A Study On The Reasons Why Patients Dropping Out Of Methadone Maintenance Treatment

Objectives To identify the reasons why Patients dropping out of Methadone Maintenance Treatment(MMT),explore the influence factors and analyze the related people's view on increasing the rate of Methadone Maintenance Treatment.The result would provide evidence for preventing patient from dropping out of Methadone Maintenance Treatment and improve their compliance effectively.Methods We selected Methadone Maintenance Treatment clinics of Qilin District in the city of Qujing,Simao District in the city of Puer and the city of Kaiyuan as survey places based on typical sampling method.We selected patients who were receiving the treatment and meeting the requirements as survey objects during investigation period.Cross-sectional study of Epidemiology was applied in this research.We investigated patients face to face and collected information about patients' general condition,drug addiction, some states of Methadone Maintenance Treatment,rehabilitation and stealing and their support from family and society.We also collected the existing information in clinics about patients who had dropped out of treatment during investigation period.At the same time,patients and their families,doctors, manager of clinics,policeman of antidrug abuse were accepted individually in~-depth interviews in accordance with the qualitative questionnaires.We collected their point of view on reasons why patients had dropped out of Methadone Maintenance Treatment and their suggestions on improving the rate of treatment.Results We collected 401 patients who were receiving the treatment,175 patients had dropping out experiences while 226 patients hadn't dropping out experiences since they participated in MMT.There were 369 cases who had dropped out of the treatment at the three study clinics.We compared people who had dropping out experiences with those who hadn't dropping out experiences,and found that influence factors such as going out frequently, stealing heroin,having compulsory drug addiction rehabilitation experience, who supervise patient MMT,having confidence in treatment,lowest dose,the status of communication with friends,having pulmonary tuberculosis, expenses of treatment had statistical significance,and the P value were lower than 0.05.The comparison of people who were receiving the treatment during survey period with people who had dropped out of the treatment showed that factors like marriage,nutritional status,HIV infection,complicated with other diseases, ways to take drug,highest dose taking had statistical significance,and the P value were lower than 0.05.Patients who had dropped out of treatment had characters of bad nutritional status,using injection or other ways at the same time,having lower level of maximum dose.The interview on those five group people showed that they were in substantial agreement on MMT.But in stealing heroin,patients had significant different view from policeman.In patient's opinion,it was unavoidable to steal heroin,and laws should be tolerant to them.But in policeman's opinion stealing heroin broke the law,so this behavior should be fought resolutely.Conclusions The main reasons of dropping out MMT were going out frequently,having compulsory drug addiction rehabilitation experiences,lower dosage,which may also be the excuses of stealing heroin.So we should strengthen MMT management and improve referral mechanism to handle the stealing heroin phenomenon scientifically.The dose of MMT in introduce phase had considerable influence on the rate of maintainence,so clinical workers should be emphasizing the importance of treating patients individually, using drug sufficiently and keeping treatment persistently.During the treatment of MMT,we should establish effective mechanism to supervise patients. Meanwhile,we should also strengthen psychotherapy and follow-up work on dropping out patients.