Illicit Heroin and Methamphetamine Use among Methadone Maintenance Treatment Patients in Dehong Prefecture of Yunnan Province, China

Rongrong Wang, Yingying Ding, Hongling Bai, Song Duan, Runhua Ye, Yuecheng Yang, Jibao Wang, Renhai Tang, Meiyang Gao, Na He, Rongrong Wang, Yingying Ding, Hongling Bai, Song Duan, Runhua Ye, Yuecheng Yang, Jibao Wang, Renhai Tang, Meiyang Gao, Na He

Abstract

Objective: Methadone maintenance treatment (MMT) was introduced to China in 2004 to reduce the harm of injecting drug users (IDUs). However, little is known about continued drug use, especially methamphetamine (MAMP), among MMT patients.

Methods: A survey was conducted among patients attending five major MMT clinics in Dehong Prefecture in 2014 to investigate the heroin and MAMP use and their associated risk factors. Participants were administered with face-to-face interviews, and urine tests for morphine and MAMP.

Results: A total of 2,121 were eligible and participated in the study. Among them, 220 (10.4%) were only positive for morphine, 12.9% were only positive for MAMP, and 196 (9.2%) were positive for both morphine and MAMP. Compared with neither use of heroin nor MAMP during MMT, heroin use (not using MAMP) was associated with ethnicity, shorter duration of MMT, lower dose of methadone, and having had no more than two sex partners in the past year; MAMP use (not using heroin) was associated with ethnicity, longer duration of MMT, higher dose of methadone and being aged <30 years (vs. ≥50 years); use of both heroin and MAMP was associated with being Dai minority (vs. Han), a marital status of divorced or widowed, having used drugs for ≥10 years and shorter duration of MMT.

Conclusion: These findings indicate the complexity in the treatment of heroin users and underscore the importance in prescribing appropriate methadone dosages in order to reduce both heroin and MAMP use.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

References

    1. Wang L, Guo W, Li D, Ding Z, McGoogan JM, Wang N, et al.; China National HIV/AIDS Surveillance Program. HIV epidemic among drug users in China: 1995–2011. Addiction. 2015; 110 Suppl 1:20–28. 10.1111/add.12779
    1. China Ministry of Health, World Health Organization (WHO). 2011 Estimates for the HIV/AIDS Epidemic in China. Beijing: China Ministry of Health, 2012.
    1. Cao X, Wu Z, Li L, Pang L, Rou K, Wang C, et al.; National Methadone Maintenance Treatment Program Working Group. Mortality among methadone maintenance clients in China: a six-year cohort study. PLoS ONE. 2013; 8: e82476 10.1371/journal.pone.0082476
    1. Pang L, Hao Y, Mi G, Wang C, Luo W, Rou K, et al. Effectiveness of first eight methadone maintenance treatment clinics in China. AIDS. 2007; 21:S103–107. 10.1097/01.aids.0000304704.71917.64
    1. Chen C, Xia Y, Hong Y, Hall BJ, Ling L. Predictors of continued HIV-risk behaviors among drug users in methadone maintenance therapy program in China-A prospective study. Harm Reduct J. 2013; 10: 23 10.1186/1477-7517-10-23
    1. Sullivan SG, Wu Z. Rapid scale up of harm reduction in China. Int J Drug Policy 2007; 18:118–128.
    1. Sun HM, Li XY, Chow EP, Li T, Xian Y, Lu YH, et al. Methadone maintenance treatment programme reduces criminal activity and improves social well-being of drug users in China: a systematic review and meta-analysis. BMJ Open. 2015; 5: e005997 10.1136/bmjopen-2014-005997
    1. Yin WY, Hao Y, Sun XH, Gong XL, Li F, Li JH, et al. Scaling up the national methadone maintenance treatment program in China: achievements and challenges. Int J Epidemiol. 2010; 39:ii29–37. 10.1093/ije/dyq210
    1. Li L, Sangthong R, Chongsuvivatwong V, McNeil E, Li J. Multiple substance use among heroin-dependent patients before and during attendance at methadone maintenance treatment program, Yunnan, China. Drug Alcohol Depend. 2011; 116: 246–249.
    1. Li L, Lin C, Wan D, Zhang L, Lai W. Continued heroin use among methadone maintenance patients in China. Addict Behav. 2012; 37:264–268. 10.1016/j.addbeh.2011.11.004
    1. Sullivan SG, Wu Z, Cao X, Liu E, Detels R. Continued drug use during methadone treatment in China: a retrospective analysis of 19,026 service users. J Subst Abuse Treat. 2014; 47:86–92. 10.1016/j.jsat.2013.12.004
    1. Ding Y, He N. Club drugs and HIV/STI infection: A new public health concern in China. Fudan Univ J Med Sci. 2012; 39: 551–557.
    1. China National Narcotics Control Commission (CNNCC). 2012 Annual Report on Drug Control in China. Ministry of Public Security, Beijing, 2012.
    1. China National Narcotics Control Commission (CNNCC). 2013 Annual Report on Drug Control in China. China, Beijing, 2013.
    1. Ko NY, Wang PW, Wu HC, Yen CN, Hsu ST, Yeh YC, et al. Self-efficacy and HIV risk behaviors among heroin users in Taiwan. J Stud Alcohol Drugs. 2012; 73:469–476.
    1. Bao YP, Liu ZM, Li JH, Zhang RM, Hao W, Zhao M, et al. Club drug use and associated high-risk sexual behavior in six provinces in China. Addiction. 2015; 110 Suppl 1:11–19. 10.1111/add.12770
    1. Ding Y, He N, Zhu W, Detels R. Sexual risk behaviors among club drug users in Shanghai, China: prevalence and correlates. AIDS Behav. 2012; 17: 2439–2449.
    1. Hittner JB, Schachne ER. Meta-analysis of the association between ecstasy use and risky sexual behavior. Addict Behav. 2012; 37:790–796. 10.1016/j.addbeh.2012.02.018
    1. Chu TX, Levy JA. Injection drug use and HIV/AIDS transmission in China. Cell Res. 2005; 15:865–869.
    1. Chang Y, Duo L, Xue H, Yuan W. Continuous urine tests for METH among methadone maintenance treatment. Chin J Drug Depend. 2011; 20:37–40.
    1. Jia M, Luo H, Ma Y, Wang N, Smith K, Mei J, et al. The HIV epidemic in Yunnan Province, China, 1989–2007. J Acquir Immune Defic Syndr. 2010; 53: S34–40. 10.1097/QAI.0b013e3181c7d6ff
    1. Liu EW, Wu ZY, Liang T, Shen LM, Zhong H, Wang B, et al. Risk factors associated with continued heroin use during methadone maintenance treatment in Guizhou province, China. Zhonghua Yu Fang Yi Xue Za Zhi. 2008; 42:875–878.
    1. Gossop M, Marsden J, Stewart D, Treacy S. Outcomes after methadone maintenance and methadone reduction treatments: two-year follow-up results from the National Treatment Outcome Research Study. Drug Alcohol Depend. 2001; 62:255–264.
    1. Kamal F, Flavin S, Campbell F, Behan C, Fagan J, Smyth R. Factors affecting the outcome of methadone maintenance treatment in opiate dependence. Irish J Med. 2007; 100:393–397.
    1. Fareed A, Casarella J, Roberts M, Sleboda M, Amar R, Vayalapalli S, et al. High dose versus moderate dose methadone maintenance: is there a better outcome? J Addict Dis 2009; 28:399–405. 10.1080/10550880903183042
    1. Faggiano F, Vigna-Taglianti F, Versino E, Lemma P. Methadone maintenance at different dosages for opioid dependence. Cochrane Database Syst Rev. 2003; 3:CD002208
    1. Liu EW, Wu Y, Liang T, Shen LM, Zhong H, Wang B, et al. Risk factors associated with continued heroin use during methadone maintenance treatment in Guizhou province, China. Zhonghua Yu Fang Yi Xue Za Zhi. 2008; 42:875–878.
    1. Baumeister M, Vogel M, Dürsteler-MacFarland KM, Gerhard U, Strasser J, Walter M, et al. Association between methadone dose and concomitant cocaine use in methadone maintenance treatment: a register-based study. Subst Abuse Treat Prev Policy. 2013; 9:46.
    1. Trujillo KA, Smith ML, Guaderrama MM. Powerful behavioral interactions between methamphetamine and morphine. Pharmacol Biochem Behav. 2011; 99:451–458. 10.1016/j.pbb.2011.04.014
    1. Shariatirad S, Maarefvand M, Ekhtiari H. Methamphetamine use and methadone maintenance treatment: an emerging problem in the drug addiction treatment network in Iran. Int J Drug Policy 2013; 24:e115–116. 10.1016/j.drugpo.2013.05.003
    1. Palha AP, Esteves M. A study of the sexuality of opiate addicts. J Sex Marital Ther 2002; 28:427–437.

Source: PubMed

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