Retention and its predictors among methadone maintenance treatment clients in China: a six-year cohort study.

Abstract

BACKGROUND:

To investigate factors associated with retention among the first cohort of drug users attending methadone maintenance treatment (MMT) clinics in China.

METHODS:

A six-year cohort of 1511 drug users was enrolled in the first 8 MMT clinics in China in 2004 and followed between March, 2004 and December, 2010. Six-year retention rates were calculated and compared by methadone dosage, clinic location, and length of follow-up. Factors associated with retention were evaluated using Cox proportional hazard regression models.

RESULTS:

The overall retention rate over 6-year was 35.7%. Highest drop-out occurred within the first 12 months of treatment. The retention rates for the 6-year by low (≤ 30 mg/day), medium (31-60 mg/day), and high (>60 mg/day) methadone dosage groups were 20.8%, 34.8% and 53.2%, respectively (p < 0.001). The highest 6-year retention rate among eight clinics was 43.8%, while the lowest one was 17.7% (p < 0.001). The results from Cox proportional hazard models indicate that clients having >30 mg daily methadone dosage (p < 0.001), having relatives receiving MMT (p = 0.027), and having >10% urine morphine positive result (p < 0.001) were more likely to be retained in MMT over the six-year period. It has also found that drug injection (p = 0.005) and needle sharing (p < 0.0001) were significantly associated with better retention.

CONCLUSIONS:

Health workers should adjust individuals' methadone dosages as a method to prevent early treatment termination. Further studies are needed to explore the impact of severity of opiate addiction on long-term retention of MMT clients. Careful assessment of drug users upon MMT enrollment may be helpful for providing additional care to clients.

• Authors: Xiaobin Cao, Zunyou Wu, Keming Rou, Li Li, Chunqing Lin, Changhe Wang, Wei Luo, Lin Pang, Wenyuan Yin, Jianhua Li, National Working Group on Methadone Maintenance Treatment Program
• Journal: Drug and alcohol dependence (Drug Alcohol Depend) Vol. 145 Pg. 87-93 (Dec 01 2014) ISSN: 1879-0046 [Electronic] Ireland
• PMID: 25448082 (Publication Type: Journal Article, Multicenter Study, Observational Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014. Published by Elsevier Ireland Ltd.

Chemical References

• Methadone

Topics

• Adult
• China (epidemiology)
• Cohort Studies
• Female
• Humans
• Male
• Medication Adherence (psychology)
• Methadone (administration & dosage)
• Opiate Substitution Treatment (methods, psychology, trends)
• Opioid-Related Disorders (drug therapy, epidemiology, psychology)
• Patient Dropouts (psychology)
• Predictive Value of Tests
• Prospective Studies
• Substance Abuse Treatment Centers (methods, trends)
• Time Factors
• Treatment Outcome
• Young Adult