A Study Of The Assessment Of The Community-Based Methadone Maintenance Treatment Programme For Opiate Addicts And The Contributing Factors To Patients' Attrition

Objective To identify and assess the effectiveness of Community-Based Methadone Maintenance Treatment Programme (MMT) in reducing the high-risk behaviors, preventing the HIV new infection, decreasing the illegal offences associated with drug use, and restoring patients'family and social function. To explore the possible reasons that caused patient who exited from treatment and supply valuable information on improving the clinic services and increasing retention. Method: In assessment survey, standardized questionnaires issued by National MMT working group are used for baseline and 1 year'evaluation survey. 1772 patients who applied to MMT and 1053 patients who received MMT at least 1 year have been interviewed in baseline and evaluation Survey. In the cross-sectional survey of potentially contributing factors to patients'attrition, 156 patients who have stayed in MMT clinics for more than 6 months and is receiving the treatment now and 130 participants who quitted the treatment are interviewed by using same semi- structure questionnaires in there study sites. Meanwhile, to explore the possible factors that have negative effect on patients'treatment, the qualitative method, such as in-depth interview and focus group discuss, have been used to collect data from government officials, clinic staff, policeman, and patient's family members.Results: Compared with baseline survey, the frequency of drug use and needle sharing of patients who stayed in treatment for more than 1 year decreased from 3.5 times per day to 0.7 times per day and 12.10% to 6.38%, respectively. Compared with baseline survey, condom use rate in the last sexual behavior of patients who stayed in treatment for more than 1 year increased from 18.28% to 31.72%, while the frequency of illegal offences reduced from 11.68% to 6.65%. Patients'social function and their relationship with family members have been improved and resumed and patients'job opportunities increased. In addition, results of survey indicate that being afraid of being arrested by policeman (37.69%), influenced by other drug user (25.38%), and less confidence on MMT are three main contributing factors that caused patients'retreat from treatment. After exit from MMT , 40.77% patients have entered compulsory treatment centers or reeducation-though-labor centers, 18.46% reused illegal drug, 16.92 %left for other places, and 12.31% feeling they have abstained completely and stopped treatment by themselves. Data of Logistic regression analysis show that whether or not keeping contact with other drug users during treatment and whether or not affording the fee of MMT played a negative role on patients'retention in treatment.Conclusion: Methadone Maintenance Treatment have played positive roles in decreasing drug use, needle sharing, sexual partners and increasing condom use, reducing the spread of HIV though drug use and sex transmission significantly. Meanwhile, it can also help to restore patients'family and social function. The main reasons that can influence patients'retention in treatment include inconvenient of clinic location, less confidence on treatment, negative effect by other drug users, being afraid of being arrested by policeman, unaffordable fee.