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Scaling up the national methadone maintenance treatment program in China: achievements and challenges.

Yin W, Hao Y, Sun X, Gong X, Li F, Li J, Rou K, Sullivan SG, Wang C, Cao X, Luo W, Wu Z - Int J Epidemiol (2010)

Bottom Line: In spite of these difficulties, ongoing evaluation has suggested reductions in heroin use, risky injection practices and, importantly, criminal behaviours among clients, which has thus provided the impetus for further expansion.Cooperation between health and public security officials has improved through regular meetings and dialogue.However, institutional capacity building is still needed to deliver sustainable and standardized services that will ultimately improve retention rates.

View Article: PubMed Central - PubMed

Affiliation: Chinese Center for Disease Control and Prevention, Beijing, China.

ABSTRACT
China's methadone maintenance treatment program was initiated in 2004 as a small pilot project in just eight sites. It has since expanded into a nationwide program encompassing more than 680 clinics covering 27 provinces and serving some 242 000 heroin users by the end of 2009. The agencies that were tasked with the program's expansion have been confronted with many challenges, including high drop-out rates, poor cooperation between local governing authorities and poor service quality at the counter. In spite of these difficulties, ongoing evaluation has suggested reductions in heroin use, risky injection practices and, importantly, criminal behaviours among clients, which has thus provided the impetus for further expansion. Clinic services have been extended to offer clients a range of ancillary services, including HIV, syphilis and hepatitis C testing, information, education and communication, psychosocial support services and referrals for treatment of HIV, tuberculosis and sexually transmitted diseases. Cooperation between health and public security officials has improved through regular meetings and dialogue. However, institutional capacity building is still needed to deliver sustainable and standardized services that will ultimately improve retention rates. This article documents the steps China made in overcoming the many barriers to success of its methadone program. These lessons might be useful for other countries in the region that are scaling-up their methadone programs.

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Related in: MedlinePlus

Timeline of events in the development of China’s MMT program
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Related In: Results  -  Collection

License 1 - License 2
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Figure 2: Timeline of events in the development of China’s MMT program

Mentions: In the early 1990s, government officials began the lengthy process of understanding how best to constrain the dual epidemic of HIV and drug use.13 This included learning from other countries, developing policies and plans suitable to China, piloting harm reduction strategies and ultimately implementing a multifaceted program to slow the HIV epidemic among drug users. A major component of this program has been the methadone maintenance treatment (MMT) program, which was initiated in 2004. The program was rapidly expanded from the initial pilot of just 8 clinics serving 1029 drug users in 2004 to 680 clinics serving 112 831 drug users daily in 2009. This article provides a detailed roadmap of this process, and discusses emerging issues and responses that contributed to the development of the world’s largest MMT program14 and the challenges still faced in the expansion of its services (summarized in Figure 2).Figure 2


Scaling up the national methadone maintenance treatment program in China: achievements and challenges.

Yin W, Hao Y, Sun X, Gong X, Li F, Li J, Rou K, Sullivan SG, Wang C, Cao X, Luo W, Wu Z - Int J Epidemiol (2010)

Timeline of events in the development of China’s MMT program
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC2992615&req=5

Figure 2: Timeline of events in the development of China’s MMT program
Mentions: In the early 1990s, government officials began the lengthy process of understanding how best to constrain the dual epidemic of HIV and drug use.13 This included learning from other countries, developing policies and plans suitable to China, piloting harm reduction strategies and ultimately implementing a multifaceted program to slow the HIV epidemic among drug users. A major component of this program has been the methadone maintenance treatment (MMT) program, which was initiated in 2004. The program was rapidly expanded from the initial pilot of just 8 clinics serving 1029 drug users in 2004 to 680 clinics serving 112 831 drug users daily in 2009. This article provides a detailed roadmap of this process, and discusses emerging issues and responses that contributed to the development of the world’s largest MMT program14 and the challenges still faced in the expansion of its services (summarized in Figure 2).Figure 2

Bottom Line: In spite of these difficulties, ongoing evaluation has suggested reductions in heroin use, risky injection practices and, importantly, criminal behaviours among clients, which has thus provided the impetus for further expansion.Cooperation between health and public security officials has improved through regular meetings and dialogue.However, institutional capacity building is still needed to deliver sustainable and standardized services that will ultimately improve retention rates.

View Article: PubMed Central - PubMed

Affiliation: Chinese Center for Disease Control and Prevention, Beijing, China.

ABSTRACT
China's methadone maintenance treatment program was initiated in 2004 as a small pilot project in just eight sites. It has since expanded into a nationwide program encompassing more than 680 clinics covering 27 provinces and serving some 242 000 heroin users by the end of 2009. The agencies that were tasked with the program's expansion have been confronted with many challenges, including high drop-out rates, poor cooperation between local governing authorities and poor service quality at the counter. In spite of these difficulties, ongoing evaluation has suggested reductions in heroin use, risky injection practices and, importantly, criminal behaviours among clients, which has thus provided the impetus for further expansion. Clinic services have been extended to offer clients a range of ancillary services, including HIV, syphilis and hepatitis C testing, information, education and communication, psychosocial support services and referrals for treatment of HIV, tuberculosis and sexually transmitted diseases. Cooperation between health and public security officials has improved through regular meetings and dialogue. However, institutional capacity building is still needed to deliver sustainable and standardized services that will ultimately improve retention rates. This article documents the steps China made in overcoming the many barriers to success of its methadone program. These lessons might be useful for other countries in the region that are scaling-up their methadone programs.

Show MeSH
Related in: MedlinePlus