Drug Use and Long-Term Methadone Maintenance Treatment in Yunnan Province

DOI: https://doi.org/10.62517/jmhs.202505113

Author(s)

Yinfeng Xu1, Xintong Wang1, Mingjiao Wang2, Xinyue Li2, Jiucheng Shen2,*

Affiliation(s)

1Medical School of Yunnan College of Business Management, Yunnan, China 2Yunnan Institute for Drug Abuse, Kunming, Yunnan, China *Corresponding Author

Abstract

Yunnan has been launching methadone maintenance treatment (MMT) since 2004 to combat heroin use and HIV epidemics. Objectives: To describe the concurrent drug use and severity of drug use among MMT clients, and to identify its associated factors. Methods: A cross-sectional study was performed in 2020-2021 in Yunnan, and 975 subjects were recruited through stratified cluster sampling. Information about drug use and other covariates were collected by self-development questionnaire and urine test. Results: The overall percentage of any drug use in Yunnan MMT population was 15.9% in the past 3 months, and was 10.7% in the past 7 days. Zero of heroin users and 5.4% of amphetamine type stimulants users were identified as high-risk group and need intensive interventions. Longer treatment, higher dose and influenced by peer were strongly associated with drug use. Conclusion: MMT has been a successful treatment in Yunnan, which could greatly reduce drug use. only very few of users were identified as high-risk group and need intensive interventions. Methadone dose, treatment period and peer influence were strongly associated with drug use, and strategies focus on these factors should be valuable for a successful achievement of MMT services.

Keywords

MMT; Yunnan; HIV Epidemics

References

[1]Guidelines for the Psychosocially Assisted Pharmacological Treatment of Opioid Dependence. Geneva: World Health Organization; 2009. PubMed PMID: 23762965. [2]NIDA International Program Methadone Research Web Guide Part B: 20 Questions and Answers Regarding Methadone Maintenance Treatment Research. Available at [3]Liu Z, Lian Z, Zhao C. Drug use and HIV/AIDS in China. Drug Alcohol Rev. 2006 Mar;25(2):173-5. doi: 10.1080/09595230500538835. PMID: 16627308. [4]Qian HZ, Schumacher JE, Chen HT, Ruan YH. Injection drug use and HIV/AIDS in China: review of current situation, prevention and policy implications. Harm Reduct J. 2006 Feb 1;3:4. doi: 10.1186/1477-7517-3-4. PMID: 16451717; PMCID: PMC1402269. [5]Chu TX, Levy JA. Injection drug use and HIV/AIDS transmission in China. Cell Res. 2005 Nov-Dec;15(11-12):865-9. doi: 10.1038/sj.cr.7290360. PMID: 16354561. [6]Lu H Z. Overview on HIV infections among people who use drugs[J]. Chinese J AIDS STD, 2020, 26(7): 794-797. [7]Wu Z, Sullivan S G, Wang Y, et al. Evolution of China's response to HIV/AIDS[J]. The Lancet, 2007, 369(9562): 679-690. [8]Dole VP, Joseph HJ. Long-term outcome of patients treated with methadone maintenance. Ann N YAcad Sci 1978;311:181-9. [9]Simpson DD, Joe GW, Lehman WEK, Sells SB. Addiction careers: etiology, treatment, and 12-year follow-up outcomes. Journal of Drug Issues 1986;16(1):107-21. [10]Cao X, Yin W Y, Pang L, et al. Risk factors which were associated with heroin use during the methadone maintenance treatment among 1301 patients in 9 cities of China[J]. Chin Journal of Epidemiology. 2010, 31(3): 269-272.. [11]Liang T, Liu E W, Zhong H, et al. Factors influencing the rate on retention to methadone maintenance treatment program among heroin addicts in Guizhou, China[J]. Chinese Journal of Epidemiology. 2009, 30(2): 131-135. [12]Zhang G,Yang YC,Tang ZH, et al. Risk factors associated with heroin use among patients from two types of methadone maintenance treatment clinics [J]. Chinese J AIDS STD,2016,22(02):106-110. DOI:10.13419/j.cnki.aids.2016.02.13. [13]Cao X, Wu Z Y, Pang L, et al. Evaluation on the long-term effectiveness among the first set eight methadone maintenance treatment clinics in China[J]. Z Chinese Journal of Epidemiology. 2012, 33(9): 879-882.. [14]Leng Bing, Yuan Xinhao, Wang Dewei, Wang Chao, Luo Ying, Wang Jian, Gao Xiaoli, Luan Rongsheng Evaluation of the Effectiveness of Methadone Outpatient Maintenance Treatment in Chenghua District, Chengdu City from 2007 to 2014 [J]. China Health Service Management, 2017, 34 (01): 68-71. [15]Evaluating the effect of Methadone Maintenance Therapy on drug users in Chenghua District of Chengdu from 2007 to 2014 [16]Liao Rui, Gong Yi, Han Jiayu, Yu Bin, Dong Peijie, Yang Shifan, Yang Shujuan Analysis of the Current Status of Methadone Maintenance Treatment for Heroin Addicts and Factors Influencing Stealing Behavior [J]. Modern Preventive Medicine, 2020, 47 (15): 2789-2792+2861. [17]Lin C, Wu Z, Detels R. Family support, quality of life and concurrent substance use among methadone maintenance therapy clients in China[J]. Public health, 2011, 125(5): 269-274. [18]Zhou K, Li H, Wei X, et al. Relationships between received and perceived social support and health-related quality of life among patients receiving methadone maintenance treatment in Mainland China[J]. Substance abuse treatment, prevention, and policy, 2017, 12(1): 1-8. [19]Teoh Bing Fei J, Yee A, Habil M H B. Psychiatric comorbidity among patients on methadone maintenance therapy and its influence on quality of life[J]. The American journal on addictions, 2016, 25(1): 49-55. [20]Jahani M A, Ebadi F, Abdi M, et al. The Effect of Methadone Maintenance Treatment Method on Mental Health and Quality of Life in People With Opioid Addiction: A Longitudinal Study in Iran[J]. Addictive Disorders & Their Treatment, 2020, 19(1): 22-29. [21]Doukas N. Older adults in methadone maintenance treatment: A literature review[J]. Journal of Social Work Practice in the Addictions, 2011, 11(3): 230-244. [22]21 Condelli WS, Dunteman GH. Exposure to methadone programs and heroin use. Am J Drug Alcohol Abuse. 1993;19(1):65-78. PubMed PMID: 8438832. [23]Gottheil E, Sterling R C, Weinstein S P. Diminished illicit drug use as a consequence of long-term methadone maintenance[J]. Journal of addictive diseases, 1993, 12(4): 45-57. [24]Gao Yawen Thoughts on blocking the source of drug control in Yunnan against the background of COVID-19 [J]. Journal of Yunnan Police College, 2022 (3): 20-24. DOI: 10.3969/j.issn.1672-6057.2022.03.004 [25]Farrell M, Ward J, Mattick R, Hall W, Stimson GV, des Jarlais D, Gossop M, Strang J. Methadone maintenance treatment in opiate dependence: a review. BMJ. 1994 Oct 15;309(6960):997-1001. doi: 10.1136/bmj.309.6960.997. PMID: 7950725; PMCID: PMC2541312. [26]McGlothlin W H,Anglin M D. Long-term follow-up of clients of high- and low-dose methadone programs.[J]. Archives of general psychiatry,1981,38(9). [27]Siassi I, Angle B P, Alston D C. Comparison of the effect of high and low doses of methadone on treatment outcome[J]. International Journal of the Addictions, 1977, 12(8): 993-1005. [28]CAPLEHORN J R M, Bell J, Kleinbaum D G, et al. Methadone dose and heroin use during maintenance treatment[J]. Addiction, 1993, 88(1): 119-124. [29]Szapocznik J, Ladner R. Factors related to successful retention in methadone maintenance: a review[J]. International Journal of the Addictions, 1977, 12(8): 1067-1085. [30]Jackson TR. Treatment practice and research issues in improving opioid treatment outcomes. Sci Pract Perspect. 2002 Jul;1(1):22-8. doi: 10.1151/spp021122. PMID: 18567961; PMCID: PMC2851066. [31]Joseph H, Stancliff S, Langrod J. Methadone maintenance treatment (MMT)[J]. The Mount Sinai Journal of Medicine, 2000, 67(5): 6. [32]Dishion T J, Owen L D. A longitudinal analysis of friendships and substance use: bidirectional influence from adolescence to adulthood[J]. 2009. [33] Andrews J A, Tildesley E, Hops H, et al. The influence of peers on young adult substance use[J]. Health psychology, 2002, 21(4): 349.