title: Factors Associated with Relapse among Heroin Addicts: Evidence from a Two-Year Community-Based Follow-Up Study in China.
abstract: BACKGROUND
  Many countries including China are facing a serious opiate dependence problem. Anti-drug work effectiveness was affected by the high relapse rate all over the world. This study aims to analyze the factors influencing heroin addict relapse, and to provide evidence for generating relapse prevention strategies.
  
  
  METHODS
  A community-based follow-up study was conducted in China between October 2010 and September 2012. A total of 554 heroin addicts in accordance with the inclusion criteria from 81 streets in 12 districts of Shanghai, China were divided into 4 groups: group 1--daily dosage taken orally of 60 mL of methadone or under combined with psychological counseling and social supports (n = 130); group 2--daily dosage taken orally of over 60 mL of methadone combined with psychological counseling and social supports (n = 50); group 3--JTT (Jitai tablets) combined with psychological counseling and social supports (n = 206); group 4--JTT combined with social supports (n = 168).
  
  
  RESULTS
  Log-rank test results showed that the cumulative relapse rate differences among four groups during the two-year follow-up period were not statistically significant (χ² = 5.889, p = 0.117). Multivariate Cox regression analysis results showed that only three independent variables were still statistically significant, including compliance with participation in psychological counseling (OR = 3.563, p = 0.000), the years of drug use (OR = 1.078, p = 0.001)and intervention model.
  
  
  CONCLUSIONS
  Using the detoxification medications combined with appropriate psychological counseling and social support measures will help improve the effectiveness of relapse prevention, which is a kind of alternative community detoxification pattern. Appropriate and standard psychological counseling is very important for anti-drug treatment. The longer the drug addiction lasts, the longer the anti-drug treatment takes.
authors.affiliation: School of Public Health, Fudan University, Shanghai 200032, China. 12111020023@fudan.edu.cn.|School of Humanities and Social Sciences, Zhejiang Chinese Medical University, Hangzhou 310053, China. 12111020023@fudan.edu.cn.
authors.forename: Chao
authors.initials: C
authors.lastname: Rong
authors.affiliation: Shanghai Mental Health Center, Shanghai 200030, China. rcnj2008@163.com.
authors.forename: Hai-Feng
authors.initials: HF
authors.lastname: Jiang
authors.affiliation: Technological and Industrial Promotion Center of Traditional Chinese Medicine, Shanghai 201203, China. guanlishui@126.com.
authors.forename: Rui-Wen
authors.initials: RW
authors.lastname: Zhang
authors.affiliation: Technological and Industrial Promotion Center of Traditional Chinese Medicine, Shanghai 201203, China. zhanglj@biopham.sh.cn.
authors.forename: Li-Juan
authors.initials: LJ
authors.lastname: Zhang
authors.affiliation: Drug Control Office, Shanghai 200129, China. zhangjc88@sina.com.
authors.forename: Jian-Chen
authors.initials: JC
authors.lastname: Zhang
authors.affiliation: The Council of Shanghai Ziqiang Social Services, Shanghai 200030, China. isurevictory@163.com.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.affiliation: School of Public Health, Fudan University, Shanghai 200032, China. xsfeng@shmu.edu.cn.|Key Laboratory of Public Health Security, Ministry of Education, Shanghai 200032, China. xsfeng@shmu.edu.cn.
authors.forename: Xue-Shan
authors.initials: XS
authors.lastname: Feng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D002681:China; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003376:Counseling; D005260:Female; D005500:Follow-Up Studies; D006556:Heroin Dependence / Q000209:etiology / Q000517:prevention & control / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D058850:Opiate Substitution Treatment; D010349:Patient Compliance; D012008:Recurrence; D012307:Risk Factors; D055502:Secondary Prevention; D012944:Social Support; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone
keywords: Jitai tablets; community-based drug treatment; follow-up study; methadone; psychological counseling
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