title: Methadone maintenance treatment programme reduces criminal activity and improves social well-being of drug users in China: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Methadone maintenance treatment (MMT) has been implemented in China since 2004 and has expanded into a nationwide programme. This study aims to evaluate changes in social functioning, family relations and drug-related criminal behaviour among MMT clients in China.
  
  
  METHODS
  Systematic review and meta-analysis.
  
  
  METHODS
  Both English and Chinese literature databases, including PubMed, Chongqing VIP Chinese Science and Technology Journals Database (CQVIP), China National Knowledge Infrastructure (CNKI) and Wanfang Data, were comprehensively searched over the period 2004-2014 for studied indicators. Study selection, quality assessment and data extraction were conducted according to the PRISMA (preferred reporting items for systematic reviews and meta-analyses) Statement. Meta-analyses were conducted using Comprehensive Meta-Analysis Biostat software.
  
  
  RESULTS
  Thirty-eight articles were included in this review (1 in English and 37 in Chinese). The self-reported arrest rate decreased from 13.1% (95% CI 9.1% to 18.5%) at baseline to 3.4% (95% CI 1.5% to 7.7%) and 4.3% (95% CI 1.6% to 11.4%) after 6 and 12 months of MMT intervention, respectively. The rate of drug selling decreased from 7.6% (95% CI 3.8% to 14.8%) at baseline to 1.9% (95% CI 0.6% to 6.2%) and 3.0% (95% CI 1.0% to 8.9%) after 6 and 12 months of intervention, respectively. Similarly, the rates of selling sex for drugs and drug-related crime decreased from 5.3% (95% CI 2.4% to 11.1%) and 9.9% (95% CI 6.8% to 14.2%) at baseline to 1.1% (95% CI 0.5% to 2.3%) and 3.4% (95% CI 2.5% to 4.5%) at 6 months, then to 0.8% (95% CI 0.3% to 1.9%) and 3.4% (95% CI 0.8% to 13.1%) at 12 months after treatment initiation, respectively. In contrast, the rate of employment of clients and the proportion of clients having a good relationship with their family increased substantially from 26.4% (95% CI 22.9% to 30.1%) and 37.9% (95% CI 32.0% to 44.2%) to 41.6% (95% CI 36.6% to 48.0%) and 59.6% (95% CI 48.1% to 70.2%) at 6 months, then to 59.8% (95% CI 52.4% to 66.8%) and 75.0% (95% CI 69.0% to 80.2%) at 12 months after treatment initiation, respectively.
  
  
  CONCLUSIONS
  MMT has significantly reduced criminal activity, and improved employment rate and social well-being, of clients of the MMT programme. MMT is an effective measure to help drug users to resume societal and familial functions in China.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Nantong University, Jiangsu, China.
authors.forename: Hua-Min
authors.initials: HM
authors.lastname: Sun
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Nantong University, Jiangsu, China.
authors.forename: Xiao-Yan
authors.initials: XY
authors.lastname: Li
authors.affiliation: The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
authors.forename: Eric P F
authors.initials: EP
authors.lastname: Chow
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Nantong University, Jiangsu, China.
authors.forename: Tong
authors.initials: T
authors.lastname: Li
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Nantong University, Jiangsu, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Xian
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Nantong University, Jiangsu, China.
authors.forename: Yi-Hua
authors.initials: YH
authors.lastname: Lu
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Nantong University, Jiangsu, China.
authors.forename: Tian
authors.initials: T
authors.lastname: Tian
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Nantong University, Jiangsu, China.
authors.forename: Xun
authors.initials: X
authors.lastname: Zhuang
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Nantong University, Jiangsu, China The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China; D003415:Crime / Q000706:statistics & numerical data*; D055030:Drug Users / Q000523:psychology*; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D060046:Maintenance Chemotherapy; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment / Q000379:methods*; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D066107:Social Skills; D055815:Young Adult
chemical_list: D009294:Narcotics; D008691:Methadone
keywords: PUBLIC HEALTH