title: Incarcerated intravenous heroin users: predictors of post-release utilization of methadone maintenance treatment.
abstract: Incarcerated intravenous heroin users have more problematic patterns of heroin use, but are less likely to access methadone maintenance treatment by their own initiative than heroin users in the community. The present study examined predictors for receiving methadone maintenance treatment post-release among incarcerated intravenous heroin users within a 24-month period. This cohort study recruited 315 incarcerated intravenous heroin users detained in 4 prisons in southern Taiwan and followed up within the 24-month period post-release. Cox proportional hazards regression analysis was applied to determine the predictive effects of sociodemographic and drug-use characteristics, attitude toward methadone maintenance treatment, human immunodeficiency virus serostatus, perceived family support, and depression for access to methadone maintenance treatment after release. There were 295 (93.7%) incarcerated intravenous heroin users released that entered the follow-up phase of the study. During the 24-month follow-up period, 50.8% of them received methadone maintenance treatment. After controlling for the effects of the detainment period before and after recruitment by Cox proportional hazards regression analysis, incarcerated intravenous heroin users who had positive human immunodeficiency virus serostatus (HR = 2.85, 95% CI = 1.80-4.52, p < .001) and had ever received methadone maintenance treatment before committal (HR = 1.94, 95% CI = 1.23-3.05, p < .01) were more likely to enter methadone maintenance treatment within the 24-month follow-up period. Positive human immunodeficiency virus serostatus with fully subsidized treatment and previous methadone maintenance treatment experiences predicted access of methadone maintenance treatment post-release. Strategies for getting familiar with methadone maintenance treatment during detainment, including providing methadone maintenance treatment prior to release and lowering the economic burden of receiving treatment, may facilitate entry of methadone maintenance treatment for incarcerated intravenous heroin users.
authors.affiliation: a Department of Psychiatry , Kaohsiung Medical University Hospital , Kaohsiung , Taiwan.|b Department of Psychiatry , Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University , Kaohsiung , Taiwan.
authors.forename: Huang-Chi
authors.initials: HC
authors.lastname: Lin
authors.affiliation: a Department of Psychiatry , Kaohsiung Medical University Hospital , Kaohsiung , Taiwan.|b Department of Psychiatry , Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University , Kaohsiung , Taiwan.
authors.forename: Peng-Wei
authors.initials: PW
authors.lastname: Wang
authors.affiliation: c School of Pharmacy, Kaohsiung Medical University , Kaohsiung , Taiwan.|d Division of Medical Statistics and Bioinformatics , Department of Medical Research, Kaohsiung Medical University Hospital , Kaohsiung , Taiwan.
authors.forename: Yi-Hsin
authors.initials: YH
authors.lastname: Yang
authors.affiliation: e Department of Infectious Diseases , Kaohsiung Medical University Hospital , Kaohsiung , Taiwan.|f Tropical Medicine Center, Kaohsiung Medical University Hospital , Kaohsiung , Taiwan.|g Department of Internal Medicine , Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University , Kaohsiung , Taiwan.
authors.forename: Jih-Jin
authors.initials: JJ
authors.lastname: Tsai
authors.affiliation: a Department of Psychiatry , Kaohsiung Medical University Hospital , Kaohsiung , Taiwan.|b Department of Psychiatry , Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University , Kaohsiung , Taiwan.
authors.forename: Cheng-Fang
authors.initials: CF
authors.lastname: Yen
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006556:Heroin Dependence / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011329:Prisoners / Q000523:psychology*; D015819:Substance Abuse, Intravenous / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D008691:Methadone
keywords: Heroin; methadone maintenance treatment; predictor