 times each week for 8 successive weeks. The PSQI was assessed before treatment, at the end of the 2nd, 4th, 6th, and 8th week of the treatment. The detection ratio of low sleep quality and the incidence of adverse acupuncture reactions were compared between the two groups at the end of the 8th week.

RESULTSThe overall PSQI score was obviously higher in the acupuncture group than in the sham-acupuncture group with statistical difference (P < 0.01). The detection ratio of low sleep quality at the end of the 8th week was lower in the acupuncture group (60.53%, 23/38 cases) than in the sham-acupuncture group (83.78%, 31/37 cases) with statistical difference (P < 0.05). The rate of adverse acupuncture reaction was 5.26% (2/38 cases) in the acupuncture group and 2.70% (1/37 cases) in the sham-acupuncture group respectively, showing no statistical difference (P > 0.05).

CONCLUSIONAcupuncture therapy could effectively and safely improve the sleep quality of outpatients receiving MMT.

Acupuncture Therapy ; Adult ; Double-Blind Method ; Female ; Humans ; Male ; Methadone ; therapeutic use ; Outpatients ; Sleep ; Sleep Initiation and Maintenance Disorders ; therapy

OBJECTIVETo learn about the effects of psychological counseling intervention on reducing heroin use, increasing methadone dosage and improving compliance rate of methadone maintenance treatment (MMT).

METHODSSubjects who had had at least one positive result for regular urine morphine tests during the past three months were recruited from 16 MMT clinics. During the three-month intervention period, the subjects received regular psychological counseling provided by doctors (once every other week) and peer education (once a week). Positive rates of urine morphine tests, average days receiving MMT during three months before the intervention and during the intervention, and average daily dosage of methadone during the last week before intervention and during the last week of the intervention programs conducted were recorded and compared.

RESULTSA total of 492 patients receiving MMT were surveyed. There were significant changes in positive rates for urine morphine tests, average daily dosage, and average days on MMT before and during the intervention programs. The positive rate for urine morphine tests dropped from 50.1% to 27.1%; the average daily dosage of methadone increased from 63.0 mg to 72.6 mg; the average days receiving MMT increased from 69.4 days to 73.9 days.

CONCLUSIONIntensive psychological counseling intervention was effective in reducing heroin use, increasing methadone dosage and improving compliance rate of MMT among patients receiving MMT.

Counseling ; Heroin Dependence ; drug therapy ; psychology ; Humans ; Methadone ; therapeutic use ; Opiate Substitution Treatment ; psychology ; Patient Compliance ; Surveys and Questionnaires

OBJECTIVETo evaluate the reliability and validity of the Chinese version of addiction severity index (ASI)-5th version (ASI-C-5), in illegal drug users receiving methadone maintenance treatment (MMT) in China.

METHODSOne hundred and eighty-six heroin addicts (144 men and 42 women) receiving MMT at three clinics in Guizhou province, southwest China, were recruited. They were all interviewed with a questionnaire of ASI-C-5 and 35 were re-interviewed at an interval of seven days to assess its test-retest reliability.

RESULTSCronbach's alpha for internal consistency of CSs varied from 0.60 to 0.81 in all domains. Test-retest reliability of composite scores (CSs) of ASI-C-5 were satisfactory (r=0.38-0.97). Based on item analysis and expert's suggestions, five items were deleted and one item was modified in ASI-C-5. Criterion validity of ASI-C-5 was found acceptable, as compared to addicts' self-rating anxiety scale (SAS) and self-rating depression scale (SDS) (r=0.59 and 0.45) except for social support rating scale (SSRS).

CONCLUSIONSASI-C-5 can be used for heroin addicts receiving MMT with acceptable reliability and validity.

Adult ; China ; Female ; Heroin Dependence ; drug therapy ; physiopathology ; Humans ; Male ; Methadone ; therapeutic use ; Reproducibility of Results ; Severity of Illness Index ; Surveys and Questionnaires

Anxiety ; epidemiology ; China ; epidemiology ; Depression ; epidemiology ; Female ; Heroin Dependence ; drug therapy ; psychology ; Humans ; Male ; Methadone ; administration & dosage ; therapeutic use

OBJECTIVETo explore the routes and factors associated with HIV new infection of heroin addicts who had been attending the methadone maintenance treatment (MMT) program.

METHODSA 1 : 1 nested case-control study was implemented with the cases (new HIV infections) and controls (HIV negative) selected from the treatment cohort of China MMT clients. Questionnaire was developed to collect information on demographic characters, behaviours on drug use, sexual behaviour, daily dosage of methadone intake, adherence to MMT, and psychological problems. Univariate analysis and multivariate condition logistic regression were used to identify factors associated with HIV infection.

RESULTS108 (54 paired) clients on MMT were recruited, with 76 males and 32 females. Among them, 95 were Han Chinese and 13 were minorities, with average time of drug use as 12.1 ± 5.0 years. Among 54 new HIV infections, 33 were infected through sharing needles, 12 were through sexual contact and 9 unidentified. Results from multivariate condition logistic regression indicated that having longer duration of heroin use before on MMT (More than 10 years vs. less than 10 years,OR = 20.9, 95% CI:1.62-269.34, P = 0.02), shared needles in the last 6 months (OR = 276.7, 95%CI:5.65-> 999.99, P < 0.01) were risk factors while better adherence (More than 0.5 vs. less than 0.5,OR = 0.07, 95%CI:0.42-0.87, P = 0.04) and living with families (OR = 0.002, 95% CI:0.001-0.94, P < 0.01) were protective factors.

CONCLUSIONSharing needles was the main route of HIV new infection among those clients that were on MMT. Factors as having received more support from both family and community, improvement of adherence to MMT, reducing the frequency of injection etc., could reduce the risk of HIV infection among those MMT clients.

Adult ; Case-Control Studies ; Female ; Follow-Up Studies ; HIV Infections ; epidemiology ; Heroin Dependence ; complications ; drug therapy ; Humans ; Male ; Matched-Pair Analysis ; Methadone ; therapeutic use ; Middle Aged