Impact of methadone on drug use and risky sex in China

Qian, Han-Zhu; Hao, Chun; Ruan, Yuhua; Cassell, Holly; Chen, Kun; Qin, Guangming; Yin, Li; Schumacher, Joseph E.; Liang, Songping; Shao, Yiming

doi:10.1016/j.jsat.2007.07.002

Cited by 32 publications

(31 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This finding has been observed when methadone patients are compared to their community counterparts who are not in treatment 9, 10, 11 and when opioid use during treatment is compared to pre- and post-treatment use 3 . Further, significantly lower rates of opioid use have been observed when patients with regular methadone program attendance are compared to those with poor attendance 12 , and when patients receiving minimal ancillary services are compared to those receiving more intensive services 13, 14 .…”

Section: Introductionmentioning

confidence: 75%

HIV Risk Reduction With Buprenorphine–Naloxone or Methadone

Woody

Bruce

Korthuis

et al. 2014

JAIDS Journal of Acquired Immune Deficiency Syndromes

View full text Add to dashboard Cite

Objectives Compare HIV injecting and sex risk in patients being treated with methadone (MET) or buprenorphine-naloxone (BUP). Methods Secondary analysis from a study of liver enzyme changes in patients randomized to MET or BUP who completed 24-weeks of treatment and had 4 or more blood draws. The initial 1:1 randomization was changed to 2:1 (BUP: MET) after 18 months due to higher dropout in BUP. The Risk Behavior Survey (RBS) measured past 30-day HIV risk at baseline and weeks 12 and 24. Results Among 529 patients randomized to MET, 391 (74%) were completers; among 740 randomized to BUP, 340 (46%) were completers; 700 completed the RBS. There were significant reductions in injecting risk (p< 0.0008) with no differences between groups in mean number of times reported injecting heroin, speedball, other opiates, and number of injections; or percent who shared needles, did not clean shared needles with bleach, shared cookers, or engaged in front/back loading of syringes. The percent having multiple sex partners decreased equally in both groups (p<0.03). For males on BUP the sex risk composite increased; for males on MET, the sex risk decreased resulting in significant group differences over time (p<0.03). For females, there was a significant reduction in sex risk (p<0.02) with no group differences. Conclusions Among MET and BUP patients that remained in treatment, HIV injecting risk was equally and markedly reduced, however MET retained more patients. Sex risk was equally and significantly reduced among females in both treatment conditions, but increased for males on BUP, and decreased for males on MET.

show abstract

Section: Introductionmentioning

confidence: 75%

HIV Risk Reduction With Buprenorphine–Naloxone or Methadone

Woody

Bruce

Korthuis

et al. 2014

JAIDS Journal of Acquired Immune Deficiency Syndromes

View full text Add to dashboard Cite

show abstract

“…4,5 China, Vietnam and Malaysia, for example, all previously scaled up compulsory drug detention centers, but are increasingly moving towards voluntary methadone maintenance and needle and syringe distribution systems to reduce the risk of blood-borne disease transmission from PWID sharing injecting equipment. 51–57 Emerging evidence suggests that expanded OST dispensation in these settings has been effective in reducing drug use. 54,56–58 This scale up of evidence-based biomedical and harm reduction interventions is occurring despite China’s previous investment in a compulsory treatment infrastructure; as such, tensions remain between voluntary, public health-oriented approaches and compulsory detainment, 59 as they do in settings that include both compulsory and voluntary approaches, such as Mexico.…”

Section: Resultsmentioning

confidence: 99%

The effectiveness of compulsory drug treatment: A systematic review

Werb

Kamarulzaman

Meacham

et al. 2016

International Journal of Drug Policy

157

112

View full text Add to dashboard Cite

Background Despite widespread implementation of compulsory treatment modalities for drug dependence, there has been no systematic evaluation of the scientific evidence on the effectiveness of compulsory drug treatment. Methods We conducted a systematic review of studies assessing the outcomes of compulsory treatment. We conducted a search in duplicate of all relevant peer-reviewed scientific literature evaluating compulsory treatment modalities. The following academic databases were searched: PubMed, PAIS International, Proquest, PsycINFO, Web of Science, Soc Abstracts, JSTOR, EBSCO/Academic Search Complete, REDALYC, SciELO Brazil. We also searched the Internet, and article reference lists, from database inception to July 15th, 2015. Eligibility criteria are as follows: peer-reviewed scientific studies presenting original data. Primary outcome of interest was post-treatment drug use. Secondary outcome of interest was post-treatment criminal recidivism. Results Of an initial 430 potential studies identified, nine quantitative studies met the inclusion criteria. Studies evaluated compulsory treatment options including drug detention facilities, short (i.e. 21-day) and long-term (i.e., 6 months) inpatient treatment, community-based treatment, group-based outpatient treatment, and prison-based treatment. Three studies (33%) reported no significant impacts of compulsory treatment compared with control interventions. Two studies (22%) found equivocal results but did not compare against a control condition. Two studies (22%) observed negative impacts of compulsory treatment on criminal recidivism. Two studies (22%) observed positive impacts of compulsory inpatient treatment on criminal recidivism and drug use. Conclusion There is limited scientific literature evaluating compulsory drug treatment. Evidence does not, on the whole, suggest improved outcomes related to compulsory treatment approaches, with some studies suggesting potential harms. Given the potential for human rights abuses within compulsory treatment settings, non-compulsory treatment modalities should be prioritized by policymakers seeking to reduce drug-related harms.

show abstract

“…In both studies, the changes in use of opioids compared to baseline were significant. In one study, for those who had ever participated in MAT the odds related to using drugs, injecting drugs and sharing needles or syringes were all significantly lower [24]. There were also beneficial results in terms of reduction of unsafe sex practices.…”

Section: Evidence For the Effect Of Medication Assisted Therapy On Rimentioning

confidence: 98%

“…In China, two different studies of MAT showed major declines in the proportion of clients injecting drugs and in the frequency of injection, covering a total of 1710 clients [17,24]. In both studies, the changes in use of opioids compared to baseline were significant.…”

Section: Evidence For the Effect Of Medication Assisted Therapy On Rimentioning

confidence: 99%