{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T17:24:13Z","timestamp":1770139453833,"version":"3.49.0"},"reference-count":65,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T00:00:00Z","timestamp":1673913600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Relapse is a great barrier to improving the effectiveness of methadone maintenance treatment (MMT). Participants with different treatment durations could vary in their compliance with MMT, which may lead to different levels of relapse risk. This study aims to identify the risk factors for relapse and assess the relapse risk of MMT participants of different treatment durations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This retrospective study used data collected from seven MMT clinics in Guangdong Province, China, from January 2010 to April 2017. Newly enrolled participants who received 6 (<jats:italic>n<\/jats:italic> = 903) and 12 (<jats:italic>n<\/jats:italic> = 710) months of consecutive treatment with complete data were included. We selected significant risk factors for relapse through the group lasso regression and then incorporated them into Bayesian networks to reveal relationships between factors and predict the relapse risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The results showed that participants who received 6-month treatment had a lower relapse rate (32.0%) than those of 12-month treatment (39.0%, <jats:italic>P<\/jats:italic> &amp;lt; 0.05). Factors including personal living status and daily methadone dose were only influential to those who received the 6-month treatment. However, age, age at the initial drug use, HIV infection status, sexual behaviors, and continuous treatment days were common factors of both durations. The highest relapse risk for those after the 6-month treatment was inferred as 66.7% while that of the 12-month treatment was 83.3%. Farmers and those who have high accessibility to MMT services may require additional attention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>It is necessary to implement targeted interventions and education based on the treatment durations of participants to decrease the relapse rate. Meanwhile, those about HIV\/sexually transmitted infection prevention and anti-narcotics should be held in the whole process.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2022.1032217","type":"journal-article","created":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T04:57:36Z","timestamp":1673931456000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["The risk assessment of relapse among newly enrolled participants in methadone maintenance treatment: A group-LASSO based Bayesian network study"],"prefix":"10.3389","volume":"10","author":[{"given":"Xijia","family":"Tang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chaonan","family":"Fan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chijie","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenjuan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zouxiang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chaofan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Ling","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,1,17]]},"reference":[{"key":"B1","unstructured":"The Global State of Harm Reduction 2020.2020"},{"key":"B2","unstructured":"Methadone Maintenance Treatment Intervention Toolkit2012"},{"key":"B3","volume-title":"Substitution Maintenance Therapy in the Management of Opioid Dependence and HIV\/AIDS Prevention: Position Paper","year":"2004"},{"key":"B4","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1097\/YCO.0000000000000509","article-title":"Meeting the challenges of opioid dependence in China: experience of opioid agonist treatment","volume":"32","author":"Chen","year":"2019","journal-title":"Curr Opin Psychiatry."},{"key":"B5","volume-title":"Development of a Relapse Risk Assessment tool for Methadone Maintenance Treatment Patients (in Chinese)","author":"Liu","year":"2021"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1190","DOI":"10.3109\/10826084.2011.561905","article-title":"Opiate users' perceived barriers against attending methadone maintenance therapy: a qualitative study in China","volume":"46","author":"Lin","year":"2011","journal-title":"Subst Use Misuse."},{"key":"B7","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1017\/S146114570700836X","article-title":"Retention rate and substance use in methadone and buprenorphine maintenance therapy and predictors of outcome: results from a randomized study","volume":"11","author":"Soyka","year":"2008","journal-title":"Int J Neuropsychopharmacol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1016\/j.drugalcdep.2005.05.002","article-title":"Factors associated with methadone maintenance therapy use among a cohort of polysubstance using injection drug users in Vancouver","volume":"80","author":"Kerr","year":"2005","journal-title":"Drug Alcohol Depend."},{"key":"B9","doi-asserted-by":"publisher","first-page":"401","DOI":"10.3389\/fphar.2020.00401","article-title":"The effect of transcranial direct current stimulation on relapse, anxiety, and depression in patients with opioid dependence under methadone maintenance treatment: a pilot study","volume":"11","author":"Sadeghi Bimorgh","year":"2020","journal-title":"Front Pharmacol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"S59","DOI":"10.1002\/lt.21339","article-title":"Treatment of alcohol and other drug dependence","volume":"13","author":"Saitz","year":"2007","journal-title":"Liver Transpl."},{"key":"B11","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.drugalcdep.2018.07.019","article-title":"Methadone maintenance treatment among patients exposed to illicit fentanyl in Rhode Island: safety, dose, retention, and relapse at 6 months","volume":"192","author":"Stone","year":"2018","journal-title":"Drug Alcohol Depend."},{"key":"B12","doi-asserted-by":"publisher","first-page":"57688","DOI":"10.5812\/jjhs.57688","article-title":"Triggers of substance abuse slip and relapse during outpatient treatment in methadone\/buprenorphine maintenance therapy clinics: a predictive model with emphasis on treatment-related factors","volume":"9","author":"Komasi","year":"2017","journal-title":"Jundishapur J Health Sci JJHS."},{"key":"B13","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1017\/S079096670001733X","article-title":"Situational and psycho-social factors associated with relapse following residential detoxification in a population of Irish opioid dependent patients","volume":"29","author":"Ducray","year":"2012","journal-title":"Ir J Psychol Med."},{"key":"B14","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1016\/S0376-8716(02)00023-6","article-title":"Abstinence reinforcement maintenance contingency and one-year follow-up","volume":"67","author":"Preston","year":"2002","journal-title":"Drug Alcohol Depend."},{"key":"B15","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1186\/s13011-017-0115-4","article-title":"Adherence to methadone maintenance treatment and associated factors among patients in Vietnamese mountainside areas","volume":"12","author":"Nguyen","year":"2017","journal-title":"Subst Abuse Treat Prev Policy."},{"key":"B16","doi-asserted-by":"publisher","first-page":"SART.S37030","DOI":"10.4137\/SART.S37030","article-title":"A Prospective study to investigate predictors of relapse among patients with opioid use disorder treated with methadone","volume":"10","author":"Naji","year":"2016","journal-title":"Subst Abuse Res Treat."},{"key":"B17","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1111\/ajad.13031","article-title":"Editorial: challenges to opioid use disorders during COVID-19","volume":"29","author":"Sun","year":"2020","journal-title":"Am J Addict."},{"key":"B18","doi-asserted-by":"publisher","first-page":"e0139942","DOI":"10.1371\/journal.pone.0139942","article-title":"Investigation of repeat client drop-out and re-enrolment cycles in fourteen methadone maintenance treatment clinics in Guangdong, China","volume":"10","author":"Zhang","year":"2015","journal-title":"PLoS ONE."},{"key":"B19","doi-asserted-by":"publisher","first-page":"e0123687","DOI":"10.1371\/journal.pone.0123687","article-title":"Factors associated with methadone treatment duration: a cox regression analysis","volume":"10","author":"Lin","year":"2015","journal-title":"PLoS ONE."},{"key":"B20","unstructured":"ArlottaCJ\n          ForbesSome Opioid Users On Methadone Have High Risk Of Relapse"},{"key":"B21","doi-asserted-by":"publisher","first-page":"946","DOI":"10.1037\/abn0000191","article-title":"Age at first use and later substance use disorder: shared genetic and environmental pathways for nicotine, alcohol, and cannabis","volume":"125","author":"Richmond-Rakerd","year":"2016","journal-title":"J Abnorm Psychol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"CD002208","DOI":"10.1002\/14651858.CD002208","article-title":"Methadone maintenance at different dosages for opioid dependence","volume":"2003","author":"Faggiano","year":"2003","journal-title":"Cochrane Database Syst Rev."},{"key":"B23","doi-asserted-by":"publisher","first-page":"765839","DOI":"10.3389\/fimmu.2022.765839","article-title":"Risk factors and nomogram for predicting relapse risk in pediatric neuromyelitis optica spectrum disorders","volume":"13","author":"Zhang","year":"2022","journal-title":"Front Immunol."},{"key":"B24","first-page":"941","article-title":"Risk-assessment in diffuse large cell lymphoma at first relapse. A study by the Italian Intergroup for Lymphomas","volume":"86","author":"Guglielmi","year":"2001","journal-title":"Haematologica."},{"key":"B25","doi-asserted-by":"publisher","first-page":"397","DOI":"10.3349\/ymj.2018.59.3.397","article-title":"Delta neutrophil index is associated with vasculitis activity and risk of relapse in ANCA-associated vasculitis","volume":"59","author":"Yoo","year":"2018","journal-title":"Yonsei Med J."},{"key":"B26","doi-asserted-by":"publisher","first-page":"e0228152","DOI":"10.1371\/journal.pone.0228152","article-title":"The relationship between psychological health and social support: evidence from physicians in China","volume":"15","author":"Sun","year":"2020","journal-title":"PLoS ONE."},{"key":"B27","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1186\/1479-5876-10-90","article-title":"A retrospective pooled analysis of response patterns and risk factors in recurrent malignant glioma patients receiving a nitrosourea-based chemotherapy","volume":"10","author":"Paccapelo","year":"2012","journal-title":"J Transl Med."},{"key":"B28","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1186\/s12882-020-01786-w","article-title":"Application of group LASSO regression based Bayesian networks in risk factors exploration and disease prediction for acute kidney injury in hospitalized patients with hematologic malignancies","volume":"21","author":"Li","year":"2020","journal-title":"BMC Nephrol."},{"key":"B29","volume-title":"The Application of Bayesian Network Based on Tabu Search Algorithm in Diseases Prediction and Diagnosis (in Chinese).","author":"Zhang","year":"2015"},{"key":"B30","doi-asserted-by":"publisher","first-page":"345","DOI":"10.20452\/pamw.15867","article-title":"Risk assessment of chronic obstructive pulmonary disease using a Bayesian network based on a provincial survey","volume":"131","author":"Shangguan","year":"2021","journal-title":"Pol Arch Intern Med."},{"key":"B31","unstructured":"Supreme People's Procuratorate of P.R.C: All Provinces Have Drug Crimes and Guangdong, Hunan and Sichuan Accounted for 40%.2018"},{"key":"B32","unstructured":"Analysis on the Number of Minors Taking Drugs and Detoxification in Guangdong. Anal Number Minors Tak Drugs Detoxif Guangdong (in Chinese)2019"},{"key":"B33","doi-asserted-by":"publisher","first-page":"e66787","DOI":"10.1371\/journal.pone.0066787","article-title":"HIV and Hepatitis C virus testing delays at methadone clinics in Guangdong Province, China","volume":"8","author":"Xia","year":"2013","journal-title":"PLoS ONE."},{"key":"B34","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1159\/000065140","article-title":"Chinese classification of mental disorders (CCMD-3): towards integration in international classification","volume":"35","author":"Chen","year":"2002","journal-title":"Psychopathology."},{"key":"B35","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.addbeh.2013.09.001","article-title":"Retention in methadone maintenance treatment in mainland China, 2004-2012: a literature review","volume":"39","author":"Zhou","year":"2014","journal-title":"Addict Behav."},{"key":"B36","first-page":"287","article-title":"Rate of adherence to and factors associated with methadone maintenance treatment program (MMTP) compliance among injecting drug use patients in Nepal","volume":"47","author":"Sharma","year":"2016","journal-title":"Southeast Asian J Trop Med Public Health."},{"key":"B37","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1080\/14659891.2019.1659868","article-title":"The effects of anxiety on relapse of patients with opioid use disorders under methadone maintenance treatment: control of the confounding variables","volume":"25","author":"Moradinazar","year":"2020","journal-title":"J Subst Use."},{"key":"B38","unstructured":"Notice of the General Office of the National Health and Family Planning Commission on the Issuance of 3 Documents Including the Basic Requirements for Maintenance Treatment Institutions of Drug Detoxification Drugs (in Chinese).2015"},{"key":"B39","doi-asserted-by":"publisher","first-page":"E2800","DOI":"10.3390\/ijerph16152800","article-title":"Dose tapering strategy for heroin abstinence among methadone maintenance treatment participants: evidence from A retrospective study in Guangdong, China","volume":"16","author":"Lu","year":"2019","journal-title":"Int J Environ Res Public Health."},{"key":"B40","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1214\/009053604000000067","article-title":"Least angle regression","volume":"32","author":"Efron","year":"2004","journal-title":"Ann Stat."},{"key":"B41","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1111\/j.1467-9868.2005.00532.x","article-title":"Model selection and estimation in regression with grouped variables","volume":"68","author":"Yuan","year":"2006","journal-title":"J R Stat Soc Ser B Stat Methodol."},{"key":"B42","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1186\/s12874-017-0442-1","article-title":"When and how should multiple imputation be used for handling missing data in randomised clinical trials \u2013 a practical guide with flowcharts","volume":"17","author":"Jakobsen","year":"2017","journal-title":"BMC Med Res Methodol."},{"key":"B43","unstructured":"Methadone\u2013Medicine Used to Treat Heroin Dependence.2021"},{"key":"B44","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/s13011-021-00347-0","article-title":"Determinants and prevalence of relapse among patients with substance use disorders: case of Icyizere Psychotherapeutic Centre","volume":"16","author":"Kabisa","year":"2021","journal-title":"Subst Abuse Treat Prev Policy."},{"key":"B45","doi-asserted-by":"publisher","first-page":"2724","DOI":"10.5958\/0974-360X.2018.00503.6","article-title":"Associated factors for relapse in opioid addicts undergoing therapy","volume":"11","author":"Hassan","year":"2018","journal-title":"Res J Pharm Technol."},{"key":"B46","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1186\/s12954-019-0304-8","article-title":"Mixed methods to explore factors associated with the decline of patients in the methadone maintenance treatment program in Shanghai, China","volume":"16","author":"Zhang","year":"2019","journal-title":"Harm Reduct J."},{"key":"B47","first-page":"35","article-title":"The relationship of social support and religious orientation with relapse rates in opioid dependent patients under methadone maintenance therapy","volume":"24","author":"Hafez asghar","year":"2015","journal-title":"Adv Nurs Midwifery."},{"key":"B48","doi-asserted-by":"publisher","first-page":"169","DOI":"10.4067\/S0034-98872008000200005","article-title":"Social support as a protective factor of recurrence after drug addiction treatment","volume":"136","author":"Garmendia","year":"2008","journal-title":"Rev Med Chil."},{"key":"B49","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1016\/j.drugalcdep.2014.09.776","article-title":"Retention and its predictors among methadone maintenance treatment clients in China: a six-year cohort study","volume":"145","author":"Cao","year":"2014","journal-title":"Drug Alcohol Depend."},{"key":"B50","doi-asserted-by":"publisher","first-page":"27","DOI":"10.5055\/jom.2007.0036","article-title":"Patterns of illicit drug use and retention in a methadone program: a longitudinal study","volume":"3","author":"Ingrid Davstad","year":"2007","journal-title":"J Opioid Manag."},{"key":"B51","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1007\/s11845-015-1314-5","article-title":"Demographic and clinical factors predicting retention in methadone maintenance: results from an Irish cohort","volume":"185","author":"Darker","year":"2016","journal-title":"Ir J Med Sci."},{"key":"B52","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1186\/s12954-017-0189-3","article-title":"Barriers to retention in methadone maintenance therapy among people who inject drugs in Bangkok, Thailand: a mixed-methods study","volume":"14","author":"Hayashi","year":"2017","journal-title":"Harm Reduct J."},{"key":"B53","unstructured":"MedMark Treat Cent.2019"},{"key":"B54","first-page":"e1229","article-title":"The impact of methadone maintenance treatment on HIV risk behaviors among high-risk injection drug users: a systematic review","volume":"2","author":"Karki","year":"2016","journal-title":"Evid-Based Med Public Health."},{"key":"B55","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1111\/j.1360-0443.2007.01767.x","article-title":"Risk factors for methadone outside treatment programs: implications for HIV treatment among injection drug users","volume":"102","author":"Vlahov","year":"2007","journal-title":"Addiction."},{"key":"B56","doi-asserted-by":"publisher","first-page":"108466","DOI":"10.1016\/j.drugalcdep.2020.108466","article-title":"Factors associated with early and later dropout from methadone maintenance treatment in specialist addiction clinics: a six-year cohort study using proportional hazards frailty models for recurrent treatment episodes","volume":"219","author":"Durand","year":"2021","journal-title":"Drug Alcohol Depend."},{"key":"B57","doi-asserted-by":"publisher","first-page":"971825","DOI":"10.3389\/fpsyt.2022.971825","article-title":"Associations of executive function and age of first use of methamphetamine with methamphetamine relapse","volume":"13","author":"Mu","year":"2022","journal-title":"Front Psychiatry."},{"key":"B58","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1097\/ADM.0000000000000156","article-title":"Evaluating the effectiveness of first-time methadone maintenance therapy across northern, rural, and urban regions of Ontario, Canada","volume":"9","author":"Eibl","year":"2015","journal-title":"J Addict Med."},{"key":"B59","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1186\/s13011-019-0223-4","article-title":"Multi-level predictors of psychological problems among methadone maintenance treatment patients in difference types of settings in Vietnam","volume":"14","author":"Le","year":"2019","journal-title":"Subst Abuse Treat Prev Policy."},{"key":"B60","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1111\/dar.12268","article-title":"Perceived barriers to utilise methadone maintenance therapy among male injection drug users in rural areas of southern Thailand","volume":"34","author":"Khampang","year":"2015","journal-title":"Drug Alcohol Rev."},{"key":"B61","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s10654-021-00839-0","article-title":"Protecting against researcher bias in secondary data analysis: challenges and potential solutions","volume":"37","author":"Baldwin","year":"2022","journal-title":"Eur J Epidemiol."},{"key":"B62","unstructured":"SilviaV\n          Secondary Data: Advantages, Disadvantages, Sources, Types.2020"},{"key":"B63","doi-asserted-by":"publisher","first-page":"g1072","DOI":"10.1136\/bmj.g1072","article-title":"Retrospective cohort studies: advantages and disadvantages","volume":"348","author":"Sedgwick","year":"2014","journal-title":"BMJ."},{"key":"B64","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.jsat.2015.05.001","article-title":"Risk factors for relapse and higher costs among Medicaid members with opioid dependence or abuse: opioid agonists, comorbidities, and treatment history","volume":"57","author":"Clark","year":"2015","journal-title":"J Subst Abuse Treat."},{"key":"B65","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1186\/s12883-016-0659-3","article-title":"Regional homogeneity changes between heroin relapse and non-relapse patients under methadone maintenance treatment: a resting-state fMRI study","volume":"16","author":"Chang","year":"2016","journal-title":"BMC Neurol."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.1032217\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T04:57:57Z","timestamp":1673931477000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.1032217\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,17]]},"references-count":65,"alternative-id":["10.3389\/fpubh.2022.1032217"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2022.1032217","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,17]]},"article-number":"1032217"}}