title: A qualitative study exploring the reason for low dosage of methadone prescribed in the MMT clinics in China.
abstract: OBJECTIVE
  Dosage of methadone maintenance therapy (MMT) is an important factor influencing retention in methadone treatment. MMT clients in China received lower dosages of methadone compared with those provided in other countries. The objective of this study is to elucidate the reason for the low methadone dosage prescribed in MMT clinics in China.
  
  
  METHODS
  Twenty-eight service providers were recruited from the MMT clinics in Zhejiang and Jiangxi Provinces, China. Qualitative in-depth interviews were conducted to ascertain the procedure for prescribing methadone in the MMT clinics.
  
  
  RESULTS
  The average dosage prescribed in the 28 clinics was 35 mg/person/day. Four major themes resulting in low dosage of methadone were identified: (1) the service providers fear the liability resulting from large doses of methadone in combination with other substances which might result in overdose fatalities, (2) lack of understanding of harm reduction which resulted in low acceptance of the long term maintenance treatment approach, (3) break-down in communication between clients and service providers about dosage adjustment, and (4) dosage reduction is perceived by most service providers as an effective way to treat the side-effects associated with MMT.
  
  
  CONCLUSIONS
  The findings of the study highlighted the necessity to formulate clear guidelines concerning individualized dosage management and to improve training among service providers' in MMT clinics in China.
authors.affiliation: Semel Institute-Center for Community Health, University of California, Los Angeles, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA 90024, USA. lincq@ucla.edu
authors.forename: Chunqing
authors.initials: C
authors.lastname: Lin
authors.forename: Roger
authors.initials: R
authors.lastname: Detels
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D002681:China; D062787:Drug Overdose; D005260:Female; D058015:Health Communication; D006556:Heroin Dependence / Q000188:drug therapy / Q000534:rehabilitation; D006801:Humans; D007406:Interview, Psychological; D016365:Liability, Legal; D008297:Male; D008691:Methadone / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D009294:Narcotics / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000534:rehabilitation; D011369:Professional-Patient Relations; D036301:Qualitative Research; D016320:Substance Abuse Treatment Centers; D016896:Treatment Outcome
chemical_list: D009294:Narcotics; D008691:Methadone