History of Alcohol and Opioid Use Impacts on the Long-Term Recovery Trajectories of Methamphetamine-Dependent Patients

Abstract

Methamphetamine (MA) has become one of the most widely used illicit substances in China and the rest of the world as well. Relapse, incarceration or death was observed after compulsory rehabilitation. However, the knowledge of recovery patterns among MA-dependent patients, early or late occurrence of these negative consequences, is limited. The aims were to explore the long-term recovery patterns and associated factors among MA-dependent patients in Shanghai, China. MA-dependent patients discharged from Shanghai compulsory rehabilitation facilities in 2009-2012 were recruited in a baseline survey. The baseline data of 232 patients were then linked with their long-term follow-up data from official records. Group-based trajectory modeling was applied to identify distinctive trajectories of the occurrence of negative consequences (incarceration, or readmission to compulsory rehabilitation, or death). Patients with monthly status data were found recovering with three distinctive trajectories: rare, late, and early occurrence groups. Multinomial logistic regression showed that having alcohol use history was associated with an increased likelihood of being in the late occurrence group relative to the rare occurrence group. Having opioid use history was associated with an increased likelihood of being in the early occurrence group relative to the rare occurrence group. In addition, being female was associated with decreased likelihood of being in the late occurrence group relative to the rare occurrence group.

Keywords: long-term follow-up; methamphetamine; negative consequences; recovery pattern; trajectory.

Figure 1

Flowchart of enrollment and follow-up of subjects in the study.

Figure 2

Recovery status of methamphetamine patients after completed the compulsory rehabilitation program in Shanghai, China.The line displayed the incidence rate (per 100 person months) and the area in the figure showed the monthly prevalence of each negative consequence (incarceration, readmission to compulsory treatment and death). There was no death case that happened during this period.

Figure 3

Trajectories as defined by group-based trajectory modeling (GBTM) analysis of recovery status over time.Three-trajectory group-based trajectory modeling was used to fit the recovery data of methamphetamine patients and predict possibility of negative consequences. Negative consequences included incarceration, readmission to compulsory treatment and death.