Linking Heroin Users in China to Drug Treatment and Other Resources in the Community: Effect of a Recovery Management Intervention Model

ABSTRACT OF THE DISSERTATIONLinking Heroin Users in China to Drug Treatment and Other Resources in the Community: Effect of a Recovery Management Intervention ModelbyFei WuDoctor of Philosophy in Social WelfareUniversity of California, Los Angeles, 2012Professor Robert Schilling, Chair Illicit drug use, especially injection heroin use, is a major contributor to the spread of HIV/AIDS and other infectious diseases in China. However, the traditional punitive approach toward drug abuse issues has been ineffective, signified by a high rate of relapse. In response, China has recently adopted a community recovery approach to reduce substance abuse, prevent infectious diseases, and assist drug user's reintegration into the society. This study investigates whether a recovery management intervention (RMI) can better link heroin users to drug treatment and other recovery related services in the community, improve their service utilization, and consequently generate positive recovery outcomes. This study conducted multivariate analysis using data of an intervention trial study entitled "Reducing HIV/AIDS and Drug Abuse among Heroin Addicts Released from Compulsory Rehabilitation in China". A latent variable modeling was utilized to test whether the RMI influences psychosocial factors (self-efficacy, self-esteem, social support, and barrier to treatment entry), predicts service utilization (drug treatment, social security, housing, employment, health etc.), which in turn predicts recovery outcomes (employment, drug use, and criminal activities). Results show that the RMI had no significant effect on drug users' psychosocial factors, and these factors were also not found to influence drug user's service utilization and recovery outcomes. Nevertheless, drug treatment enrollment and other social service utilization increased significantly among the RMI participants. In turn, increased service utilization led to more positive recovery outcomes in this group. The RMI also exerted direct effects on heroin users' community recovery through enhanced treatment and service utilization. Exploring effects of interventions like the RMI can shed light on how to make drug user's transition from the criminal justice system to the community effectively in China and other societies facing the same problem. Findings from this study suggest that better treatment enrollment, service utilization, and recovery outcomes can be potentially achieved with carefully designed case management interventions. More research effort needs to be placed in this field before introducing and implementing case management interventions on a larger scale in China