title: Illicit Heroin and Methamphetamine Use among Methadone Maintenance Treatment Patients in Dehong Prefecture of Yunnan Province, China.
abstract: OBJECTIVE
  Methadone maintenance treatment (MMT) was introduced to China in 2004 to reduce the harm of injecting drug users (IDUs). However, little is known about continued drug use, especially methamphetamine (MAMP), among MMT patients.
  
  
  METHODS
  A survey was conducted among patients attending five major MMT clinics in Dehong Prefecture in 2014 to investigate the heroin and MAMP use and their associated risk factors. Participants were administered with face-to-face interviews, and urine tests for morphine and MAMP.
  
  
  RESULTS
  A total of 2,121 were eligible and participated in the study. Among them, 220 (10.4%) were only positive for morphine, 12.9% were only positive for MAMP, and 196 (9.2%) were positive for both morphine and MAMP. Compared with neither use of heroin nor MAMP during MMT, heroin use (not using MAMP) was associated with ethnicity, shorter duration of MMT, lower dose of methadone, and having had no more than two sex partners in the past year; MAMP use (not using heroin) was associated with ethnicity, longer duration of MMT, higher dose of methadone and being aged <30 years (vs. ≥50 years); use of both heroin and MAMP was associated with being Dai minority (vs. Han), a marital status of divorced or widowed, having used drugs for ≥10 years and shorter duration of MMT.
  
  
  CONCLUSIONS
  These findings indicate the complexity in the treatment of heroin users and underscore the importance in prescribing appropriate methadone dosages in order to reduce both heroin and MAMP use.
authors.affiliation: Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China; Department of Disease Control and Prevention, National Health and Family Planning Commission, Beijing, China.
authors.forename: Rongrong
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China.
authors.forename: Yingying
authors.initials: Y
authors.lastname: Ding
authors.affiliation: Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China.
authors.forename: Hongling
authors.initials: H
authors.lastname: Bai
authors.affiliation: Dehong Prefecture Center for Disease Control and Prevention, Mangshi, Yunnan Province, China.
authors.forename: Song
authors.initials: S
authors.lastname: Duan
authors.affiliation: Dehong Prefecture Center for Disease Control and Prevention, Mangshi, Yunnan Province, China.
authors.forename: Runhua
authors.initials: R
authors.lastname: Ye
authors.affiliation: Dehong Prefecture Center for Disease Control and Prevention, Mangshi, Yunnan Province, China.
authors.forename: Yuecheng
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Dehong Prefecture Center for Disease Control and Prevention, Mangshi, Yunnan Province, China.
authors.forename: Jibao
authors.initials: J
authors.lastname: Wang
authors.affiliation: Dehong Prefecture Center for Disease Control and Prevention, Mangshi, Yunnan Province, China.
authors.forename: Renhai
authors.initials: R
authors.lastname: Tang
authors.affiliation: Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China.
authors.forename: Meiyang
authors.initials: M
authors.lastname: Gao
authors.affiliation: Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China.
authors.forename: Na
authors.initials: N
authors.lastname: He
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019969:Amphetamine-Related Disorders / Q000188:drug therapy* / Q000652:urine; D000701:Analgesics, Opioid / Q000627:therapeutic use; D002681:China; D003430:Cross-Sectional Studies; D003625:Data Collection / Q000379:methods / Q000706:statistics & numerical data; D055030:Drug Users / Q000145:classification / Q000706:statistics & numerical data; D005260:Female; D006556:Heroin Dependence / Q000188:drug therapy* / Q000652:urine; D006801:Humans; D016015:Logistic Models; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008694:Methamphetamine; D008875:Middle Aged; D009020:Morphine / Q000652:urine; D015999:Multivariate Analysis; D058850:Opiate Substitution Treatment / Q000379:methods / Q000706:statistics & numerical data; D015813:Substance Abuse Detection / Q000379:methods / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D008694:Methamphetamine; D009020:Morphine; D008691:Methadone