Comparison of outcomes after 3-month methadone maintenance treatment between heroin users with and without HIV infection: a 3-month follow-up study

Harm Reduction Journal

Cheng-Fang Yen³  Hung-Chi Wu²  Hsun-Cheng Chang⁴  Kuan-Sheng Chung¹  Chih-Yao Hsu¹  Yi-Chun Yeh³  Chia-Nan Yen⁴  Huang-Chi Lin³  Peng-Wei Wang³ 

[1] Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, No. 130, Kaisyuan 2nd Rd., Kaohsiung City 80276, Lingya Dist, Taiwan;Department of Community Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, No. 130, Kaisyuan 2nd Rd., Kaohsiung City 80276, Lingya Dist, Taiwan;Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, 100 Tzyou 1st Road, Kaohsiung 807, Taiwan;Department of Psychiatry, Tainan Hospital, Department of Health, Executive Yuan, Tainan, Taiwan

关键词: Quality of life;    Depression;    HIV;    Methadone;    Heroin;   

Others  :  1206311
DOI  :  10.1186/s12954-015-0047-0

 received in 2014-12-16, accepted in 2015-04-27,  发布年份 2015

【 摘 要 】

Background

The aim of this study was to compare the changes in primary (heroin use-related) and secondary (depressive symptoms and quality of life, QOL) outcome indicators of 3-month methadone maintenance treatment (MMT) between heroin users with and without HIV infection.

Methods

A total of 242 intravenous heroin-dependent individuals (30 with and 212 without HIV infection) receiving MMT were recruited. Primary (severity of heroin dependence, harm caused by heroin use and current heroin use) and secondary (depressive symptoms and QOL) outcome indicators were determined before and after receiving 3-month MMT. Changes in primary and secondary outcome indicators between the two groups were compared using mixed-model analysis.

Results

Heroin users both with and without HIV infection showed significant improvement in three primary outcome indicators after 3-month MMT, and there was no difference in the changes of these primary outcome indicators between the two groups. However, improvements in depressive symptoms and the physical domain of QOL among HIV-infected heroin users were poorer than in those without HIV infection.

Conclusions

The results of this study indicated that heroin users with HIV infection did improve in the primary but not the secondary outcomes after 3-month MMT.

【 授权许可】

   
2015 Wang et al.; licensee BioMed Central.

【 参考文献 】

• [1]Darke S. Pathways to heroin dependence: time to re-appraise self-medication. Addiction. 2013; 108:659-67.
• [2]Darke S. The life of the heroin user : typical beginnings, trajectories and outcomes. Cambridge University Press, Cambridge, UK; New York; 2011.
• [3]Zhao L, Holzemer WL, Johnson M, Tulsky JP, Rose CD. HIV infection as a predictor of methadone maintenance outcomes in Chinese injection drug users. AIDS Care. 2011; 24:195-203.
• [4]Statistics of communicable diseases and surveillance reports in Taiwan area. (Department of. Health EY, Taiwan ed. 2003.
• [5]Yang C-H, Yang S-Y, Shen M-H, Kuo H-S. The changing epidemiology of prevalent diagnosed HIV infections in Taiwan, 1984–2005. Int J Drug Policy. 2008; 19:317-23.
• [6]Statistics of communicable diseases and surveillance reports in Taiwan area. (Department of Health EY, Taiwan ed. 2007.
• [7]Dole Vp NM. A medical treatment for diacetylmorphine (heroin) addiction: A clinical trial with methadone hydrochloride. JAMA. 1965; 193:646-50.
• [8]Johansson BA, Berglund M, Lindgren A. Efficacy of maintenance treatment with methadone for opioid dependence: a meta-analytical study. Nord J Psychiatry. 2007; 61:288-95.
• [9]Chen Y-MA, Kuo SH-S. HIV-1 in Taiwan. The Lancet. 2007; 369:623-5.
• [10]Edelman EJ, Gordon K, Becker WC, Goulet JL, Skanderson M, Gaither JR et al.. Receipt of opioid analgesics by HIV-infected and uninfected patients. J Gen Intern Med. 2013; 28:82-90.
• [11]Kingree JB, Glasford MT, Jones-Allen M. A comparison of HIV-positive and HIV-negative crack users enrolled in a residential addiction treatment program. Am J Drug Alcohol Abuse. 1997; 23:569-80.
• [12]Byrd D, Murray J, Safdieh G, Morgello S. Impact of opiate addiction on neuroinflammation in HIV. J Neurovirol. 2012; 18:364-73.
• [13]Lee TS, Shen HC, Wu WH, Huang CW, Yen MY, Wang BE et al.. Clinical characteristics and risk behavior as a function of HIV status among heroin users enrolled in methadone treatment in northern Taiwan. Subst Abuse Treat Prev Policy. 2011; 6:6. BioMed Central Full Text
• [14]Havard A, Teesson M, Darke S, Ross J. Depression among heroin users: 12-Month outcomes from the Australian Treatment Outcome Study (ATOS). J Subst Abuse Treat. 2006; 30:355-62.
• [15]Sherr L, Clucas C, Harding R, Sibley E, Catalan J. HIV and depression–a systematic review of interventions. Psychol Health Med. 2011; 16:493-527.
• [16]Gossop M, Marsden J, Stewart D, Lehmann P, Strang J. Methadone treatment practices and outcome for opiate addicts treated in drug clinics and in general practice: results from the National Treatment Outcome Research Study. Br J Gen Pract. 1999; 49:31-4.
• [17]Wang P-W, Wu H-C, Yen C-N, Yeh Y-C, Chung K-S, Chang H-C et al.. Predictors of the severity of depressive symptoms among intravenous heroin users receiving methadone maintenance treatment in Taiwan: An 18-month follow-up study. Psychol Addict Behav. 2012; 26:145-50.
• [18]Bing E et al.. PSychiatric disorders and drug use among human immunodeficiency virus–infected adults in the united states. Arch Gen Psychiatry. 2001; 58:721-8.
• [19]Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med. 1998; 28:551-8.
• [20]Lin S-H, Chen KC, Lee S-Y, Hsiao C-Y, Lee IH, Yeh TL et al.. The economic cost of heroin dependency and quality of life among heroin users in Taiwan. Psychiatry Res. 2013; 209(3):512-7.
• [21]Aranda-Naranjo B. Quality of Life in the HIV-Positive Patient: Implications and Consequences. J Assoc Nurse AIDS Care. 2004; 15:20S-7.
• [22]American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th ed Washington, DC: American Psychiatric Press; 2000. 1.0. edition. Washington, D.C.: American Psychiatric Association.
• [23]Guo Y, Logan H, Glueck D, Muller K. Selecting a sample size for studies with repeated measures. BMC Med Res Methodol. 2013; 13:100. BioMed Central Full Text
• [24]Kreidler SM, Muller KE, Grunwald GK, Ringham BM, Coker-Dukowitz ZT, Sakhadeo UR. GLIMMPSE: online power computation for linear models with and without a baseline covariate. J S Softw. 2013;54.
• [25]Gossop M, Darke S, Griffiths P, Hando J, Powis B, Hall W et al.. The Severity of Dependence Scale (SDS): psychometric properties of the SDS in English and Australian samples of heroin, cocaine and amphetamine users. Addiction. 1995; 90:607-14.
• [26]Chen VC, Chen H, Lin TY, Chou HH, Lai TJ, Ferri CP et al.. Severity of heroin dependence in Taiwan: reliability and validity of the Chinese version of the Severity of Dependence Scale (SDS). Addict Behav. 2008; 33:1590-3.
• [27]Chien CP, Cheng TA. Depression in Taiwan: epidemiological survey utilizing CES-D. Seishin Shinkeigaku Zasshi. 1985; 87:335-8.
• [28]Yao G, Chung CW, Yu CF, Wang JD. Development and verification of validity and reliability of the WHOQOL-BREF Taiwan version. J Formos Med Assoc. 2002; 101:342-51.
• [29]Bolker BM, Brooks ME, Clark CJ, Geange SW, Poulsen JR, Stevens MHH et al.. Generalized linear mixed models: a practical guide for ecology and evolution. Trends Ecol Evol. 2009; 24:127-35.
• [30]Gowing LR. The role of opioid substitution treatment in reducing HIV transmission. BMJ. 2012; 345:e6425.
• [31]MacArthur GJ, Minozzi S, Martin N, Vickerman P, Deren S, Bruneau J et al.. Opiate substitution treatment and HIV transmission in people who inject drugs: systematic review and meta-analysis. BMJ. 2012; 345:e5945.
• [32]Tsao JC, Stein JA, Dobalian A. Pain, problem drug use history, and aberrant analgesic use behaviors in persons living with HIV. Pain. 2007; 133:128-37.
• [33]Hilderink PH, Burger H, Deeg DJ, Beekman AT, Oude Voshaar RC. The Temporal Relation Between Pain and Depression: Results From the Longitudinal Aging Study Amsterdam. Psychosom Med. 2012; 74:945-51.
• [34]Razali SM, Khalib AQ. Pain symptoms in Malay patients with major depression. Asian J Psychiatr. 2012; 5:297-302.
• [35]Rijavec N, Grubic VN. Depression and pain: often together but still a clinical challenge: a review. Psychiatr Danub. 2012; 24:346-52.
• [36]Gonzalez A, Zvolensky MJ, Parent J, Grover KW, Hickey M. HIV symptom distress and anxiety sensitivity in relation to panic, social anxiety, and depression symptoms among HIV-positive adults. AIDS Patient Care STDS. 2012; 26:156-64.
• [37]Pearson CR, Micek MA, Pfeiffer J, Montoya P, Matediane E, Jonasse T et al.. One Year After ART Initiation: Psychosocial Factors Associated with Stigma Among HIV-Positive Mozambicans. AIDS Behav. 2009; 13:1189-96.
• [38]Tsai Ac WSDPMLRKKMBBDR. A marginal structural model to estimate the causal effect of antidepressant medication treatment on viral suppression among homeless and marginally housed persons with hiv. Arch Gen Psychiatry. 2010; 67:1282-90.
• [39]Evans DL, Ten Have TR, Douglas SD, Gettes DR, Morrison M, Chiappini MS et al.. Association of depression with viral load, CD8 T lymphocytes, and natural killer cells in women with HIV infection. Am J Psychiatry. 2002; 159:1752-9.
• [40]Kumar AM, Berger JR, Eisdorfer C, Fernandez JB, Goodkin K, Kumar M. Cerebrospinal fluid 5-hydroxytryptamine and 5-hydroxyindoleacetic acid in HIV-1 infection. Neuropsychobiology. 2001; 44:13-8.
• [41]Pyne JM, Asch SM, Lincourt K, Kilbourne AM, Bowman C, Atkinson H et al.. Quality indicators for depression care in HIV patients. AIDS Care. 2008; 20:1075-83.
• [42]Carpenter KM, Smith JL, Aharonovich E, Nunes EV. Developing therapies for depression in drug dependence: results of a stage 1 therapy study. Am J Drug Alcohol Abuse. 2008; 34:642-52.
• [43]Logie C, James L, Tharao W, Loutfy M. Associations Between HIV-Related Stigma, Racial Discrimination, Gender Discrimination, and Depression Among HIV-Positive African, Caribbean, and Black Women in Ontario, Canada. AIDS Patient Care STDS. 2013; 27:114-22.
• [44]Cunningham WE, Sohler NL, Tobias C, Drainoni ML, Bradford J, Davis C et al.. Health services utilization for people with HIV infection: comparison of a population targeted for outreach with the U.S. population in care. Med Care. 2006; 44:1038-47.
• [45]Yehia BR, Fleishman JA, Hicks PL, Ridore M, Moore RD, Gebo KA et al.. Inpatient health services utilization among HIV-infected adult patients in care 2002–2007. J Acquir Immune Defic Syndr. 2010; 53:397-404.
• [46]Sohler NL, Wong MD, Cunningham WE, Cabral H, Drainoni ML, Cunningham CO. Type and pattern of illicit drug use and access to health care services for HIV-infected people. AIDS Patient Care STDS. 2007; 21 Suppl 1:S68-76.
• [47]Cunningham CO, Sohler NL, Berg KM, Shapiro S, Heller D. Type of substance use and access to HIV-related health care. AIDS Patient Care STDS. 2006; 20:399-407.
• [48]Krueger C, Tian L. A Comparison of the General Linear Mixed Model and Repeated Measures ANOVA Using a Dataset with Multiple Missing Data Points. Biological Res Nursing. 2004; 6:151-7.
• [49]Darke S. Self-report among injecting drug users: a review. Drug Alcohol Depend. 1998; 51:253-63.
• [50]Jackson CT, Covell NH, Frisman LK, Essock SM. Validity of Self-Reported Drug Use among people with co-occurring mental health and substance use disorders. J Dual Diagn. 2005; 1:49-63.
• [51]Connock M, Juarez-Garcia A, Jowett S, Frew E, Liu Z, Taylor RJ et al.. Methadone and buprenorphine for the management of opioid dependence: a systematic review and economic evaluation. Health Technol Assess. 2007; 11:1-171.
• [52]Krishnan A, Wickersham JA, Chitsaz E, Springer SA, Jordan AO, Zaller N et al.. Post-release substance abuse outcomes among HIV-infected jail detainees: results from a multisite study. AIDS Behav. 2013; 17 Suppl 2:S171-80.