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Objective To explore the effect of the physician-nurse-social worker linkage rehabilitation model on the psychological status in patients receiving methadone maintenance treatment （MMT）. Methods Ninety-four patients who received MMT were enrolled and randomly divided into experimental group （n = 48） and control group （n = 46）. The experimental group received physician-nurse-social worker linkage rehabilitation model intervention, while the control group received conventional methadone treatment service. The anxiety, depression and quality of life of the two groups were evaluated before the intervention, 3 months and 6 months after the intervention. Results After 6 months of physician-nurse-social worker linkage rehabilitation mode intervention, the depression status and the anxiety status of the experimental group subjects were significantly improved compared with those before intervention, and both BDI and BAI scores were significantly lower than those of the control group subjects （P < 0.05）. Moreover, the proportion of "had depression" and "had anxiety" in the experimental group were significantly lower than those in the control group （P < 0.05）. After 6 months of intervention, the QOL-DA score of the experimental group subjects （183.77 ± 8.90） was significantly higher than that of the control group subjects （174.76 ± 11.14）（P < 0.01）. Conclusion The physician-nurse-social worker linkage rehabilitation model had certain advantages in improving the psychological state of MMT patients, which is worthy of promotion. [ABSTRACT FROM AUTHOR]

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Objective To study the influence of psychological factors on the loss of methadone maintenance treatment and its countermeasures, and to provide a basis for formulating corresponding intervention countermeasures. Methods From April 2012 to July 2013.a prospective cohort study was conducted to conduct a follow-up survey of patients in 6 methadone maintenance treatment clinics in Guangzhou. The basic information. psychological factors and other information of the treated person were collected. The national unified methadone maintenance treatment information collection system was used to collect daily medication records of patients. The Cox proportional hazards regression model was used to analyze the influencing factors of the loss of methadone maintenance treatment patients. Results Among the 548 subjects. 485(89. 2%) were male, and their age was (41.9±6. 5) years old. The one-year loss rate was 54. 7% (300/548). Multivariate Cox regression analysis found that among the psychological factors self efficacy (HR=0.97, P=0.005) was the main cause of loss. Conclusion The lower the self-efficacy, the easier it is to lose. In or der to reduce the loss rate.in addition to providing methadone, methadone clinics should also carry out appropriate psychological intervention services to improve patients' confidence in persisting in taking medication. [ABSTRACT FROM AUTHOR]

Objective · To investigate the hepatitis C virus (HCV) infection, knowledge related to hepatitis C virus, and treatment motivation among the heroin dependents treated in methadone maintenance treatment (MMT) clinics and to provide evidence for formulating related intervention strategies in the future. Methods · Two hundred and forty participants receiving MMT underwent serologic test to evaluate HCV infection among them. HCV related knowledge questionnaire, AUDIT, Stigma Scale, Beck Depression Inventory, and Beck Anxiety Inventory were used to assess patients. Results · The HCV infection rate among participants was 70.0% (168/240) and most of them were co-infected with hepatitis A (43.3%). HCV knowledge scores were low due to lack of self-protection consciousness and average scores were 6.5±3.5. The main factor affecting the motivation to treatment is treatment costs. Conclusion · The HCV infection rate in MMT patients is high and the patients lack related knowledge. The factors influencing the motivation for treatment are complicated. [ABSTRACT FROM AUTHOR]

Objective To investigate the quality of life of the patients with methadone maintenance treatment and its influencing factors．Method A total of 121 patients who were receiving methadone maintenance therapy in Qujing of Yunnan Province were surveyed with the QLICD-DA．Result The average score of physiological function， psychological function， social function， specific module and the total quality of life was: 68.18， 55.00， 54.13， 74.54 and 65.50．Conclusions Early use of methadone maintenance treatment can improve the quality of life of patients．We should strengthen the local social construction， give more care and support for the poor economic situation and take corresponding measures to improve their quality of life. [ABSTRACT FROM AUTHOR]

Objectives: In August 2005, the Taiwanese government introduced Methadone Maintenance Treatment (MMT), one of the major strategies in fighting drug abuse; however, as of 2010, the MMT strategy still had not demonstrated effectiveness in reducing the addicted population or the recidivism rate. The aims of this study were to determine whether MMT was effective in Taiwan and to provide objective evidence to authorities before more resources were invested in this protocol. Methods: This study used a non-experimental design approach. A total of 3343 drug abusers released from correctional facilities during the first half of 2009 were divided into adaptive and non-adaptive MMT groups. Follow-up observation was done over 18 months and included drug recidivism and both property and violent crimes for each group. Results: The drug recidivism rate for the MMT group was 30.57%, whereas that for the non-MMT group was 42.03%. The lower rate of the MMT group was expected, but the efficacy of MMT was not evident at the 6- and 12-month observational periods. Only 23.64% of the addicts remained in MMT therapy. Conclusions: The adequacy of MMT implementation and its supporting measures in Taiwan must be further examined. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the compliance and influencing factors of methadone maintenance treatment in drug addict. METHODS: 98 drug addicts accepting methadone maintenance treatment in Methadone outpatient department of Dongguan from Feb. 2013 to Dec. 2014 were selected; among which 49 cases did not participate in the administration for a total of more than 15 days within 3 months were set as depigmentation group; and another 49 cases participate in the administration for 6 months were set as maintenance group. The baseline data (gender, age, educational level, social support, and marriage, etc.), the heroin craving scores and urine morphine positive rate of two group were compared and analyzed after treatment of 8 months. RESULTS: After treatment of 8 months, the average heroin craving scores and urine morphine positive rate of depigmentation group were respectively (23.97 ± 2.18) scores and (89.37 ±0.36)%, significantly higher than those of maintenance group [ (20.06 ±1.87 ) scores and (76.23 ±1.02)%], with statistically significant difference (P <0.05) .There were statistically significant differences between two groups in gender, age, educational level, social support, and marriage (P <0.05 ) .CONCLUSIONS: The compliance of methadone maintenance treatment is affected by many factors, and the clinical application of targeted measures should be taken to improve the compliance of patients. [ABSTRACT FROM AUTHOR]

Objective: To understand the characteristics and explore the influencing factors of HBsAg positivity in methadone maintenance treatment (MMT) clinic patients. Methods: A face to face interview and medical record review were conducted in 1 040 patients at three MMT clinics in Guangxi from September to November in 2014. The questionnaire information included general demographic characteristics, drug use history, MMT status, sexual behaviors, and health status, etc . Blood samples were collected from the patients at the same time for the detections of the level of HBsAg, anti-HBs and anti-HCV. By using χ (2) test, unconditional logistic regression model and Bayesian network model the influencing factors for HBsAg positivity in MMT clinic patients and the complex network relationship among these factors were explored. Results: A total of 1 031 MMT clinic patients were surveyed, the HBsAg positive rate was 11.35 % (117/1 031). The anti-HCV positive rate was 71.77 % (740/1 031), among the anti-HCV positive patients, the HBsAg positive rate was 10.27 % (76/740). After adjusting for the confounding factors, anti-HBs positive persons might not be HBsAg positive ( OR =0.05, 95 %CI : 0.03-0.09), and anti-HCV positive persons might not be HBsAg positive too ( OR =0.30, 95 %CI : 0.17-0.52) compared with anti-HBs negative and anti-HCV negative persons, respectively. The persons with family history of hepatitis B virus infection were more likely to be HBsAg positive compared those with no such family history ( OR =5.30, 95 %CI : 2.68-10.52). Bayesian network model analysis results showed that family history of hepatitis B virus infection and anti-HBs were directly related with HBsAg positivity. Anti-HCV, intravenous drug use in the past three months and other drug using during treatment were indirectly related with HBsAg positivity. Conclusions: Anti-HBs, family history of hepatitis B virus infection, anti-HCV, intravenous drug use in past three months and other drug use during treatment were related with the HBsAg positivity in MMT clinic patients. So, it is necessary to enhance health education, improve health awareness and decrease high risk behaviors to reduce the rate of HBV infection.

When facing the worldwide abuse of opioid substance, one of the effective responses is opioid substitution therapy (OST). However, different OST service patterns may affect the therapeutic outcome. Using the System Engineering Initiative for Patient Safety (SEIPS) model, we can analyze the factors that affecting the outcomes of patients from the perspective work system. In this paper, SEIPS model is used to describe the existing OST service model. According to the operation mechanism of the methadone maintenance treatment in China and the existing OST service model, some suggestions are put forward to carry out effective OST service in the country.

Objective: To explore the reasons and factors associated with new psychoactive substances abuse among patients with access to methadone maintenance treatment (MMT). Methods: A well-developed questionnaire and urine tests were used to collect information about demographic characteristics, condition of MMT and drug abuse, family and social support of MMT clients. A 1∶1 matched case-control study was conducted, and conditional logistic regression model was used to identify factors associated with new psychoactive substances abuse. Results: A total of 212 (106 pairs) clients receiving MMT were recruited, and most of them were males (78.3 % , 166/212), married or cohabitant (48.6 % , 103/212) and unemployed (63.2 % , 134/212). The average age of the clients was (45.1±7.2) years. The main types of abused new psychoactive substances were benzodiazepine (62.3 % , 66/106) and methamphetamine (39.6 % , 42/106). The proportion of abusing multi new psychoactive substances was 8.5 % (9/106). Results from multivariate conditional logistic regression analysis indicated that using opioid drug during the past 6 months of MMT treatment might increase the risk of abusing new psychoactive substances ( OR =3.25, 95 %CI : 1.35-7.79), benzodiazepine ( OR =3.25, 95 %CI : 1.11- 9.47) and methamphetamine ( OR =13.31, 95 %CI : 1.12-158.01). Moreover, MMT for more than9 years reduced the risk of abuse of new psychoactive substances ( OR =0.03, 95 %CI : 0.01-0.21), benzodiazepine ( OR =0.02, 95 %CI : 0.00-0.36) and methamphetamine ( OR =0.02, 95 %CI : 0.00-0.69). Conclusion: Less new psychoactive substances abuse might be associated with longer duration of MMT treatment. And inappropriate support from family and friends might increase the risk of abusing new psychoactive substances in MMT clients, especially in clients who used opioid.

Objective: To estimate the prevalence of HIV/HCV co-infection and explore the influence factors and their interaction on HIV/HCV co-infection of patient's access to methadone maintenance treatment (MMT). Methods: A face to face interviews were conducted among 750 patients at two MMT clinics in Guangxi Zhuang Autonomous Region. The questionnaires information included demographic characteristics, HIV and HCV infection status, history of drug abuse, urine test for morphine, high risk sex behaviors, needle sharing, dropped out etc . Methods of χ (2) test one-way, multivariate logistic regression and interactions were used to analyze the related factors of HIV/HCV co-infection. Results: The study subjects included 750 participants, 18.31 % (127/691) of patients were co-infected with HIV and HCV. The HIV/HCV co-infection rate in patients who shared needles with others or dropped out of treatment was 35.84 % (81/226) and 19.88 % (64/322) respectively, which were higher than those who have never shared needles or dropped out (9.89 % , 46/465 and 17.07 % , 63/369). Logistic regression analysis results showed that after adjusted for confounding factors, patients who shared needles ( OR =4.50, 95 %CI : 2.72-7.43) and dropped out of treatment ( OR =1.71, 95 %CI : 1.04-2.80) were more likely to be infected with HIV/HCV. Interaction analysis showed that sharing needles and dropping out of treatment exist additive effect on co-infection of HIV and HCV ( RERI =4.21, AP =0.44, SI =1.95). Conclusions: Needle sharing and dropping out of treatment are associated with HIV/HCV co-infection. Health education, psychological counseling and other measures should be taken to reduce needle sharing and dropping out of MMT.

Objective: To investigate the association between three single nucleotide polymorphism (SNP) genes DRD2 (rs1800497, rs6275, and rs1799978) and the dosage used on methadone maintenance treatment (MMT). Methods: From the methadone maintenance treatment centers, 257 MMT patients were recruited to participate in a case-control study and divided into two groups-control groups under low dosage ( n =89) and case ( n =168) group with high dosage. Quanto software was used to estimate the sample size as 180. Information related to social-demographic status, history on drug use and medication were collected. And DRD2 SNPs were genotyped to explore the relationship between polymorphism of DRD2 gene and the dosage of methadone maintenance treatment. Results: Distributions of DRD2 rs6275 between different groups were significantly different. Patients carrying TC genotype needed lower dose of methadone when compared to the patients that carrying CC genotype counterparts ( OR =0.338, 95% CI : 0.115-0.986). Patients that carrying C allele at rs6275 needed lower methadone dose than those that carrying genotype TT ( OR =0.352, 95% CI : 0.127-0.975). Distributions of genotypes, alles in the other two SNPs (rs1800497, rs1799978) were not significantly different between groups under different dosages. Conclusion: DRD2 rs6275 was associated with dosage of methadone used for the MMT patients. However, no significant associations were found between rs1800497, rs1799978 and the dosage of methadone.

Objective: To estimate the incidence of drop out of treatment in patients with access to methadone maintenance treatment and explore the correlation and interaction between insufficient methadone dosage and morphine positive urine on the drop out in Guangxi Zhuang Autonomous Region. Methods: Face to face interview was conducted in 1 031 patients at 3 methadone maintenance treatment clinics in Guangxi. Results: The study included 1 031 participants, 40.6 % of them (419/1 031) had stopped treatment. The drop out rates in urine morphine positive group and methadone dosage<100 mg/d group were 57.6 % (99/172) and 37.4 % (347/929) respectively, higher than those in urine morphine negative group and methadone dosage ≥100 mg/d group (42.3 % , 363/859, and 26.5 % , 27/102). Orderly logistic regression analysis results showed that after adjusted factors, such as gender, age, marital status, ethnic group, patients who received a dosage less than 100 mg/day ( OR =3.05, 95 %CI : 1.84-5.06) and had morphine positive urine ( OR =2.25, 95 %CI : 1.59-3.19) were more likely to drop out of the treatment. Interaction analysis showed that dosage less than 100 mg/d and morphine positive urine during treatment had additive interaction ( RERI =256.46, AP =0.87, S = 8.05) and multiplication interaction ( OR =2.45, 95 %CI : 1.71-3.49). Conclusion: Insufficient dosage and morphine positive urine were significantly correlated with drop out of treatment in patients with access to methadone maintenance treatment.

Objective: To understand the current status of receiving no methadone maintenance treatment (MMT) and influencing factors in HIV infected injecting drug users (IDUs) in Dehong Dai and Jingpo autonomous prefectures, Yunnan province. Methods: Data of survival of IDUs with AIDS in Dehong were collected from " Chinese National Comprehensive HIV/AIDS and Care Information System" in December, 2014. Results: There were 987 IDUs who should receive MMT, the majority of them were males (94.6%, 934/987), aged 35-44 years (53.0%, 523/987) and farmers (77.2%, 762/987). Among the 987 IDUs, 60.2% (592/987) received no MMT. Multivariate logistic regression analysis showed that being female ( OR =2.66, 95 %CI : 1.21-5.87), in Jingpo ethnic group ( OR =3.05, 95 % CI : 1.97-4.71) were the major risk factors for receiving no MMT; not being farmers ( OR =0.46, 95 %CI : 0.31-0.70), in Dai ethnic group ( OR =0.53, 95 %CI : 0.36-0.79), diagnosed HIV infection history ≥10 years ( OR =0.60, 95 %CI : 0.45-0.81) were the major protective factors for receiving no MMT. The reasons for receiving no MMT included long distance journey (289 , 48.8%), fear of exposure (124, 20.9%), poor daily medication compliance (59, 10.0%), fear of side effects (47, 7.9%), others (73, 12.3%). Conclusions: The proportion of receiving no MMT in IDUs with AIDS in Dehong was high. Being female and farmer, in Jingpo ethnic group, low educational level, short diagnosed HIV infection history were influencing factors for receiving no MMT. The effective intervention measures should be taken to further improve MMT coverage according to the different characteristics of the patients.