Theme: Epidemiology & Public Health Research Year: 2019
Background: Proper tapering strategies for dosing contribute to reduce heroin relapse
among methadone maintenance treatment (MMT) participants. But there exist diversified
and general tapering strategies in different countries. We aimed to explore a specific
tapering strategy that is associated with lower risks of concurrent heroin use among MMT
Method: We conducted a retrospective study from 2006 to 2017 in nine MMT clinics in
Guangdong, China. Tapering characteristics included taper start week, the duration of taper
phase, the proportion of taper phase over the duration of MMT, the proportion of weeks in
dose decreasing throughout taper phase, dose change ratio. We performed logistic
regression to identify tapering characteristics associated with concurrent heroin use.
Results: This study included 961 participants, with 56.4% reported concurrent heroin use.
Participants who started tapering later after enrollment in MMT (>52 weeks vs. <16 weeks: OR=0.464, 0.227-0.945), had a shorter taper phase (<13 weeks vs. >52 weeks: OR=0.299,
0.123-0.719; 13-25 weeks vs. >52 weeks: OR=0.380, 0.172-0.832), a lower proportion of
taper phase over the duration of MMT treatment (25-49% vs. ≥90%: OR=0.325, 0.123-0.844;
50-74% vs. ≥90%: OR=0.446,0.207-0.949), more proportion of weeks in dose decreasing
throughout taper phase (75-89% vs. <25%: OR=0.266,0.102-0.655; >90% vs. <25%: OR=0.337, 0.120-0.905), less than 5% of dose change ratio per week (<5% vs. 5-10%: OR=0.410, 0.231-0.720), and less than 5 mg/week of dose change (<5 mg/week vs. 5-10 mg/week: OR=0.569,0.368-0.873) were less likely to have concurrent heroin use. Conclusion: Starting tapering late, a shorter taper phase, gradual dose tapering decreased concurrent heroin use. *Corresponding author: Li Ling, [email protected]. Supported by the National Natural Science Foundation of China (NO.81473065).