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China faces the challenge of dual epidemics of drug use and HIV/AIDS and recently methadone maintenance treatment (MMT) programs were implemented nationwide. This rapid expansion of treatment has been hampered by underutilization of MMT and high MMT dropout rates. To enhance understanding of these issues, and congruent with NIDA’s mission of promulgating research-based interventions to improve treatment services globally, Dr. Yih-Ing Hser led two projects.
“REAL-TIME ASSESSMENT OF TRIGGERS AND COPING RESPONSES IN CHINA” (PI: Yih-Ing Hser, Ph.D.; NIDA R21DA033285) is a collaboration between the UCLA Integrated Substance Abuse Programs (ISAP) and the Shanghai Mental Health Center (Co-PI: Min Zhao, M.D., Ph.D). Improved self-monitoring and self-management are important elements in chronic disease management. These concepts are relatively new to Chinese methadone maintenance treatment (MMT) providers and patients. Communication technologies and the proliferation of cellphones in China provide great opportunities to engage and network with patients and to collect ecological momentary assessment (EMA) data on triggers and coping responses. Informed by cognitive behavioral therapies, this project will test the feasibility and acceptability of EMA data collection of triggers and coping responses using cellphone and text messaging technology. The long-term goal is to develop promising strategies that optimize treatment effectiveness and support sustained recovery by taking advantage of the popularity of cellphone use, and adapting and applying evidence-based principles to address drug use and HIV/HCV risk behaviors.
“Improving Methadone Maintenance Treatment Compliance and Outcomes in China” (PI: Yih-Ing Hser, Ph.D.; NIDA R21 DA025252-01) was a collaboration between the UCLA Integrated Substance Abuse Programs (ISAP), the Shanghai Mental Health Center (Co-PI: Min Zhao, M.D., Ph.D), and the Yunnan Institute for Drug Abuse (Co-PI: Jianhua Li, Ph.D.). Motivational incentives (MI; a form of contingency management) have been well researched and proven efficacious by many studies conducted in Western countries. This study aimed to evaluate the efficacy of using a MI intervention to reduce treatment dropout and opiate use in methadone maintenance treatment (MMT) in China. A two-phased study, the goal of the developmental phase was to adapt study protocols and assessment questionnaires to the local community via input from focus group participants and community advisory board members. The second phase was a pilot-test of the MI intervention in several MMT clinics located in Shanghai and Kunming and involving approximately 320 MMT patients.
“Reducing HIV/AIDS and Drug Abuse: Linking Compulsory Rehabilitation to Methadone Maintenance” (PI: Yih-Ing Hser, Ph.D.; NIDA R21 DA025385-01) was a collaboration between the UCLA Integrated Substance Abuse Programs (ISAP) and the Shanghai Mental Health Center (Co-PI: Min Zhao, M.D., Ph.D) to develop and pilot-test a Recovery Management Intervention (RMI) program for heroin addicts released from compulsory rehabilitation in China. The study explored the effectiveness of the intervention in improving the transition to the community and access to methadone maintenance treatment.
Analysis of study data is underway. Current findings are presented in these articles.
Hser, Y.I., Fu, L., Wu, F., Du, J., & Zhao, M. (2012). Pilot trial of a recovery management intervention for heroin addicts released from compulsory rehabilitation in China. Journal of Substance Abuse Treatment. April 18. [Epub ahead of print] PMID: 22520276.
Hser, Y.I., Li, J., Jiang, H., Zhang, R., Du, J., Zhang, C., Zhang, B., Evans, E., Wu, F., Chang, Y.J., Peng, C., Huang, D., Stitzer, M.L., Roll, J., & Zhao, M. (2011). Effects of a randomized contingency management intervention on opiate abstinence and retention in methadone maintenance treatment in China. Addiction, 106(10): 1801-1809.Hser, Y., Du, J., Li, J., Zhao, M., Chang, Y.J., Peng, C.Y., & Evans, E. (in press). Hepatitis C among methadone maintenance treatment patients in Shanghai and Kunming, China. Journal of Public Health.
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