title: Methadone maintenance treatment in China: perceived challenges from the perspectives of service providers and patients.
abstract: BACKGROUND
  China has recently adopted methadone maintenance treatment (MMT) as a national strategy to address the problem of drug abuse and related public health issues such as HIV and HCV infections. However, low enrollment and retention rates suggest that barriers may exist in MMT utilization. This study examined both patients' perceptions and service providers' perceptions of challenges in MMT implementation in China.
  
  
  METHODS
  Four focus groups were conducted in two Chinese cities, Shanghai and Kunming, to explore the perceived and experienced barriers in MMT participation in China. All focus group discussions with participants were audio taped and transcribed. Atlas.ti 5.1 was used to analyze data.
  
  
  RESULTS
  Service providers and patient participants reported positive experiences (e.g. effects of MMT in curbing withdrawal symptoms) but also expressed concerns about side effects and continued heroin use during MMT. They also identified barriers in participating and remaining in MMT, including affordability (fee requirement), acceptability (methadone as a substitution, dose, long-term nature), accommodation and accessibility (inconvenient operation hours, lack of transferability to other MMT clinics during travel) and competition between public health and public security.
  
  
  CONCLUSIONS
  The present findings have implications for reconsidering the current MMT policies and practices in order to improve access, utilization and, ultimately, the effectiveness of MMT in China.
authors.affiliation: UCLA Integrated Substance Abuse Programs, 11075 Santa Monica Blvd, Suite 200, University of California, Los Angeles, CA 90025, USA. feiwu@ucla.edu
authors.forename: Fei
authors.initials: F
authors.lastname: Wu
authors.forename: Ching-Yi
authors.initials: CY
authors.lastname: Peng
authors.forename: Haifeng
authors.initials: H
authors.lastname: Jiang
authors.forename: Ruimin
authors.initials: R
authors.lastname: Zhang
authors.forename: Min
authors.initials: M
authors.lastname: Zhao
authors.forename: Jianhua
authors.initials: J
authors.lastname: Li
authors.forename: Yih-Ing
authors.initials: YI
authors.lastname: Hser
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002681:China; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000517:prevention & control; D006297:Health Services Accessibility; D006526:Hepatitis C / Q000517:prevention & control; D006556:Heroin Dependence / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D058850:Opiate Substitution Treatment; D016320:Substance Abuse Treatment Centers; D015819:Substance Abuse, Intravenous / Q000517:prevention & control
chemical_list: D008691:Methadone