Study On The Effects Of Methadone Maintenance Treatment(MMT) On Quality Of Life，drug Craving And Associated Factors Among Heroin Addicts In Hami District

Objective:To explore the effects of methadone maintenance treatment (MMT) on quality of life (QOL), drug craving and its associated factors among heroin addicts, in order to provide reference basis for improving the effectiveness of methadone maintenance treatment.To understand the effect of methadone maintenance treatment in Hami district; to provide a scientific basis to better promote and to improve MMT in Xinjiang.Methods:A quasi-experiment study was adopted and carried out in Hami district. All heroin addicts on MMT, who received MMT within one month, were selected from eight MMT out patient departments, and followed at the time of just entering the study and six months after the treatment respectively. potential control subjects,who are heroin addicts admitted by Hami compulsory rehabilitation centers within two weeks, were followed at the time of first two weeks and one month after compulsory rehabilitation. All subjects were assessed by "Conununity MMT base line questionnaire""WHOQOL-BREF" and "Craving for heroin questionnaire".Scores of QOL and degree of heroin craving in two groups were compared and examined using T-test and ANOVA. Chi-square test and logistic regression analysis were used for univariate and multivariate analysis to explore the factors affecting MMT.Results:Our study include150cases in experimental group and control group respectively.result of QOL scores showed:(1)there was no significant difference in scores of QOL within two group in their baseline,while six months of MMT, QOL was higher than that in control group after one month compulsory rehabilitation; the difference of scores in the " physilogical domain","environment domain","the total score of QOL", and "general QOL" were significant;(2)in the experimentol group, QOL scores were increased after six months MMT; comparing with basline data, significant difference were observed in the scores of "physilogical domain","psychological domain","the total score of QOL","general QOL",and "general health status", compared with that of baseline.(3)in the control group,no significant difference was observed in the scores of QOL between the baseline and after compulsory rehabilitation for one month, expect "general health status"(4)in the experimental group,87cases (58%) improved their quality of life after six months MMT;results of multivariate logistic regression analysis showed occupational situation (OR=0.171,95%CI:0.008-0.630) and length of drug-addiction (OR=6.560,95%CI:2.267-13.983) were important factors which influencing therapeutic effects, occupational situation and patients with long-time of addiction have better treatment effect.The comparison of the scores of heroin craving between the two groups and two time point revealed:(1)there was no significant difference in the scores of craving between experiment group and control group in their baseline except "expectation as for effect" factor;(2)the scores of craving were much lower in experimental group after six months MMT than that in control group after one month compulsory rehabilitation;(3)compared with baseline, the scores of craving, apart from "self-control",factor,decreased significantly after MMT for six months;(4)the scores of craving after one month compulsory rehabilitation have not changed obviously compared with their base line in the control group;(5)after six months MMT,70cases (46.7%) have improved their degree of heroin craving in experimental group.Results of multivariate logistic regression analysis showed length of drug-addiction(OR=0.888,95%CI:0.352-2.250),education degree (OR=1.950,95%CI:0.575-6.687), history of rehabilitation (OR=2.842,95%CI:1.356-5.956) were important factors influencing therapeutic results in the degree of heroin craving.Conclusion:Compared with compulsory rehabilitation, MMT might be more effective in improvements of the quality of life and the degree of heroin craving for heroin addicts.Occupational situation and length of drug-addiction period might be important factors influencing the QOL of MMT patients; length of drug-using, education degree, and history of rehabilitation might affect the degree of heroin craving of MMT patients. Positive measures are needed to enhance the therapeutic effects of MMT.Integration of social resources, individual treatment, setting up social support system are suitable for MMT in Hami region, Specific conditions, and strengthening comprehensive interventions may be helpful ways for improving the result of MMT.