Background: Methadone maintenance treatment (MMT) is an effective measure to control drug abuse, prevent AIDS, and improve family and social functions among those with heroin addiction. Relevant surveys in recent years show that the number of outpatients receiving MMT has a downward trend.
Aims: To understand variation in maintenance treatment rates and causes of withdrawal for outpatients receiving MMT in Shanghai since initiation of this program.
Method: This study was a retrospective investigation, with data from the AIDS Comprehensive Prevention and Control Data Information Management System of the China AIDS Prevention and Control Center. Descriptive statistics were used to describe demographic data, treatment maintenance rate, and number of new outpatients receiving MMT in Shanghai From May 2005 to June 2016. The causes of withdrawal were summarized and analyzed.
Results: From May 2005 to June 2016, there were a total of 7181 outpatients receiving MMT in Shanghai. These patients were primarily male (male to female ratio around 3:1), young adults (more than 90% of these patients were 25 to 54 years old), with junior high school education level and below (65.4%), single (total of unmarried, divorced and widowed: 63.1%), and unemployed or underemployed (81.5%). The daily dose of methadone in MMT patients showed an upward trend since 2008, and gradually declined after reaching its peak in 2013. The mean (sd) dose of methadone taken in the years studied was 56 (2.75) ml/d. The number of new outpatients increased sharply in 2007 and 2008 (more than 1500), and then decreased year by year. The number of outpatients had increased continuously from 2005 to 2011, with the peak in 2011 (3840 patients), and then decreased gradually. The maintenance rate was stable at over 80% since 2010. The main causes of withdrawal: 1) arrested due to unrelated criminal causes (19.89%), 2) sent to compulsory isolated rehabilitation center due to occasional drug use, and 3) physical reasons (disease/pregnancy/death, 11.80%).
Conclusion: The maintenance rate has been kept at a relatively good level since the initiation of the MMT outpatient clinic service in Shanghai. The number of patients receiving treatment showed an increase-then-decrease trend. The main causes of patients' withdrawal were mainly related to "crime" and "relapse". In order to make MMT outpatient service better, subsequent studies need to carry out related investigations to understand the causes of these changes and patients reasons for withdrawal.
背景: 美沙酮维持治疗（Methadone Maintenance Treatment，MMT）是控制海洛因成瘾者滥用毒品、预防艾滋病，以及改善其家庭和社会功能的有效措施，而近些年相关调查显示，我国美沙酮维持门诊治疗人数呈现下降趋势。.
目的: 了解自开诊以来，上海市美沙酮维持治疗门诊患者治疗维持率的变化趋势及脱失原因。.
方法: 研究为回顾性调查，数据来自中国疾病预防控制中心艾滋病综合防治数据信息管理系统，采用描述性统计方法对2005.5-2016.6 全市接受MMT 患者的人口学资料、治疗维持率和新增人数进行描述，并就脱失原因进行分析。.
结果: 2005.5-2016.6 期间，上海市接受MMT 的患者共计7181 人，患者以男性（男女比例约为3:1）、青壮年（25-54 岁占90% 以上）为主，初中及以下文化水平居多（65.4%）、单身（未婚、离异或丧偶占63.1%）居多，多为无业或待业（81.5%）。MMT 患者日均服用美沙酮的剂量从2008 年起呈上升趋势，于2013 年达到最高峰后逐渐下降，历年平均服用美沙酮的剂量为56(2.75)ml/d。新增治疗人数在2007 和2008年急剧增加（均超过1500 人），继而逐年降低。治疗人数在2005-2011 年间不断增加，于2011 年达到峰值（3840 人）后逐渐下降。治疗维持率自2010 年起稳定在80% 以上。患者退出治疗的主要原因包括：（1）因与毒品无关的刑事案件被逮捕(19.89%)，（2）因偶吸被强制隔离戒毒(16.06%)，（3）身体原因（疾病/怀孕/ 死亡，11.80%)。.
结论: 上海市MMT 门诊开展以来维持率较好，在治患者人数呈现先增长后下降的变化趋势，患者脱失原因主要与“ 犯罪” 和“ 复吸” 有关。后续研究需开展相关调查，从不同层面深入了解造成上述变化和患者脱失的原因，促使MMT 门诊更好开展。.
Keywords: Methadone maintenance treatment; heroin dependence; maintenance rate.