Who uses methadone services in China? Monitoring the world's largest methadone programme

Abstract

AimsTo describe the data collected by the Chinese methadone maintenance treatment (MMT) system and the characteristics of clients entering the programme. Design Descriptive study using routinely collected data from the MMT data management system for the period March 2004 and March 2010. Setting All MMT clinics in China. Participants Clients who enrolled for services between March 2004 and March 2010. Measurements Routinely collected data included: demographic information; drug use, sexual and criminal behaviours; status of infection with human immunodeficiency virus (HIV), hepatitis C virus (HCV) and syphilis; random urine-opiate test results; and the daily methadone dose received. Differences among clients by year were examined. Findings During the period examined, there were 251 974 clients attending 684 clinics in 27 provinces. Overall, the mean age was 34.4 years, 83.8% were male, 70.2% were unemployed, 75% had ever injected drugs, 17% had shared needles and 7.4% were HIV-positive. The profile of clients changed over time, with fewer HIV-positive individuals, fewer injecting drug users, fewer needle-sharers, fewer females and fewer unemployed. Half the clients dropped out within 6 months. The average final dose received was 49.4 mg. The estimated probability of interrupting treatment before 6 months was 52.5%. Conclusions The profile of clients enrolling in methadone maintenance treatment in China is continually changing and appears to be associated with reduced risk of HIV. High dropout in the programme may limit its effectiveness. The availability of a centralized, real-time data system was extremely useful for monitoring the progress of the Chinese methadone maintenance treatment programme.

Contemporary Asian Drug Policy: Insights and Opportunities for Change

“…Although there are reports of limitations on dosing of methadone in China, the country has adopted some innovative solutions to attract and maintain access to hard-to-reach rural populations. Mobile methadone clinics, first introduced in Yunnan in 2010, have expanded to ten other provinces (Sullivan et al, 2014). There are some two dozen vans that service rural areas, giving patients greater flexibility and access to medication therapies (Yin et al, 2010).…”

Factors related to client satisfaction with methadone maintenance treatment in China

“…A total of 767 MMT clinics were established in 28 provinces by the end of 2014 (National Health and Family Planning Commission of China, 2015). The clinics are generally located in administrative areas with more than 500 registered opiate users, affiliated with local Center for Disease Control and Prevention (CDC), hospital, psychosocial health center, or voluntary detoxification center (Sullivan et al, 2014). Ancillary services include counselling, testing of sexually transmitted infection, psychosocial support, education, skills training for employment, referrals for related health issues and incentives (Lin & Detels, 2011).…”

The Correlation Between Attitudes Toward HIV/AIDS Transmission Through the Use of Syringes and the Type of Dropout Among the Participants of Methadone Maintenance Treatment

“…Previous study reported that 7.4% of MMT participants were HIV positive, while other researchers reported the HIV and Hepatitis C co-infection rate of 49.1%. 14,15 The limitation of this study was due to it used a cross-sectional design. Thus, it was difficult to determine the cause and effect since the data collection was conducted at the same time.…”