Abstract
BackgroundBoth compulsory detoxification treatment and community-based methadone maintenance treatment (MMT) exist for heroin addicts in China. We aim to examine the effectiveness of three intervention models for referring heroin addicts released from compulsory detoxification centers to community methadone maintenance treatment (MMT) clinics in Dehong prefecture, Yunnan province, China.MethodsUsing a quasi-experimental study design, three different referral models were assigned to four detoxification centers. Heroin addicts were enrolled based on their fulfillment to eligibility criteria and provision of informed consent. Two months prior to their release, information on demographic characteristics, history of heroin use, and prior participation in intervention programs was collected via a survey, and blood samples were obtained for HIV testing. All subjects were followed for six months after release from detoxification centers. Multi-level logistic regression analysis was used to examine factors predicting successful referrals to MMT clinics.ResultsOf the 226 participants who were released and followed, 9.7% were successfully referred to MMT(16.2% of HIV-positive participants and 7.0% of HIV-negative participants). A higher proportion of successful referrals was observed among participants who received both referral cards and MMT treatment while still in detoxification centers (25.8%) as compared to those who received both referral cards and police-assisted MMT enrollment (5.4%) and those who received referral cards only (0%). Furthermore, those who received referral cards and MMT treatment while still in detoxification had increased odds of successful referral to an MMT clinic (adjusted OR = 1.2, CI = 1.1-1.3). Having participated in an MMT program prior to detention (OR = 1.5, CI = 1.3-1.6) was the only baseline covariate associated with increased odds of successful referral.ConclusionFindings suggest that providing MMT within detoxification centers promotes successful referral of heroin addicts to community-based MMT upon their release.
Highlights
Both compulsory detoxification treatment and community-based methadone maintenance treatment (MMT) exist for heroin addicts in China
Strategies for facilitating successful transition from detoxification center to treatment clinic have yet to be studied in China. It is within this context that we present the current study, which examines the effectiveness of three different referral models to determine whether any of them have a positive impact on rates of successful referral to MMT within six months of release from detoxification centers
Most subjects had never participated in a needleexchange program (97.3%) and a large proportion tested positive for HIV (30.1%)
Summary
Both compulsory detoxification treatment and community-based methadone maintenance treatment (MMT) exist for heroin addicts in China. We aim to examine the effectiveness of three intervention models for referring heroin addicts released from compulsory detoxification centers to community methadone maintenance treatment (MMT) clinics in Dehong prefecture, Yunnan province, China. In 1987, the first heroin detoxification centers were established in in Lanzhou city, Gansu province in southwestern China, where illicit drug use is relatively common. In China, more than 90% of heroin users relapse after being released from detoxification centers [6,7,8,9]. It is critical that effective interventions are identified to engage heroin users being released from compulsory detoxification in therapy regimens, such as methadone maintenance treatment (MMT), in order to facilitate recovery
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