Concurrent Heroin Use and Correlates among Methadone Maintenance Treatment Clients: A 12-Month Follow-up Study in Guangdong Province, China.

Xiaofeng Luo,Peizhen Zhao,Xia Zou,Wen Chen,Weiming Tang,Lei Zhang,Li Ling,Xiao Gong

doi:10.3390/ijerph13030305

Abstract

Objective: To assess concurrent heroin use and correlates among Methadone Maintenance Treatment (MMT) clients in Guangdong Province, China. Method: Demographic and drug use data were collected with a structured questionnaire, and MMT information was obtained from the MMT clinic registration system in Guangdong. Human immunodeficiency virus (HIV-) and hepatitis C virus (HCV) infected status and urine morphine results were obtained from laboratory tests. Logistic regressions were employed to investigate the factors associated with concurrent heroin use. Results: Among the 6848 participants, 75% continued using heroin more than once during the first 12 months after treatment initiation. Concurrent heroin use was associated with inharmonious family relationship (OR (odds ratio) = 1.49, 95% CI (confidence intervals): 1.24–1.78), HIV positivity (OR = 1.25, 95% CI: 1.01–1.55), having multiple sex partners (OR = 1.34, 95% CI: 1.07–1.69), having ever taken intravenous drugs (OR = 0.81, 95% CI: 0.69–0.95), higher maintenance dose (OR = 1.13, 95% CI: 1.01–1.28) and poorer MMT attendance (OR<20% = 1.32, 95% CI: 1.13–1.53; OR20%– = 1.33, 95% CI: 1.14–1.54; OR50%– = 1.69, 95% CI: 1.44–2.00). Among those who used heroin concurrently, the same factors, and additionally being older (OR35– = 1.26, 95% CI: 1.11–1.43; OR≥45 = 1.63, 95% CI: 1.30–2.05) and female (OR = 1.60, 95% CI: 1.28–2.00), contribute to a greater frequency of heroin use. Conclusions: Concurrent heroin use was prevalent among MMT participants in Guangdong, underscoring the urgent needs for tailored interventions and health education programs for this population.

Highlights

China is adjacent to the “Golden Triangle” and “Golden Crescent”, two of the three largest drug production and manufacturing regions in the world, and has seen a substantial increase in the number of illicit drug users since the 1980s [1]
Given that concurrent heroin use might be significantly associated with the retention in Maintenance Treatment (MMT) [18] and health-related quality of life [10], targeted intervention programs are urgently needed for those clients in the study
Findings from this study provide important implications for future harm reduction programs targeting heroin use among clients on MMT adherence in Guangdong

Summary

Introduction

China is adjacent to the “Golden Triangle” and “Golden Crescent”, two of the three largest drug production and manufacturing regions in the world, and has seen a substantial increase in the number of illicit drug users since the 1980s [1]. Public Health 2016, 13, 305; doi:10.3390/ijerph13030305 www.mdpi.com/journal/ijerph

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