Incarcerated Intravenous Heroin Users: Predictors of Post-Release Utilization of Methadone Maintenance Treatment

BACKGROUND:

Incarcerated intravenous heroin users (IIHUs) have more problematic patterns of heroin use but are less likely to access methadone maintenance treatment (MMT) by their own initiative than heroin users in the community.

OBJECTIVE:

The present study examined predictors for receiving MMT postrelease among IIHUs within a 24-month period.

DESIGN/METHODS:

This cohort study recruited 315 IIHUs detained in four prisons in southern Taiwan and followed up within 24-month period postrelease. Cox proportional hazards regression analysis was applied to determine the predictive effects of the sociodemographic and drug-use characteristics, attitude toward MMT, HIV serostatus, perceived family support, and depression for access to MMT after release.

RESULTS:

Two hundred and ninety five (93.7%) IIHUs were released and entered the follow-up phase of the study. During the 24-month follow-up period, 50.8% of them received MMT. After controlling for the effects of the detainment period before and after recruitment by Cox proportional hazards regression analysis, IIHUs who had positive HIV serostatus (HR = 2.85, 95% CI = 1.80-4.52, p < .001) and had ever received MMT before committal (HR = 1.94, 95% CI = 1.23-3.05, p < .01) were more likely to enter MMT within the 24-month follow-up period.

DISCUSSION:

Positive HIV serostatus with fully subsidized treatment and previous MMT experiences predicted access of MMT postrelease. Strategies for getting familiar with MMT during detainment including providing MMT prior to release and lowering economic burden of receiving treatment may facilitate entry of MMT for IIHUs.

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By:   Lin HC1,2, Wang PW1,2, Tsai JJ3,4,5, Yen CF1,2.

• 1 Department of Psychiatry , Kaohsiung , Taiwan.
• 2 Department of Psychiatry , School of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University , Kaohsiung , Taiwan.
• 3 Department of Infectious Diseases , Kaohsiung Medical University Hospital , Kaohsiung , Taiwan.
• 4 Tropical Medicine Center, Kaohsiung Medical University Hospital , Kaohsiung , Taiwan.
• 5 Department of Internal Medicine , School of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University , Kaohsiung , Taiwan. 

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