Structural-level factors affecting implementation of the methadone maintenance therapy program in China

Lin, Chunqing; Wu, Zunyou; Rou, Keming; Yin, Wenyuan; Wang, Changhe; Shoptaw, Steven; Detels, Roger

doi:10.1016/j.jsat.2009.09.002

« Previous Next »Journal of Substance Abuse Treatment
Volume 38, Issue 2 , Pages 119-127, March 2010

Structural-level factors affecting implementation of the methadone maintenance therapy program in China

Chunqing Lin, Ph.D.
- Department of Epidemiology, School of Public Health, University of California at Los Angeles, Los Angeles, CA 90024, USA
- Corresponding author. Epidemiology, UCLA School of Public Health, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA 90024, USA. Tel.: +1 310 910 9707; fax: +1 310 794 2495.
Zunyou Wu, Ph.D.
- National Center for AIDS/STD Control and Prevention, Chinese Centers for Disease Control and Prevention, Xuanwu District, Beijing 100050, China
Keming Rou, B.S.
- National Center for AIDS/STD Control and Prevention, Chinese Centers for Disease Control and Prevention, Xuanwu District, Beijing 100050, China
Wenyuan Yin, M.D.
- National Center for AIDS/STD Control and Prevention, Chinese Centers for Disease Control and Prevention, Xuanwu District, Beijing 100050, China
Changhe Wang, M.S.
- National Center for AIDS/STD Control and Prevention, Chinese Centers for Disease Control and Prevention, Xuanwu District, Beijing 100050, China
Steven Shoptaw, Ph.D.
- Department of Family Medicine and Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA 90024, USA
Roger Detels, M.D., M.S.
- Department of Epidemiology, School of Public Health, University of California at Los Angeles, Los Angeles, CA 90024, USA

Received 10 April 2009; received in revised form 1 September 2009; accepted 20 September 2009. published online 16 December 2009.

Abstract

This study identifies structural-level factors influencing methadone maintenance therapy (MMT) program implementation in China. Twenty-eight service providers and 560 randomly selected clients from 28 MMT clinics in the study area underwent face-to-face interviews. Number of clients, retention rate, coverage, and structural-level factors were collected from a survey of service providers. Individual-level factors and self-reported illicit drug use information were obtained from clients. Urine specimens were collected from the client participants to test for heroin use. Clinics affiliated with the local Centers for Disease Control and Prevention (CDC) had more clients, higher retention rates, and broader coverage than those not affiliated with the CDC. Longer operating hours, incentive for compliant clients, and comprehensive services were positively associated with client recruitment and coverage. Comprehensive services and incentives for compliant clients were negatively associated with concurrent illicit drug use. Comprehensive services should be incorporated into the MMT program. Extended operating hours and incentives for compliant clients should be implemented.

Keywords: Methadone maintenance therapy, China, Structural-level factors, Drug users, HIV/AIDS