| Objective:To learn the general characteristics and health status of outpatients with Methadone Maintenance Treatment(hereinafter referred to MMT), and evaluate the effects of health, related behavior, social and family function after they participate in MMT, and assess the impact of MMT on relevant policies environment. To provide the basis for policies development for the authorities and guiding opinions for improving MMT work in Jiangxi Province.Methods:Using the methods of combining quantitative surveys with qualitative interviews.According to the sequential method, each clinic selected 60% outpatients randomly to conduct the questionnaire survey with the treating patients of all 13 MMT clinics as the base in Jiangxi Province, and a total of 1501 people were investigated from November 10, 2014. We choose 5 to 10 outpatients to have in-depth interviews in accordance with the scale of each clinic patients, and a total of 87 cases were interviewed. Then each clinic used the simple random sampling method to select 30%family members, who were related with the extracted outpatients, to have a investigation of 457 cases. Similarly, we choose 5 to 10 family members of outpatients to conduct in-depth interviews in each MMT clinic with a total of 76 cases.The investigation and interviews were all completed by investigators with uniform training. Chi-square test and rank test were used for the data analysis.Results:1. A total of 1501 MMT outpatients were investigated. The proportion of males and females was 79.7% and 20.3%, respectively. The average age was 41.83 ± 7.21 years old. The educational level of the outpatients was mostly junior middle school,accounting for 53.4%; marital status was mostly the married or cohabitees,accounting for 52.2%. In the 457 family members, the proportion of males and females was 38.7% and 61.3%, with the average age 49.96 ± 15.32 years old. Their educational level was mostly junior middle school, accounting for 41.1%; maritalstatus mostly was the married or cohabitees, accounting for 78.3%; 50.8% of the family members were the parents of outpatients and 33.9% of the family members were the marital relationship.2. The physical health status: 59.2% of outpatients felt well about the effect of methadone replacement treatment, who had no drug addiction. 79.2% of outpatients believed that health status was better, 74.6% of outpatients felt that their mental state improved, 74.5% of outpatients slept better, 66.2% of outpatients ate better, 56.6% of outpatients gained weight, 20.9% of outpatients had less common diseases than before, and 4.6% of outpatients felt no change after methadone treatment. 97.7% of all the MMT outpatients was willing to continue to participate in MMT. The positive rate of HIV was significantly reduced after MMT(P<0.001). And family members reflected the health status of outpatients was significantly improved(P<0.001), the infection rate of HIV was 1.1% during MMT, which was significantly lower than4.2% before treatment(P<0.001). The prevalence of tuberculosis was 0.2%, which was significantly lower than 4.6% than before(P<0.001).3. Change of behavior: The condom use rate when outpatients had sexual relations recently was 38.6%, which was significantly higher than 28.7% before treatment(P <0.001).4. Social function: The survey results of outpatients and their families showed that the employment rate after treatment was significantly higher than before(P<0.05), the frequency of contacts with close friends who used drugs reduced(P<0.005), and the relations with neighbors improved significantly before and after treatment(P <0.001). In addition, the survey results of outpatients showed that, the support and care obtained from friends improved significantly(P<0.05), the trouble or difficulties sharing with friends was no difference before treatment(P>0.05). And the contacts with close friends who not used drugs increased significantly(P<0.005).5. The illegal and criminal acts: The survey results of outpatients found that, the behavior arrested by public security departments, the behavior of stealing and lying because of financial difficulties, the behavior of having sex with others because of financial difficulties, and the behavior of trafficking drugs were all reduced significantly before and after treatment(all P<0.05). The survey results of familymembers showed that, the behavior of stealing and lying after treatment reduced than before(P<0.001), and the behavior of trafficking drugs had no significant differences than before(P>0.05).6. Family function: The survey results of outpatients and their families showed that, the frequencies of lying to families, stealing family property, and being blamed by families because of drug abuse were all decreased significantly after treatment(all P <0.001). The frequency that outpatients help to do housework increased(all P<0.001), the relations with family members improved(all P <0.001), and the behavior shared the trouble or difficulty with families increased significantly after treatment(all P <0.001). The survey results of outpatients also showed that, support and care which patients obtained from family members increased significantly before and after treatment(P<0.001).7. Policy environment: MMT work promoted the cognition of relevant government departments to MMT, and created a good supportive environment for the positive publicity and education work of MMT. Finance of MMT was gradually incorporated into the scope of the government’s budget. MMT work promoted the government to introduce relevant policies, and the introduction of policies provided a supportive environment for the sustainable development of MMT.Conclusions:The drug addiction, mental status, infection rate of HIV, the prevalence of tuberculosis and other aspects of MMT outpatients had improved significantly, which suggested that MMT can improve the health status of outpatient effectively. The safe sexual behavior had improved which suggested that MMT can reduce the risk of STD and AIDS. The raising employment rate, the reducing contacts with close friends who used drugs, the improving relations with neighbors, and the increasing support of friends indicated that MMT can promote the recovery of social function in outpatients.The behavior of stealing and lying, having sex with others because of financial difficulties, trafficking drugs and other illegal and criminal acts were all reduced,which suggested that MMT can promote the society to be harmony and stability effectively. The behavior of lying to family, stealing the family property, and being blamed by the family were all decreased. The frequency of helping to do housework,relations with family members, support obtained from family were all improved significantly, which suggested that MMT can improve the outpatients’ family function.From these results, we can find that MMT clinic work in Jiangxi Province has achieved significant effects in the health and social aspects. Meanwhile, MMT work promoted the introduction and adjustment of relevant policies, and provided the policy environment for the sustainable development of MMT work. From the point of view of health protection of outpatients, family harmony and building of harmonious society, it is important to create a good policy environment and to ensure the sustainable development for MMT. |
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