Five-year retrospective cohort study for methadone maintenance treatment among drug users in Guangxi

ObjectiveTo explore dynamic trend and related factors of retention of community-based methadone maintenance treatment(MMT)among drug users in Guangxi.MethodsA five-year retrospective cohort study was conducted among drug users enrolled from MMT clinics in Guangxi in 2007.Descriptive method was used to describe demographic characteristics and drug use behaviors among the drug users and survival analysis was adopted to determine retention time and its related factors.ResultsTotally 2 121 drug users were included in this study and the median duration of the drug users receiving MMT within 5 years was 31.1±23.8 months;the retention rates of less than 1 year,1 year,2 years,3 years,4 years,and more than 5 years were 25.0%,75.0%,56.9%,45.0%,34.4%,and 26.4%,respectively.The drug users were most likely to drop out during the first 1-2 year after the start of the treatment(with a retention rate of 45.2% in 2009),then gradually stabilized in subsequent years(with the retention rates varying from 31.3% to 47.7% between 2010 and 2012).Multiple Cox proportional hazard regression model analyses showed that the drug users being farmer(hazard ratio HR=1.319,P=0.001),having injection drug use before MMT(HR=1.509,P<0.001),using heroine secretly during treatment(HR=2.157,P=0.007)were risk factors for non-retention;while having a good relationship with family members(HR=0.689,P=0.002),having wage income in the past six months(HR=0.880,P=0.034),with daily dosage of MMT higher than 60 ml/day(HR=0.817,P=0.016)were protective factors for the retention.ConclusionRetention of MMT among drug users was low in Guangxi.Being farmer,relationship with family members,having wage income,with injection drug use before MMT,using heroine secretly during treatment,and daily dosage of MMT are important factors for retention of MMT.