title: Concurrent heroin use among methadone maintenance clients in China.
abstract: BACKGROUND
  The study examined concurrent illicit heroin use among methadone maintenance clients in China and its association with clients' demographic characteristics, treatment experience, and personal social network.
  
  
  METHODS
  Face-to-face surveys were conducted with 178 clients randomly recruited from six methadone maintenance treatment (MMT) clinics in Sichuan, China. Concurrent heroin use was measured based on self-report of heroin use during the past 30 days and a confirmatory urine morphine test. The participants' demographic characteristics and treatment factors were measured and examined. The drug use status of their family members and friends was also assessed.
  
  
  RESULTS
  A total of 80 participants (44.9%) who either reported illicit heroin use in the past 30 days or had a positive urine test were defined as using heroin concurrently. Having drug-using friends was significantly associated with increased concurrent heroin use. Longer length of treatment (2 years or longer) was associated with increased concurrent heroin use. Among those who had both drug-using family members and friends, more women (71.4%) than men (50.0%) used heroin. For those who had no drug-using family members or friends, more men (34.8%) than women (20.8%) used heroin.
  
  
  CONCLUSIONS
  Study findings indicate an urgent need to address concurrent illicit heroin use among MMT clients. Further examination of the influence of social networks on concurrent drug abuse behavior is encouraged. Results also highlight the importance of understanding gender differences in treatment seeking and behavioral changes, which is crucial to the development of gender-specific treatment strategies.
authors.affiliation: Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California at Los Angeles, Los Angeles, CA 90024, USA. lililili@ucla.edu
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.forename: Chunqing
authors.initials: C
authors.lastname: Lin
authors.forename: Dai
authors.initials: D
authors.lastname: Wan
authors.forename: Linglin
authors.initials: L
authors.lastname: Zhang
authors.forename: Wenhong
authors.initials: W
authors.lastname: Lai
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China; D005260:Female; D003932:Heroin / Q000008:administration & dosage*; D006556:Heroin Dependence / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment; D012307:Risk Factors; D057566:Self Report; D017678:Sex Distribution; D012944:Social Support; D012959:Socioeconomic Factors; D016320:Substance Abuse Treatment Centers; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D009294:Narcotics; D003932:Heroin; D008691:Methadone
references.citation: JAMA. 1999 Mar 17;281(11):1000-5
references.pmid: 10086434
references.citation: Zhonghua Yu Fang Yi Xue Za Zhi. 2008 Dec;42(12):875-8
references.pmid: 19141219
references.citation: Subst Use Misuse. 2011;46(9):1190-8
references.pmid: 21417558
references.citation: Am J Addict. 2000 Winter;9(1):38-50
references.pmid: 10914292
references.citation: Drug Alcohol Depend. 2010 Mar 1;107(2-3):141-8
references.pmid: 19914783
references.citation: Drug Alcohol Depend. 2007 Jul 10;89(2-3):306-9
references.pmid: 17383117
references.citation: Psychiatr Serv. 2001 Sep;52(9):1223-9
references.pmid: 11533397
references.citation: Addiction. 2003 Apr;98(4):441-52
references.pmid: 12653814
references.citation: Zhonghua Liu Xing Bing Xue Za Zhi. 2010 Mar;31(3):269-72
references.pmid: 20510050
references.citation: Drug Alcohol Depend. 1995 Apr;38(1):1-9
references.pmid: 7648991
references.citation: Int J Drug Policy. 2007 Mar;18(2):118-28
references.pmid: 17689354
references.citation: Am J Drug Alcohol Abuse. 2000 Nov;26(4):523-35
references.pmid: 11097190
references.citation: Ir Med J. 2007 Mar;100(3):393-7
references.pmid: 17491538
references.citation: J Subst Abuse Treat. 2010 Mar;38(2):119-27
references.pmid: 20015606
references.citation: Behav Res Ther. 2008 Oct;46(10):1170-5
references.pmid: 18675399
references.citation: Int J Epidemiol. 2010 Dec;39 Suppl 2:ii29-37
references.pmid: 21113034
references.citation: Addiction. 1998 Jan;93(1):51-60
references.pmid: 9624711
references.citation: Addiction. 2010 Apr;105(4):732-9
references.pmid: 20403022
references.citation: Drug Alcohol Depend. 2001 Dec 1;65(1):65-75
references.pmid: 11714591
references.citation: AIDS. 2007 Dec;21 Suppl 8:S103-7
references.pmid: 18172377
references.citation: Addiction. 2006 Jul;101(7):1003-13
references.pmid: 16771892
references.citation: J Acquir Immune Defic Syndr. 2010 Feb;53 Suppl 1:S116-20
references.pmid: 20104102
references.citation: Drug Alcohol Depend. 2001 Sep 1;64(1):47-53
references.pmid: 11470340
references.citation: Addiction. 2007 Jul;102(7):1057-63
references.pmid: 17567394
references.citation: Drug Alcohol Depend. 2003 Jun 5;70(3):327-30
references.pmid: 12757970
references.citation: AIDS. 1996 Aug;10(9):1017-24
references.pmid: 8853736
references.citation: Am J Drug Alcohol Abuse. 1993;19(3):251-62
references.pmid: 8213691
references.citation: J Subst Abuse Treat. 2005 Jun;28(4):321-9
references.pmid: 15925266
references.citation: Drug Alcohol Depend. 2001 May 1;62(3):255-64
references.pmid: 11295330
references.citation: Am J Drug Alcohol Abuse. 1987;13(1-2):59-71
references.pmid: 3687885
references.citation: Am J Drug Alcohol Abuse. 2003;29(4):713-27
references.pmid: 14713135