Study On The Effects Of Methadone Maintenance Treatment (MMT) On Quality Of Life, Drug Craving And Associated Factors Among Heroin Addicts

Objective: To explore the effects of methadone maintenance treatment (MMT) on quality of life (QOL), drug craving and its associated factors among heroin addicts, and to providing reference basis for improving the effectiveness of methadone maintenance treatment.Methods: A quasi-experiment study was adopted and carried out in Hunan province. All heroin addicts on MMT, who received MMT within one month, were selected from eight MMT outpatient departments, and followed at the time of just entering the study and six months after the treatment respectively. Potential control subjects, who are heroin addicts admitted by Changsha compulsory rehabilitation centers within two weeks, were followed at the time of first two weeks and one month after compulsory rehabilitation. All the subjects were assessed by "Community MMT baseline questionnaire", "WHOQOL-BREF" and "Craving for heroin questionnaire". The scores of QOL and the degree of heroin craving in two groups were compared and examined with T-test and ANOVA. Chi-square test and logistic regression analysis were used for univariate and multivariate analysis to explore the factors associated with MMT effects.Results: 356 cases in the experiment group and 126 cases in the control group were included in our study. The comparison of QOL between two groups and two time point showed: (1) There was no significant difference in scores of QOL between experiment group and control group in their baseline, but after six months of MMT the scores of QOL was higher than that in control group after one month compulsory rehabilitation, the difference of scores in the "physilogical domain", "environment domain", "the total score of QOL", and "General QOL" were significant. (2) In the experiment group, the scores of QOL were increased after six months MMT, showing significant difference in the scores of "physilogical domain", "psychological domain", "the total score of QOL", "General QOL", and "General health status" compared with that of baseline. (3) In the control group, we observed no significantly different in the scores of QOL between the baseline and after compulsory rehabilitation for one month, apart from "General health status". (4) In the experiment group, 184 cases (51.7%) have improved their quality of life after six months MMT; Results of multivariate logistic regressionanalysis showed that gender((?) =0.482,95%CI: 0.288-0.806)and lengthof drug-using ((?) =1.349, 95%CI: 1.079-1.853) were important factors that influenced therapeutic effects, male and patients with long-time druguse have better treatment effect.The comparison of the scores of heroin craving between the two groups and two time point revealed: (1) There was no significant difference in the scores of craving between experiment group and control group in their baseline except "expectation as for effect" factor. (2) The scores of craving were much lower in experiment group after six months MMT than that in control group after one month compulsory rehabilitation. (3) Compared with baseline, the scores of craving, apart from "self-control" factor, decreased significantly after MMT for six months. (4) The scores of craving after one month compulsory rehabilitation have not changed obviously compared with their baseline in the control group. (5) After six months MMT, 176 cases (49.4%) have improved their degree of heroin craving in experiment group. Results ofmultivariate logistic regression analysis showed that Gender ((?) =0.527, 95%CI: 0.314-0.884) , employment situation ((?) =0.396, 95%CI: 0.208-0.754) , drug injecting ((?)=3.63S, 95%CI: 1.287-10.282) , and history of rehabilitation ((?) =3.427, 95%CI: 1.104-10.639) were important factors that influenced therapeutic results in the degree ofheroin craving.Conclusion: Compared with compulsory rehabilitation, methadone maintenance treatment might be more effective in improvements of the quality of life and the degree of heroin craving for heroin addicts. Gender and length of drug-using might be important factors influencing the QOL of MMT patients; Gender, employment situation, drug injecting, and history of rehabilitation might affect the degree of heroin craving of MMT patients. Positive measures are needed to enhance the therapeutic effects of MMT. Integration of social resources, individual treatment, setting up social support system which is suitable for China's specific conditions, and strengthening comprehensive interventions will prove to be helpful.