Referring heroin users from compulsory detoxification centers to community methadone maintenance treatment : A comparison of three models

Journal article


Yan, Liping, Liu, Enwu, McGoogan, Jennifer M., Duan, Song, Wu, Li-Tzy, Comulada, Scott and Wu, Zunyou. (2013). Referring heroin users from compulsory detoxification centers to community methadone maintenance treatment : A comparison of three models. BMC Public Health. 13(1), pp. 1-8. https://doi.org/10.1186/1471-2458-13-747
AuthorsYan, Liping, Liu, Enwu, McGoogan, Jennifer M., Duan, Song, Wu, Li-Tzy, Comulada, Scott and Wu, Zunyou
Abstract

Background
Both compulsory detoxification treatment and community-based methadone maintenance treatment (MMT) exist for heroin addicts in China. We aim to examine the effectiveness of three intervention models for referring heroin addicts released from compulsory detoxification centers to community methadone maintenance treatment (MMT) clinics in Dehong prefecture, Yunnan province, China.

Methods
Using a quasi-experimental study design, three different referral models were assigned to four detoxification centers. Heroin addicts were enrolled based on their fulfillment to eligibility criteria and provision of informed consent. Two months prior to their release, information on demographic characteristics, history of heroin use, and prior participation in intervention programs was collected via a survey, and blood samples were obtained for HIV testing. All subjects were followed for six months after release from detoxification centers. Multi-level logistic regression analysis was used to examine factors predicting successful referrals to MMT clinics.

Results
Of the 226 participants who were released and followed, 9.7% were successfully referred to MMT(16.2% of HIV-positive participants and 7.0% of HIV-negative participants). A higher proportion of successful referrals was observed among participants who received both referral cards and MMT treatment while still in detoxification centers (25.8%) as compared to those who received both referral cards and police-assisted MMT enrollment (5.4%) and those who received referral cards only (0%). Furthermore, those who received referral cards and MMT treatment while still in detoxification had increased odds of successful referral to an MMT clinic (adjusted OR = 1.2, CI = 1.1-1.3). Having participated in an MMT program prior to detention (OR = 1.5, CI = 1.3-1.6) was the only baseline covariate associated with increased odds of successful referral.

Conclusion
Findings suggest that providing MMT within detoxification centers promotes successful referral of heroin addicts to community-based MMT upon their release.

Keywordsheroin addiction; detoxification; methadone maintenance treatment; HIV; China
Year2013
JournalBMC Public Health
Journal citation13 (1), pp. 1-8
PublisherBioMed Central
ISSN1471-2458
Digital Object Identifier (DOI)https://doi.org/10.1186/1471-2458-13-747
Scopus EID2-s2.0-84881274963
Open accessPublished as ‘gold’ (paid) open access
Research or scholarlyResearch
Page range1-8
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online13 Aug 2013
Publication process dates
Accepted03 Aug 2013
Deposited06 May 2021
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Continued drug use during methadone treatment in China: A retrospective analysis of 19,026 service users
Sullivan, Sheena G., Wu, Zunyou, Cao, Xiaobin, Liu, Enwu and Detels, Roger. (2014). Continued drug use during methadone treatment in China: A retrospective analysis of 19,026 service users. Journal of Substance Abuse Treatment. 47(1), pp. 86 - 92. https://doi.org/10.1016/j.jsat.2013.12.004
HIV and syphilis prevalence among men who have sex with men : A cross-sectional survey of 61 cities in China
Wu, Zunyou, Xu, Jie, Liu, Enwu, Mao, Yurong, Xiao, Yan, Sun, Xinhua, Liu, Yufen, Jiang, Yan, McGoogan, Jennifer M., Dou, Zhi, Mi, Guodong, Wang, Ning, Sun, Jiangping, Liu, Zhongfu, Wang, Lu, Rou, Keming, Pang, Lin, Xing, Wenge, Xu, Juan, ... National MSM Survey Group. (2013). HIV and syphilis prevalence among men who have sex with men : A cross-sectional survey of 61 cities in China. Clinical Infectious Diseases. 57(2), pp. 298-309. https://doi.org/10.1093/cid/cit210
Factors associated with mortality of HIV-positive clients receiving methadone maintenance treatment in China
Liu, Enwu, Rou, Keming, McGoogan, Jennifer M., Pang, Lin, Cao, Xiaobin, Wang, Changhe, Luo, Wei, Sullivan, Sheena G., Montaner, Julio S. G., Bulterys, Marc, Detels, Roger, Wu, Zunyou and China’s National Working Group on Methadone Maintenance Treatment. (2013). Factors associated with mortality of HIV-positive clients receiving methadone maintenance treatment in China. Journal of Infectious Diseases. 3(1), pp. 442-453. https://doi.org/10.1093/infdis/jit163
Antiretroviral therapy to prevent HIV transmission in serodiscordant couples in China (2003-11) : A national observational cohort study
Jia, Zhongwei, Mao, Yurong, Zhang, Fujie, Ruan, Yuhua, Ma, Ye, Li, Jian, Guo, Wei, Liu, Enwu, Dou, Zhihui, Zhao, Yan, Wang, Lu, Li, Qianqian, Xie, Peiyan, Tang, Houlin, Han, Jing, Jin, Xia, Xu, Juan, Xiong, Ran, Zhao, Decai, ... Shao, Yiming. (2013). Antiretroviral therapy to prevent HIV transmission in serodiscordant couples in China (2003-11) : A national observational cohort study. The Lancet. 382(9899), pp. 1195-1203. https://doi.org/10.1016/S0140-6736(12)61898-4