The risk assessment of relapse among newly enrolled participants in methadone maintenance treatment: A group-LASSO based Bayesian network study

Abstract

BackgroundRelapse is a great barrier to improving the effectiveness of methadone maintenance treatment (MMT). Participants with different treatment durations could vary in their compliance with MMT, which may lead to different levels of relapse risk. This study aims to identify the risk factors for relapse and assess the relapse risk of MMT participants of different treatment durations.MethodThis retrospective study used data collected from seven MMT clinics in Guangdong Province, China, from January 2010 to April 2017. Newly enrolled participants who received 6 (n = 903) and 12 (n = 710) months of consecutive treatment with complete data were included. We selected significant risk factors for relapse through the group lasso regression and then incorporated them into Bayesian networks to reveal relationships between factors and predict the relapse risk.ResultsThe results showed that participants who received 6-month treatment had a lower relapse rate (32.0%) than those of 12-month treatment (39.0%, P < 0.05). Factors including personal living status and daily methadone dose were only influential to those who received the 6-month treatment. However, age, age at the initial drug use, HIV infection status, sexual behaviors, and continuous treatment days were common factors of both durations. The highest relapse risk for those after the 6-month treatment was inferred as 66.7% while that of the 12-month treatment was 83.3%. Farmers and those who have high accessibility to MMT services may require additional attention.ConclusionIt is necessary to implement targeted interventions and education based on the treatment durations of participants to decrease the relapse rate. Meanwhile, those about HIV/sexually transmitted infection prevention and anti-narcotics should be held in the whole process.

Benefits and challenges experienced by participants on long-term methadone maintenance treatment in China: a qualitative study

“…The interviews were conducted in six clinics from five cities in Guangdong Province, China, from December 2021 to September 2022. This setting was selected because it previously homed the most people who use drugs (PWUD) in China, accounting for over 30% of the total number, and is now running the largest number of MMT clinics (75) [ 9 , 13 ]. The purposive sampling strategy was applied to explore in-depth information from participants with various experiences [ 14 ].…”

Nociceptive Flexion Reflex Threshold is No Suitable Marker for Diagnosing Opioid-Induced Hyperalgesia

“…Treatment-seeking persons with opioid use disorder are prone to relapse. [70][71][72][73] Some participants were likely to be influenced by other substance classes or additional opioids. Owing to different handling at treatment sites, the proportion of co-users and choice of substances may vary between the groups.…”