Dose Tapering Strategy for Heroin Abstinence among Methadone Maintenance Treatment Participants: Evidence from A Retrospective Study in Guangdong, China

Lu, Qian; Zou, Xia; Liu, Yin; Gong, Chengcheng; Li, Ling

doi:10.3390/ijerph16152800

Cited by 8 publications

(5 citation statements)

References 31 publications

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“…However, almost every participant expressed a desire for dose tapering and took action toward full recovery from opioid dependency. This is consistent with previous studies, which indicated that around 41–57% of participants tapered their doses [ 28 , 29 ]. According to our findings, the frequency, speed, and duration of dose tapering varied among participants, with those on relatively higher doses, such as over 100 mg per day, being more adaptable to larger decreases.…”

Section: Discussionsupporting

confidence: 93%

Benefits and challenges experienced by participants on long-term methadone maintenance treatment in China: a qualitative study

Tang,

Xiong,

Chen

et al. 2024

BMC Med

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Background Methadone maintenance treatment (MMT) has been implemented in China for nearly two decades, with a significant decrease in the number of participants in recent years. However, there is a lack of comprehensive research focusing on the long-term effectiveness in the context of this decline, especially from the perspectives of MMT participants themselves. This study aims to address this gap by examining the benefits and challenges experienced by long-term MMT participants in China, to uncover potential causes of the decrease in participant numbers and to improve the effectiveness of the program. Methods We conducted semi-structured interviews with 21 long-term MMT participants (treatment duration ≥ 5 years) recruited through purposive sampling from 6 MMT clinics in the Guangdong Province, China, between December 2021 and August 2022. Thematic analysis was employed to analyze the transcribed interviews. Two analysts independently coded the data, and a third researcher double-coded 20% of transcripts to ensure intercoder reliability. Results Overall, participants corroborated the notable decline in MMT participants during their long-term MMT, citing death, arrest, and self-perceived abstinence from heroin, as their perceived driving factors. They reported positive changes in their health, family relationships, and social functioning. However, they identified economic hardship as their greatest challenge associated with MMT, further exacerbated by other barriers including the conflict of clinic opening hours and working schedules, discrimination from employers, and COVID-19-related restrictions. Additionally, participants identified issues with dose adjustment and emergency treatment continuation. Conclusions This study outlines the overall improvement in the quality of life of long-term MMT participants. However, it highlights the need for official guidelines for dose adjustment and emergency treatment continuation as well as the provision of health education, job referrals, and flexibility of clinic opening times to facilitate the return to society receiving participants. Establishing a follow-up mechanism for those receiving MMT is also recommended to prevent relapses to heroin and other illicit substances.

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Section: Discussionsupporting

confidence: 93%

Benefits and challenges experienced by participants on long-term methadone maintenance treatment in China: a qualitative study

Tang,

Xiong,

Chen

et al. 2024

BMC Med

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“…Drop-out was usually defined as being absent from MMT for more than 14 consecutive days ( 39 ). The continuous treatment days were days participants resumed MMT after their last drop-out ( 18 ).…”

Section: Methodsmentioning

confidence: 99%

The risk assessment of relapse among newly enrolled participants in methadone maintenance treatment: A group-LASSO based Bayesian network study

Tang

Fan

Wang

et al. 2023

Front. Public Health

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BackgroundRelapse is a great barrier to improving the effectiveness of methadone maintenance treatment (MMT). Participants with different treatment durations could vary in their compliance with MMT, which may lead to different levels of relapse risk. This study aims to identify the risk factors for relapse and assess the relapse risk of MMT participants of different treatment durations.MethodThis retrospective study used data collected from seven MMT clinics in Guangdong Province, China, from January 2010 to April 2017. Newly enrolled participants who received 6 (n = 903) and 12 (n = 710) months of consecutive treatment with complete data were included. We selected significant risk factors for relapse through the group lasso regression and then incorporated them into Bayesian networks to reveal relationships between factors and predict the relapse risk.ResultsThe results showed that participants who received 6-month treatment had a lower relapse rate (32.0%) than those of 12-month treatment (39.0%, P < 0.05). Factors including personal living status and daily methadone dose were only influential to those who received the 6-month treatment. However, age, age at the initial drug use, HIV infection status, sexual behaviors, and continuous treatment days were common factors of both durations. The highest relapse risk for those after the 6-month treatment was inferred as 66.7% while that of the 12-month treatment was 83.3%. Farmers and those who have high accessibility to MMT services may require additional attention.ConclusionIt is necessary to implement targeted interventions and education based on the treatment durations of participants to decrease the relapse rate. Meanwhile, those about HIV/sexually transmitted infection prevention and anti-narcotics should be held in the whole process.

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“…Drop-out was usually de ned as being absent for MMT for more than 14 consecutive days 30 . The continuous treatment days were days participants resumed MMT after their last drop-out 19 .…”

Section: Continuous Treatment Daysmentioning

confidence: 99%

The Risk Assessment of Relapse among Newly-enrolled Participants in Methadone Maintenance Treatment: A Group-Lasso Based Bayesian Networks Study

Tang

Fan

Wang

et al. 2022

Preprint

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Relapse is a great barrier to improving the effectiveness of methadone maintenance treatment (MMT). Participants with different treatment durations could vary in the compliance with MMT, which may lead to different levels of relapse risk. This study aims to identify the risk factors for relapse and assess the relapse risk of MMT participants of different treatment durations. This retrospective study used data collected from 9 MMT clinics in Guangdong Province, China from January 2010 to April 2017. Newly enrolled participants who received 6 (n = 903) and 12 (n = 710) months of consecutive treatment with complete data were include. We selected significant risk factors for relapse through group-lasso regression and then incorporated them into Bayesian networks to reveal relationships between factors and predict the relapse risk. The results showed that participants who received 6-month treatment had a lower relapse rate (32.0%) than those of 12-month (39.0%, P<0.05). Factors including personally living status and daily methadone dose were only influential to those who received 6-month treatment rather than those after 12-month treatment. However, age, age at the initial drug use, HIV infection status, sexual behaviors, and continuous treatment days were common factors of both durations. The highest relapse risk for those after 6-month treatment was inferred as 66.7% while that of 12-month treatment was 83.3%. Farmers and those who have high accessibility to MMT services may require additional attention. Therefore, it is of necessity to implement targeted interventions and education based on the treatment durations of participants to decrease the relapse rate. Meanwhile, those about HIV/sexually transmitted infection prevention and anti-narcotics should be held in the entire process.

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Dose Tapering Strategy for Heroin Abstinence among Methadone Maintenance Treatment Participants: Evidence from A Retrospective Study in Guangdong, China

Cited by 8 publications

References 31 publications

Benefits and challenges experienced by participants on long-term methadone maintenance treatment in China: a qualitative study

Benefits and challenges experienced by participants on long-term methadone maintenance treatment in China: a qualitative study

The risk assessment of relapse among newly enrolled participants in methadone maintenance treatment: A group-LASSO based Bayesian network study

The Risk Assessment of Relapse among Newly-enrolled Participants in Methadone Maintenance Treatment: A Group-Lasso Based Bayesian Networks Study

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