Status Investigation of Outpatients Receiving Methadone Maintenance Treatment (MMT) in Shanghai from 2005 to 2016

BACKGROUND: Methadone maintenance treatment (MMT) is an effective measure to control drug abuse, prevent AIDS, and improve family and social functions among those with heroin addiction. Relevant surveys in recent years show that the number of outpatients receiving MMT has a downward trend. AIMS: To understand variation in maintenance treatment rates and causes of withdrawal for outpatients receiving MMT in Shanghai since initiation of this program. METHOD: This study was a retrospective investigation, with data from the AIDS Comprehensive Prevention and Control Data Information Management System of the China AIDS Prevention and Control Center. Descriptive statistics were used to describe demographic data, treatment maintenance rate, and number of new outpatients receiving MMT in Shanghai From May 2005 to June 2016. The causes of withdrawal were summarized and analyzed. RESULTS: From May 2005 to June 2016, there were a total of 7181 outpatients receiving MMT in Shanghai. These patients were primarily male (male to female ratio around 3:1), young adults (more than 90% of these patients were 25 to 54 years old), with junior high school education level and below (65.4%), single (total of unmarried, divorced and widowed: 63.1%), and unemployed or underemployed (81.5%). The daily dose of methadone in MMT patients showed an upward trend since 2008, and gradually declined after reaching its peak in 2013. The mean (sd) dose of methadone taken in the years studied was 56 (2.75) ml/d. The number of new outpatients increased sharply in 2007 and 2008 (more than 1500), and then decreased year by year. The number of outpatients had increased continuously from 2005 to 2011, with the peak in 2011 (3840 patients), and then decreased gradually. The maintenance rate was stable at over 80% since 2010. The main causes of withdrawal: 1) arrested due to unrelated criminal causes (19.89%), 2) sent to compulsory isolated rehabilitation center due to occasional drug use, and 3) physical reasons (disease/pregnancy/death, 11.80%). CONCLUSION: The maintenance rate has been kept at a relatively good level since the initiation of the MMT outpatient clinic service in Shanghai. The number of patients receiving treatment showed an increase-then-decrease trend. The main causes of patients’ withdrawal were mainly related to “crime” and “relapse”. In order to make MMT outpatient service better, subsequent studies need to carry out related investigations to understand the causes of these changes and patients reasons for withdrawal.