Investigation Of Alcohol Use In Methadone Maintenance Treatment Patients And Effect Of Brief Intervention

Objective: To investigate the prevalence of current and problem alcohol use among the patients of methadone maintenance treatment(MMT)in Shanghai.Based on the brief intervention(BI)and Chinese Culture to adjust the intervention program,and to evaluate the clinical effect of this intervention.Methods: The combination of quantitative research and qualitative research was used in this study.Alcohol use,related factors and the effect of BI were analyzed comprehensive.The general condition questionnaire,Alcohol Use Disorders Identification Test(AUDIT),drinking attitude questionnaire,change motivation assessment scale,Patient Health Questionnaire depression module(PHQ-9),7-item Generalized Anxiety Disorder Scale(GAD-7)and General Well-Being Schedule(GWB)were used to collect the information among the patients in all 14 MMT clinics in Shanghai.Hazardous and harmful drinking patients screened by AUDIT were completely random into experimental and control groups and then received related invention according to the score.All of two group's followup data were collected by the baseline questionnaire at the end of 3rd month.In the qualitative research,we use methods of semi-structure interview of purposive sampling to select 6 patients in experimental group.Quantitative and qualitative research can complement each other.Results: A total of 1167 MMT patients in Shanghai needed to investigated,and 837 respondents were completed,with a response rate of 71.7%.In the intervention experiment,23 patients dropped out,and the rate was 22.8%.The prevalence of alcohol use among MMT patients was 30.9%,12.3% patients were assessed hazardous and harmful drinkers,and the other 13 patients had the possibility of alcohol dependence.There were significant differences in gender,whether drinking before and after heroin abuse,PHQ-9 score and GAD-7 score between drinkers and non-drinkers(p<0.05).The trend of alcohol consumption in MMT patients was decreased during heroin use and increased after methadone maintenance treatment.In the brief alcohol intervention experimental for MMT patients,the AUDIT score,alcohol use risk level,PHQ-9 score,GAD-7 score,GWB score were significantly improved in both groups(p<0.05).But there were no significant differences between experimental group and control group(p>0.05).In the evaluation of brief intervention immediate effect,we found intervention group slightly higher than before in the importance,confidence,possibility of absence with no significant difference(p>0.05).But change the thinking stage motivation assessment score significantly increased(p<0.05).The results of qualitative interviews showed that there was some effect of brief intervention in alcohol drinking knowledge propaganda,advice of absence,feel of concerned.The dangers of drinking,the care from family and doctors can promote abstinence.Boredom,relaxation and sociability are the causes of alcohol consumption.Conclusion:(1)MMT patients with alcohol use is generally in Shanghai clinics and there were more patients with dangerous and harmful drinking behavior.(2)The level of depression and anxiety of drinking group were lower than non-drinking group.(3)BI group can help patients reduce alcohol consumption,improve anxiety and depression levels,but there is no significant difference with control group.(4)The BI can enhance patient motivation to change during meditation.