Abstract
Methadone maintenance treatment (MMT) programs have been rapidly scaled up nationwide in China in recent years, and psychosocial intervention measures, including counseling, were recommended for improving the outcomes of MMT. However, the effectiveness of counseling in MMT programs remains controversial. This study investigated the efficacy of educational and behavioral counseling (EBC) mode in an MMT program in China. A total of 125 eligible participants were randomized to EBC or a control group. Patients in the EBC group received weekly, manual-guided, group educational counseling for 8 weeks and individual behavioral counseling for the next 8 weeks. Patients in the control group received standard methadone maintenance treatment as usual (TAU). During the 16-week trial, the EBC group showed better treatment attendance (P = 0.022) and a greater increase in knowledge regarding heroin addiction (P = 0.001) and MMT (P = 0.005) than did the TAU group. Between the two groups, there were no significant differences regarding drug abstinence and reduction of risky behaviors. EBC affiliated with MMT improved patients' cognition and adherence to treatment, facilitating their successful recovery. ChiCTR-IOR-15006673: http://www.chictr.org.cn.
Highlights
China has the world’s largest number of illicit drugs users [1, 2], with this population representing a major driver of the country’s HIV epidemic due to unsafe practices, such as sharing drug injection equipment [3, 4]
As an apparently effective harm reduction measure for reducing illicit opiate use, drug-related criminal behaviors and risk of HIV [5,6,7], a national methadone maintenance treatment (MMT) program was initiated as an HIV control strategy in China in 2004 [4, 8]
Despite the strong progress made in slowing the HIV infection rate among drug users in China, rapidly scaling up the MMT program has created a wide range of challenges and gaps that need to be addressed, such as the demand for qualified service providers, misconceptions regarding methadone medication, low average methadone doses, high rates of concurrent drug use among clients, high drop-out rates, and poor service quality in the clinics [9,10,11,12]
Summary
China has the world’s largest number of illicit drugs users [1, 2], with this population representing a major driver of the country’s HIV epidemic due to unsafe practices, such as sharing drug injection equipment [3, 4]. As an apparently effective harm reduction measure for reducing illicit opiate use, drug-related criminal behaviors and risk of HIV [5,6,7], a national methadone maintenance treatment (MMT) program was initiated as an HIV control strategy in China in 2004 [4, 8]. Despite the strong progress made in slowing the HIV infection rate among drug users in China, rapidly scaling up the MMT program has created a wide range of challenges and gaps that need to be addressed, such as the demand for qualified service providers, misconceptions regarding methadone medication, low average methadone doses, high rates of concurrent drug use among clients, high drop-out rates, and poor service quality in the clinics [9,10,11,12]. A recent study of high rate of hepatitis C seroconversion in MMT programs indicated an urgent need to improve MMT treatment services in order to obtain maximum benefits from this harm reduction approach [17]
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