Factors associated with methadone treatment duration: a Cox regression analysis.

Chao-Kuang Lin,Tony Szu-Hsien Lee,En Chao,Chia-Chun Hung,Ching-Yi Peng,Gabriele Fischer

doi:10.1371/journal.pone.0123687

Abstract

This study examined retention rates and associated predictors of methadone maintenance treatment (MMT) duration among 128 newly admitted patients in Taiwan. A semi-structured questionnaire was used to obtain demographic and drug use history. Daily records of methadone taken and test results for HIV, HCV, and morphine toxicology were taken from a computerized medical registry. Cox regression analyses were performed to examine factors associated with MMT duration. MMT retention rates were 80.5%, 68.8%, 53.9%, and 41.4% for 3, 6, 12, and 18 months, respectively. Excluding 38 patients incarcerated during the study period, retention rates were 81.1%, 73.3%, 61.1%, and 48.9% for 3 months, 6 months, 12 months, and 18 months, respectively. No participant seroconverted to HIV and 1 died during the 18-months follow-up. Results showed that being female, imprisonment, a longer distance from house to clinic, having a lower methadone dose after 30 days, being HCV positive, and in the New Taipei city program predicted early patient dropout. The findings suggest favorable MMT outcomes of HIV seroincidence and mortality. Results indicate that the need to minimize travel distance and to provide programs that meet women’s requirements justify expansion of MMT clinics in Taiwan.

Highlights

Treating heroin dependence and stemming the human immunodeficiency virus (HIV) infection amongst heroin users challenge public health professionals and health providers over the last three decades
Retention rates were 80.5% (n = 103), 68.8% (n = 88), 53.9% (n = 69), and 41.4% (n = 53) for individuals who consistently stayed in treatment for 3 months, 6 months, 12 months, and 18 months respectively
For the remaining 90 patients, retention rates were 81.1% (n = 73), 73.3% (n = 66), 61.1% (n = 55), and 48.9% (n = 44) for those who stayed in treatment consistently for 3 months, 6 months, 12 months, and 18 months, respectively

Summary

Introduction

Treating heroin dependence and stemming the human immunodeficiency virus (HIV) infection amongst heroin users challenge public health professionals and health providers over the last three decades. Countries in South East Asia and East Asia, including China, Indonesia, Malaysia, Thailand, and Vietnam, have been launching and expanding MMT programs as an essential response to reduce the harms of injection drug use. This trend of adopting harm reduction as an approach to reduce the ill effects of heroin dependency followed a series of important announcements and PLOS ONE | DOI:10.1371/journal.pone.0123687. Other international health organizations, including the World Health Organization (WHO) and the Joint United Nations Program on HIV/AIDS (UNAIDS), recommended harm reduction programs as best practices and crucial for reducing HIV infection among injecting drug users (IDU) [2]. In Taiwan, MMT as a harm reduction program was introduced in 2006 throughout the nation to stem the spread of HIV amongst heroin injection users

Methods

Results

Conclusion