Factors associated with concurrent heroin use in methadone maintenance treatment patients in psychiatric out-patient-unit at Samutprakan hospital
Keywords:
Methadone maintenance treatment (MMT), Concurrent heroin use, Samutprakan hospitalAbstract
Heroin dependence is a major substance use problem in Thailand. Methadone maintenance treatment (MMT) is an effective method against heroin dependence. However concurrentheroin use was found among patients receiving MMT program. This study aimed to investigatefactors associated with concurrent heroin use in the patients enrolled in MMT program.
In May 2017, cross-sectional descriptive study was conducted in psychiatric outpatient-unit at Samutprakan hospital. Demographic data and substance related data were collected and analyzed by descriptive statistics. Chi-square test and logistic regression analysis on SPSS program were used to identify the factors associated with concurrent heroin use in MMT patients.
In the past 3 months, majority of 33 participants were male (87.88%), mean age 43.61 years old, graduated from junior high school (36.36%) and employed (69.70%). They lived with heroin user (21.21%), had history of incarceration (81.82%) and the mean time of imprisoned was 3.39 (SD 0.63), the mean age of frst heroin usage was 18.94 years old. Prior to enrolled in MMT program, they were daily heroin user (84.85%), mean heroin daily dose use was 240.30 milligrams (SD 52.53). Half of them had history of inpatient substance rehabilitation (48.48%) and the average of inpatient substance rehabilitation was 1.30 times (SD 0.33). Two third (63.63%) of patients were found to be concurrent heroin users. Mean time of MMT enrollment was 37.03 months (SD 4.53) and mean dosage of methadone was 61.06 milligrams (SD 5.71). Living with heroin user, intravenous midazolam injection, multiple substances usage and benzodiazepine prescription from physician were found to be statistically significant factor related with the concurrent users (p-value = 0.024, 0.012, 0.000 and 0.041 respectively). Intravenous midazolam usage was found to be statistically significant factor associated with the concurrent users [odds ratio = 6.19 (95% CI = 1.008 – 38.062); p-value = 0.049]
The factor that associated with patients enrolled in MMT program was intravenous midazolam usage. The medical personnel in MMT program should concern about this problem.
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