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Methadone maintenance treatment programme reduces criminal activity and improves social well-being of drug users in China: a systematic review and meta-analysis
Open accessAbstract
Objective: Methadone maintenance treatment (MMT) has been implemented in China since 2004 and has expanded into a nationwide programme. This study aims to evaluate changes in social functioning, family relations and drug-related criminal behaviour among MMT clients in China. Design: Systematic review and meta-analysis. Methods: Both English and Chinese literature databases, including PubMed, Chongqing VIP Chinese Science and Technology Journals Database (CQVIP), China National Knowledge Infrastructure (CNKI) and Wanfang Data, were comprehensively searched over the period 2004–2014 for studied indicators. Study selection, quality assessment and data extraction were conducted according to the PRISMA (preferred reporting items for systematic reviews and meta-analyses) Statement. Meta-analyses were conducted using Comprehensive Meta-Analysis Biostat software. Results: Thirty-eight articles were included in this review (1 in English and 37 in Chinese). The self-reported arrest rate decreased from 13.1% (95% CI 9.1% to 18.5%) at baseline to 3.4% (95% CI 1.5% to 7.7%) and 4.3% (95% CI 1.6% to 11.4%) after 6 and 12 months of MMT intervention, respectively. The rate of drug selling decreased from 7.6% (95% CI 3.8% to 14.8%) at baseline to 1.9% (95% CI 0.6% to 6.2%) and 3.0% (95% CI 1.0% to 8.9%) after 6 and 12 months of intervention, respectively. Similarly, the rates of selling sex for drugs and drug-related crime decreased from 5.3% (95% CI 2.4% to 11.1%) and 9.9% (95% CI 6.8% to 14.2%) at baseline to 1.1% (95% CI 0.5% to 2.3%) and 3.4% (95% CI 2.5% to 4.5%) at 6 months, then to 0.8% (95% CI 0.3% to 1.9%) and 3.4% (95% CI 0.8% to 13.1%) at 12 months after treatment initiation, respectively. In contrast, the rate of employment of clients and the proportion of clients having a good relationship with their family increased substantially from 26.4% (95% CI 22.9% to 30.1%) and 37.9% (95% CI 32.0% to 44.2%) to 41.6% (95% CI 36.6% to 48.0%) and 59.6% (95% CI 48.1% to 70.2%) at 6 months, then to 59.8% (95% CI 52.4% to 66.8%) and 75.0% (95% CI 69.0% to 80.2%) at 12 months after treatment initiation, respectively. Conclusions: MMT has significantly reduced criminal activity, and improved employment rate and social well-being, of clients of the MMT programme. MMT is an effective measure to help drug users to resume societal and familial functions in China.
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In justice-involved populations, evidence-based SUD treatment is effective in reducing substance use, re-offending, and re-incarceration, and in facilitating recovery.
“In justice- involved populations, evidence- based SUD treat ment is effective in reducing substance use as well as re- offending and re- incarceration, and in facilitating recovery 343- 346 .”
From Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention (2023) · cites this paper as [345]
The Results (Criminal activities; page unavailable) report lower arrest and drug-related crime rates among methadone maintenance clients in China, and the Conclusions describe improved social well-being and a return to society. The review concerns drug users receiving methadone maintenance, not specifically justice-involved populations or evidence-based SUD treatment generally. It does not establish reductions in re-incarceration, and its crime measures do not specifically establish re-offending. (LLM, conf=0.88)
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Metadata
- Authors
- Sun, H.-M., Li, X.-Y., Chow, E. P. F., Li, T., Xian, Y., Lu, Y.-H., Tian, T., Zhuang, X., & Zhang, L.
- Affiliations
- Nantong University (CN)
- Department of Epidemiology and Biostatistics, School of Public Health, Nantong University, Jiangsu, China
- The Alfred Hospital (AU)
- Corresponding author
- Zhang, Lei
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2015-01
- Volume
- 5
- Issue
- 1
- Pages
- e005997
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC4289728
- OpenAlex
- W2010754558
- Cited by
- 114
- References
- 58
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 11 · 2023: 7 · 2022: 10 · 2021: 10 · 2020: 8 · 2019: 15 · 2018: 8 · 2017: 19 · 2016: 15 · 2015: 3
- FWCI
- 2.16
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by-nc)
- Funders
- National Natural Science Foundation of China (81373060)
- Nantong University
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Keywords
- methadone maintenance treatment, opioid use disorder, drug offenses, arrest rates, drug selling, social functioning, family relationships, social well-being, China, harm reduction, drug users
- MeSH terms
- Adolescent, Adult, China, Crime, Employment, Female, Humans, Interpersonal Relations, Male, Methadone, Middle Aged, Opioid-Related Disorders, Narcotics, Drug Users, Young Adult, Opiate Substitution Treatment, Maintenance Chemotherapy, Social Skills
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